African Civil Society position paper on HIV and AIDS in Africa:
Moving to Action
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Dear all:
Between 10 and 12 April 2006, over 80 representatives of civil
society organisations in Africa, including women' groups, youth
networks, associations of people living with HIV, the media, na-
tional NGO networks, trade unions, faith-based organisations
etc, met in Abuja, Nigeria to deliberate on key HIV and AIDS ad-
vocacy challenges confronting the continent. Specifically, par-
ticipants met to discuss and review strategies for achieving
scaled-up implementation of the Abuja Declaration and Framework
Plan of Action, the UNGASS Declaration of Commitment, and the
Universal Access initiative on prevention, treatment, care and
support in Africa.
It was a momentous occasion for civil society organisations on
HIV and AIDS in Africa, with participants from 17 countries com-
ing together to form the African Civil Society Coalition on HIV
and AIDS, to provide an advocacy and communications platform for
energising HIV and AIDS campaigns by African civil society
groups.
The statement below issued at the end of the consultation, ti-
tled "African Civil Society Position Paper on HIV and AIDS in
Africa: Moving to Action", outlines a clear call by the groups
to African leaders and governments on urgent steps that need to
be taken to accelerate action to reverse the HIV and AIDS epi-
demic on the continent, especially as the leaders prepare to
gether in Abuja, Nigeria in May 2-4 for the African Union Summit
on AIDS, Tuberculoiss and Malaria, and in New York, USA on May
31-June 1, for the United Nations Special Review Session on
HIV/AIDS.
Omololu Falobi
Journalists Against AIDS (JAAIDS) Nigeria
mailto:omololu@nigeria-aids.org
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African Civil Society position paper on HIV and AIDS in Africa:
Moving to Action
We, African civil society organizations comprising organizations
and networks of people living with HIV, young people, women, re-
ligious leaders and community workers at the frontline of the
fight against AIDS, met in Abuja, Nigeria on April 10 to 12 2006
to develop a consolidated position for use during the review
processes of the Abuja Declaration and Framework Plan for ac-
tion, and the United Nations General Assembly Special Session on
AIDS (UNGASS) Declaration of Commitment (DoC), and to chart a
way forward regarding access for all people requiring informa-
tion and services related to HIV prevention, care, support and
treatment. This statement reflects the outcomes of these delib-
erations, as well as the sentiments of the undersigned African
Civil Society Organisations.
African Civil Society Organisations are:
Unified in our commitment to working in partnership with all
stakeholders who recognise the role of Civil Society as a force
for change, and as a critical ally of communities affected by
poverty, inequality and disease;
Concerned that although there are now more resources available
to fight AIDS in Africa than there were five years ago, urgent
action is needed to reach the millions of African people who are
still excluded from access to life-saving prevention, care and
support and treatment services;
Horrified by the fact that in some instances, corruption and
mismanagement of funds have jeopardised the rights of people
living with HIV and affected by HIV and AIDS to access preven-
tion, care and support and treatment, and that in the absence of
structures and systems to monitor the use of funds in a trans-
parent manner, the continent will be unable to sustainably re-
spond to the challenges of scaling up towards Universal Access;
Outraged that two decades into the AIDS epidemic, Africans are
faced with the reality that many of our health systems are buck-
ling under the pressure of new AIDS treatment programmes; large
portions of our budgets are externally-funded and subject to un-
acceptable conditionalities; many of our best, brightest and
most educated are systematically poached by institutions based
in the Global North; the rights of women and girls continue to
be violated with impunity, further deepening their vulnerability
to infection and stigma; young people remain on the margins of
policy and programme design even as their vulnerability to in-
fection has not yet been addressed; and people living with HIV
in many communities remain unable to access basic services due
to the stigma and discrimination that they face on a daily ba-
sis;
