Humanitarian and grassroots organizations say 30 years into the AIDS epidemic, testing, treatment and care are falling far short of what's needed. The groups are meeting in Nairobi this week to discuss new approaches to deal with the epidemic.
OXFAM AIDS expert Wasai Jacob Nanjakululu, who's attending the conference, says, "The purpose of holding this meeting is to reflect on why 30 years down the line…we have made some progress, but not significant enough."
Many ignorant of HIV status
"Almost 80 to 90 percent of people living with HIV and AIDS do not yet know they live with HIV. It's…sad, especially since in countries like in east and southern Africa combined carry over 50 percent of the burden of HIV/AIDS globally," he says.
He says that estimate is based on studies by the World Health Organization (WHO) and UNAIDS. Another says about 70 percent of those who need treatment are not receiving it.
"We are wondering whether in fact if we've been doing the right thing as NGOs. We need to be more critical whether we've been part of the problem or part of the solution," he says.
Better plan needed
"From this citizen summit, come up with a radical action plan that would enable us to achieve universal access, prevention, treatment, care and support services," he says.
One "radical" approach recommended by WHO is called "provider initiated testing and counseling." The proposed policy calls for offering HIV testing to anyone who goes to a public health clinic for any reason.
"So that we can begin to know people's HIV status early enough and therefore give them a better chance to manage it better," he says.
Early treatment, fewer infections
Another WHO proposal calls for an annual HIV test during generalized epidemics. Those found positive would be placed on anti-retroviral (ARV) treatment immediately, rather than waiting for the immune system to fail.
"We would use treatment to actually cut down on new infection….because it has been found that people are mostly infectious when they are in the early stages of infection with HIV," he says.
Nanjakululu says OXFAM is among the organizations that have the capacity to mobilize communities, something he calls the "missing link" in AIDS policies.
"Communities must be involved in deciding how to deal with HIV and AIDS," he says.
Promises not kept
He says, "Although sub-Saharan Africa is heavily affected by HIV and AIDS, our governments do not seem to live up to their commitments."
In 2001, at the Abuja summit, African governments pledged that 15 percent of their national budgets would be devoted to health to fight HIV/AIDS, TB and malaria.
"Now, eight years down the line, it's only Botswana and The Gambia who have lived up to that commitment. Over 80 to 90 percent of resources going into the HIV/AIDS war chest is external from donors," he says.
Nanjakululu says it means African governments have "embarrassed" themselves "by ceding the agenda to drive AIDS activities to external actors."
The Nairobi AIDS meeting continues through Friday.