Nelson Mandela Foundation

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March 25, 2009 – Adopting a forward-looking approach to HIV/AIDS in Southern Africa is key to curtailing the spread of the disease in the region.

This was the message when a small reading group of the hyper-endemic pillar of aids2031 gathered at the Nelson Mandela Foundation on March 16 to discuss the paper, Turning off the Tap – Looking Forward to 2031.

The aim of the meeting was to review and critique the synthesis paper and identify additional references. The purpose was also to provide peer review of the paper and to monitor the development of the synthesis paper providing regular critique and feedback as the paper develops.

Hein Marais, a consultant, was commissioned to put together a paper by the hyper-endemic pillar’s working group to spell out why Southern Africa is so hyper-endemic, what has been done to address the epidemic, and what options for policy and action are available for curbing this epidemic.

“The genesis of aids2031 was in 2006 after the meeting at the UN in June,” said the Foundation’s CEO Achmat Dangor. “It became apparent to everyone at that meeting that one of the biggest challenges was the backwards-looking and short-term planning approach most people adopt including government.

“Not a single government had a long-term, forward-looking plan. Aids2031 is a coalition of individuals and organisations who were eager to develop some strategic thinking for the next 25 years.

“The Foundation was asked to convene the hyper-endemic pillar and along with the Joachim Chissano Foundation, and the University of KwaZulu-Natal, asked to co-chair the Pillar Working Group and to find solutions to AIDS-related problems facing the region.

“The purpose of this meeting is to develop a paper which will establish the scientific and strategic requirements necessary to find solutions,” Dangor added.

“We hope a number of strategic documents will come out of this umbrella paper.”

The key points around the synthesis paper:

  • Overall the document received positive reviews, especially the strong, well-referenced analysis and synthesis, the logical flow of arguments, the document’s non academic but action-orientation nature and the extensive use of wide-based references;
  • Specific areas that needed fleshing out were identified and discussed. Some of these included:
    • Emerging interventions;
    • Social spending issues;
    • Leadership issues and the manner in which governance occurs;
    • Role of social and cultural norms and practices in understanding the epidemic;
    • A critique of the options/interventions that have not really worked.
  • Additional references for supporting or challenging some of the conclusions were cited and discussed. The readers and secretariat committed to transmitting these references to Marais by March 18.

Present at the meeting were: Professor Likeness Simbayi, acting executive director of the Human Sciences Research Council; Dr Itumeleng Kimane from the National University of Lesotho; Mbulawa Mugabe, senior regional policy advisor for UNAIDS, who chaired the session; and Makhamokha Mohale, co-ordinator of the aids2031 hyper-endemic pillar and Mandisa Mbali, a research co-ordinator for the hyper-endemic pillar.

The need for the paper to spell out how Southern Africa differs from other regions, particularly with regards to those drivers which exist in other regions where HIV/AIDS is not as prevalent, was highlighted during the session.

In terms of solutions, discussion focused around developing methods of ensuring correct condom usage, trying to find ways of ensuring a decrease in mother-to-child transmission, and anti-retroviral provision among others.

The need for local government and other campaigns to be accountable for the funds they have received for various HIV initiatives was also highlighted, while the necessity of tailoring solutions to different countries’ needs was also pointed out.

“The paper is not aimed to be academia for academics,” said Dangor. “Instead, we need to provide a document that is accessible to the layperson.”

Two other papers, one around the finances and resources for HIV in the future, and another paper on the role of leadership with regards to the HIV epidemic in sub-Saharan Africa, will be developed as part of the hyper-endemic pillar’s strategic response and will be guided by Marais’ paper.

The deadline for final comments from those at the meeting and other role players on the first draft of the paper was Wednesday, March 18, with the next draft expected by the end of this week.