Alarmed that onerous debt repayment obligations and condition-
alities by international finance institutions (IFIs) continue to
undermine the capacity of most African governments to devote
sufficient resources for HIV and AIDS including meeting the 15%
Abuja commitment, we note that only two African countries
reached the target of 15% of health spending within their na-
tional budgets and if debt repayments are factored in, not a
single African country would have reached the target set in
2001;
Deeply disturbed by the fact that without a massive and sus-
tained effort to meaningfully involve civil society organiza-
tions, the global difficulties that impeded the attainment of
the 3 by 5 campaign will also be encountered in the push to-
wards Universal Access in the next four years;
Dismayed that that despite the pledges made by states in the UN-
GASS DoC, not one single African country has met the target of
reducing HIV infection amongst young people by 25% by 2005 nor
have any African countries managed to ensure 90% access to in-
formation, education, services and life-skills, or reduce by
20% the number of babies infected by HIV;
Strongly convinced that Universal Access to prevention, treat-
ment, care and support can only be achieved where goals and tar-
gets are set: without goals there can be no progress towards ac-
cess;
Unshakeable in our belief that comprehensive prevention, care
and support and treatment are indivisible: action in one area
without equivalent actions in the other areas is unacceptable;
Recommitted to moving beyond words to address the poverty, ineq-
uity and violence that drive and exacerbate the impact of HIV
and AIDS on the communities that we represent and work with;
Within the Abuja Declaration and Framework Plan for Action, we
therefore call for:
1. Leadership, Partnership and Accountability
a.. Enact domestic legislation to ensure that the Abuja Declara-
tion is given effect in a manner that is commensurate with the
State of Emergency declared by many countries;
b.. Establish as a matter of urgent priority an inclusive and
participatory process for the development of national targets
and indicators which includes clear timeframes that will be re-
viewed on an annual basis;
c.. Include within the 15% health spending target, a specific
set of separate targets for each of the three diseases: AIDS,
Tuberculosis and Malaria;
d.. Establish independent national oversight committees with ac-
tive participation of civil society, to monitor the Abuja Decla-
ration;
e.. Ensure that there is adequate resourcing and planning to en-
able civil society participation in the processes outlined
above;
f.. Put in place explicit accountability mechanisms that address
the allocation of responsibilities, timeframes, funding and ac-
cess to information by civil society organizations involved in
monitoring and reviewing progress;
g.. Recognise the importance of building and maintaining part-
nerships with all stakeholders within civil society including
people living with HIV, young people, the media, parliamentari-
ans, the private sector, faith-based organizations, trade unions
and community-based groups.
2. Sustainable Financing and Health Systems Strengthening
a.. Work in partnership with civil society organizations to ac-
celerate action on the removal of unfavourable conditionalities
for accessing resources, particularly the removal of budgetary
ceilings imposed by IFIs on social sector spending and the re-
moval of odious debt repayments which are demanded at the ex-
pense of the health and human rights of African people;
b.. Explore and support innovative means of mobilising addi-
tional domestic resources to secure sustainable and predictable
financing for HIV and AIDS (such as the International Finance
Facility and the Airline Solidarity Contribution), including re-
ducing military spending in order to increase social spending,
and ensuring that National Economic Planning Processes reflect
the commitments made in the Declaration;
3. Human Resources
a.. Ensure that health systems and infrastructure strengthening
is supported by a commensurate investment into the human re-
sources of Africa by putting in place long-term, comprehensive
and fully costed Human Resource Plans at national and regional
levels to address Africas primary challenge.
b.. Specifically that all WHO guidelines for effective delivery
of health care should be met by 2010, in particular the ratios
recommended regarding the number of doctors and nurses per pa-
tient, the number of hospitals and clinics per population.
