The long-awaited rollout of antiretroviral (ARV) drugs through public health systems is at last becoming a reality in a growing number of African countries. But the initial excitement greeting the announcement of each new AIDS treatment programme is often tempered by a closer examination of the figures, and the realisation that only a fraction of those in need will initially be able to access therapy.
Equity in Health
Treatment activists from 21 African countries have formed a movement to promote quality care and support for all Africans living with HIV/AIDS. At a meeting in Cape Town, South Africa recently over 70 activists gathered to inaugurate the Pan-African HIV/AIDS Treatment Access Movement (PHATAM). The organisation was founded by two of the world's leading activists, Zackie Achmat of the Treatment Action Campaign (TAC), South Africa and Milly Katana of the Health Rights Action Group in Uganda. PHATAM is dedicated to mobilising African communities, political leaders and all sectors of society to ensure that access to antiretroviral treatment is a fundamental part of comprehensive care for all peopie with HIV/AIDS.
The U.S. government has cut off funds to an AIDS programme for refugees in Africa - six weeks after President George Bush toured the continent promising to fight AIDS and launching a US$15 billion initiative. The U.S. objects to one of the aid agencies involved, Marie Stopes International, which runs family planning programmes in China. Organisations that work on reproductive health and AIDS argue that the decision betrays the Bush administration's wider hostility to abortion. Its commitment to a rightwing Christian agenda has led to its promotion of abstinence rather than condoms as a strategy against HIV/AIDS.
Africa's twin epidemics of HIV/AIDS and famine must be fought together because they are intertwined, Alex de Waal, director of Justice Africa and an adviser to the U.N. Economic Commission for Africa, writes in a New York Times op-ed. HIV/AIDS is crippling African nations' ability to resist famine because the disease is killing young people who make up the majority of farmers and other laborers, de Waal says. Meanwhile, famine and malnutrition destroy health, making people more susceptible to disease, more likely to quickly progress from HIV to AIDS and less likely to respond well to existing treatments, de Waal states, adding that the epidemics have disrupted social structures and made it more difficult for affected populations to recover.
African civil society groups packed their bags to return home distressed that commitments made at the recent UN General Assembly Special Session on HIV- AIDS would amount to mere rhetoric.
In the lead up to the African Union Summit, held from 19 to 27 July 2010 in Uganda, Save the Children has joined a broad coalition of civil society groups from across Africa and around the world to call on African leaders to deliver four key commitments that will save the lives of mothers and children. Civil society recommend that leaders at the Summit should commit to putting a plan in place. Every African country must develop and implement an accelerated national plan for reducing maternal, newborn and child deaths. Stakeholders should make sure that the resources are available. Every African country should meet and exceed its 2001 promise in Abuja, Nigeria to spend at least 15% of the national budget on health care. Additionally, a meaningful portion of this budget must specifically dedicated to maternal, newborn, and child health. Thirdly, health worker shortages should be addressed. Countries must recruit, train and retain more doctors, nurses, and midwives to help reduce the overall gap of 800,000 health workers in Africa by 2015. Fourthly, the coverage gap between rich and poor must be addressed. Countries must ensure health care, including emergency obstetric care, is accessible for the poorest people and is free at the point of use for pregnant women and children under five.
The Common Market for Eastern and Southern Africa, Africa's major free trade bloc, plans to lobby the United States and pharmaceutical companies for the right to produce generic antiretroviral drugs, according to the group's secretary general, Reuters reports. COMESA Secretary-General Erastus Mwencha said that patent disputes in the World Trade Organisation are "robbing the region of a key weapon against AIDS," according to Reuters.
A quarter of all clinical trials are now done in the developing world, but often the research lacks a rigorous ethical framework. Western researchers or funders tend to shoulder the blame for trials that the international scientific community deems unethical, says Gilbert Dechambenoit in this editorial in the African Journal of Neurological Sciences. But, he argues, African scientists should bear just as much responsibility for unethical scientific practices.
In 2010, the UN’s Population Division predicted that the African continent, the population of which is now 1·2 billion, will have 3·5 billion people by the year 2100. By 2015, the projection for the year 2100 had risen to 4·4 billion. In many ways this is good news for Africa—the population increase reflects impressive progress in reducing mortality, especially child mortality, and improving life expectancy. But the response to the news in developed countries has been of concern, often turning into panic. John Bongaarts, vice president of the Population Council, warned that “Most of these people are going to end up in slums. That’s not good news.” Mertule Mariam said: “Alarmingly, population growth in Africa is not slowing as quickly as demographers had expected...the number of Africans seeking a better life in Europe and other richer places is likely to increase several times over”. These reactions have revived discussions in developed countries on what should be done to alleviate the apparent crisis. Policy prescriptions in developed countries focus on family planning services and education of girls. The author argues that these recommendations might be sensible, but if Africans do not take the lead in framing the population discourse, their motivations and needs could be overlooked. New policies must consider African development. An African-led response to population change might begin with efforts to establish the size of the population Africa wants, in the context of broader developmental ambitions. Rather than being dictated by fears in developed countries of mass emigration, conflict, and environmental destruction, such a strategy would be based on the needs of African people. As well as national objectives, a continent-wide perspective on population goals led by the African Union, might be useful. Just as many of the drivers of population change are pan-national (eg, armed conflict, environmental damage, or economic pressures), so are some of its results. In consultation with their people, African Governments will no doubt propose further population policies that are closely tailored to the needs of their societies. What is important, the author poses, is that these objectives and policies are established by Africans.
African leaders met in Abuja, Nigeria, in May to discuss the battle against HIV/AIDS, tuberculosis and malaria, the continent’s top three killers, at a summit organised by the African Union (AU). The pan-African body’s gathering would be attended by attended by senior government figures from at least 18 African countries including SA. Health ministers from 24 countries and finance ministers from about 10 countries had confirmed their attendance; the central theme being universal access to care for HIV/AIDS, tuberculosis and malaria across Africa by 2010.