4. Comprehensive Prevention, Care, Treatment and Support
a.. Urgently scale up prevention efforts in order to meet the
DoC targets agreed upon in 2001, with particular emphasis on
sexuality education and life-skills and specific efforts aimed
at decreasing the vulnerability of women and youth, and promot-
ing their ability to fully enjoy their sexual and reproductive
health and rights;
b.. Accelerate action on lifting tariffs on cost and price of
medicines and trade rules and mechanisms that impede access to
affordable medicines; creating an enabling environment for local
production of medicines;
5. Research and Development
a.. African states must urgently commit build and strengthen na-
tional and regional research capacity and infrastructure so as
to lead HIV research efforts that Africans will directly benefit
from including treatment, prevention, indigenous African tra-
ditional medicines, and behavioural and social science;
b.. African states must urgently commit to financial and human
resources for the research, development and planning for future
access of vaccines, microbicides and other female-controlled
methods of preventing new HIV infections nationally and re-
gionally;
6. Womens Rights and Gender Equality
a.. Through policy, institutional and legal frameworks, develop
a policy, legislative and administrative environment in which
the rights of African women and girls, especially those living
with HIV are actively promoted, fully enjoyed and protected
within and through the ratification and domestication of inter-
national instruments such as CEDAW, the Protocol to the African
Charter on Human and Peoples Rights on the rights of Women in
Africa; Solemn Declaration on Gender Equality in Africa (2004);
7. Human Rights
a.. Create enabling environments through policy, institutional
and legal frameworks at national level that promote and protect
the human rights of those living with and affected by HIV and
AIDS, and that further reduces their vulnerability to stigma and
discrimination through the enactment of Human Rights legisla-
tion;
b.. Ensure that the rights of orphans and vulnerable children
are promoted and protected through the massive scaling up of ef-
forts aimed at providing children with the protections outlined
in the Convention on the Rights of the Child, to which all Afri-
can states are signatories;
Within the UNGASS DoC and the Declaration Statement on Universal
Access, we further call for Heads of States and government to
adopt the following:
1. Explicit Targets
At the Abuja Summit, and again at the UNGASS Review, ensure that
the following targets are inserted into any document that is
adopted in regards to Universal Access:
By 2010, ensure that at least 10 million people have access to
HIV treatment including 7 million Africans - through an accel-
eration of HIV treatment scale-up efforts by all stakeholders,
including civil society, people living with HIV, member-states,
donor countries and multilateral institutions. In order to en-
sure that this target is reached equitably, Member States should
develop, in an inclusive manner, specific targets for the inclu-
sion of vulnerable populations in national treatment plans, in-
cluding, for example, active injecting drug users, children, men
who have sex with men, women, and migrant populations.
By 2010, ensure that all pregnant women living with HIV have
access to information and ARV therapy to prevent mother to child
transmission.
By 2010, ensure that the information and means to avoid HIV in-
fection is available to all citizens through an accelerated ef-
fort by civil society, people living with HIV/AIDS, member
states, donor countries and multilateral institutions.
2. Commitment to Tracking Progress on Universal Access
At the Abuja Summit and again at the UNGASS Review, ensure that
African states commit to the review of progress towards the pre-
vention, care and support and treatment targets contained in the
DoC and outlined above. This should be done in a High-level
Joint Publication developed by key stakeholders within civil so-
ciety in partnership with the African Union. The Summit is re-
quested to adopt the following recommendation:
By June 2008, ensure that the African Union Commission, in
close collaboration with civil society organisations and other
key stakeholders, produces a High-level Review of Progress to-
wards the goals of ensuring that a minimum of 7 million Africans
have access to treatment services related to HIV and AIDS; en-
suring that all pregnant women living with HIV have access to
information and ARV therapy; and ensuring that all Africans have
access to the information and means to avoid HIV infection.
ENDS
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For steering committee of the African Civil Society Coalition on
HIV and AIDS:
ActionAid International - Africa
African Council of AIDS Service Organisations (AfriCASO)
African Microbicides Advocacy Group (AMAG)
Central African Network of AIDS Service Organisations (CANASO)
Eastern African Network of AIDS Service Organisations (EANASO)
Global Youth Coalition on AIDS (GYCA)
Journalists Against AIDS (JAAIDS) Nigeria
Network of African People Living with HIV/AIDS (NAP+)
Treatment Action Campaign (TAC)
Open Society Institute for Southern Africa (OSISA)
Oxfam International
Panos Institute GAP
Southern Africa AIDS Information Dissemination Service (SAfAIDS)
Society for Women and AIDS in Africa (SWAA)
World AIDS Campaign
Abuja, Nigeria, 12 April 2006