The time to act on HIV/AIDS is now

Lesotho Times - - Leader - Matthew t Har­ring­ton

SLOWLY, but surely, the ab­nor­mal­ity of Le­sotho’s political im­passe is drag­ging into an­other year. And much like last year, when we were promised by political lead­ers that the 28 Fe­bru­ary 2015 elec­tions would be the panacea to this na­tion’s political woes, we are be­ing promised that the rec­om­men­da­tions by the SADC Com­mis­sion of In­quiry will fi­nally bring peace.

As re­ported else­where in this edi­tion, All Ba­sotho Con­ven­tion (ABC) leader and for­mer premier, Thomas Tha­bane, as­sured op­po­si­tion sup­port­ers that the rec­om­men­da­tions of the Jus­tice Mpa­phi Phumaphi-led com­mis­sion would be im­ple­mented “to the let­ter”.

Dr Tha­bane said the Phumaphi re­port would “lib­er­ate” Le­sotho and its out­comes re­sult in sta­bil­ity in the King­dom. While it’s one thing to play to the gallery of sup­port­ers, it is quite an­other to raise false hope es­pe­cially con­sid­er­ing the im­prob­a­bil­ity of such an out­come. Govern­ment is al­ready dig­ging in and cast­ing as­per­sions on the ve­rac­ity of the re­port as ev­i­denced by the court chal­lenge launched last month by Lt-col Tefo Hashatsi. The Spe­cial Forces com­man­der is push­ing for the com­mis­sion’s find­ings to be de­clared il­le­gal be­fore they are even tabled. Even if Lt-col Hashatsi’s court chal­lenge is dis­missed, it il­lus­trates the an­tag­o­nis­tic pos­ture to­wards the in­quiry and its out­comes by the pow­ers that be.

Added to that, a num­ber of se­nior govern­ment of­fi­cials have stren­u­ously em­pha­sized that the com­mis­sion’s rec­om­men­da­tions, how­ever damn­ing, would not be pros­e­cutable. All this points to the re­al­ity that im­ple­ment­ing the find­ings will be much eas­ier said than done. It is, thus, naïve for op­po­si­tion political lead­ers to pin their hopes solely on the SADC Com­mis­sion of In­quiry. Over the years, SADC has earned for it­self the ig­no­ble ti­tle of a “pa­per tiger” be­cause its role in spear­head­ing political change and cul­ti­vat­ing demo­cratic prac­tises in trou­bled mem­ber states is still evolv­ing.

Al­though the bloc has suc­ceeded in main­tain­ing sta­bil­ity in such coun­tries as Mada­gas­car and Zim­babwe, it has been ac­cused of ig­nor­ing the real causes of con­flict and be­ing un­able to hold cer­tain lead­ers to ac­count for their un­demo­cratic ac­tions. The atroc­i­ties com­mit­ted by Zim­bab­wean Pres­i­dent Robert Mu­gabe’s hench­man fol­low­ing his de­feat in the first round of the 2008 pres­i­den­tial elec­tions of­fers am­ple ev­i­dence of SADC lead­ers un­will­ing­ness to bring one of their own to ac­count with the ex­cep­tion of Botswana Pres­i­dent Ian Khama who spoke out against the orgy of vi­o­lence.

Hun­dreds of op­po­si­tion sup­port­ers were killed in a cam­paign of vi­o­lence which also en­tailed tor­ture, beat­ings, false ar­rests and ar­son at­tacks. How­ever, Mr Mu­gabe was re­warded by SADC with the premier­ship of a coali­tion govern­ment that also in­cluded the win­ner of the pres­i­den­tial elec­tion’s first round, Mor­gan Ts­van­gi­rai. Us­ing the state ap­pa­ra­tus, such as the army and po­lice, which were still at his dis­posal, Mr Mu­gabe man­aged to claw back power by hook or by crook to the detri­ment of the will of the peo­ple.

As the Mada­gas­car case also shows, SADC usu­ally suc­ceeds in lit­tle more than pa­per­ing over the cracks with­out ad­dress­ing the root causes of the political stand­off. The so­lu­tion in Mada­gas­car only came about through in­ter­nal di­a­logue bro­kered by SADC af­ter the politi­cians fi­nally came to their senses. Di­a­logue is likely to be the ul­ti­mate so­lu­tion to the log­jam in our beloved Moun­tain King­dom when our lead­ers re­alise this in­sta­bil­ity is a lose-lose sce­nario for all in­volved. The longer this hor­rid soap opera plays out, Le­sotho’s stand­ing among the com­mu­nity of na­tions con­tin­ues to go down the drain. With it are the for­tunes of our al­ready im­pov­er­ished econ­omy which is al­ready feel­ing the strain of the in­sta­bil­ity.

Mean­while, op­po­si­tion leg­is­la­tors who are sup­posed to serve their elec­tors re­main in the trenches with no end in sight to the im­passe.

The sit­u­a­tion de­mands lead­ers who refuse to nor­mal­ize the ab­nor­mal by reach­ing out to their op­po­nents to get Le­sotho go­ing again. Oth­er­wise, the strug­gle con­tin­ues. Ev­ery year on the first of De­cem­ber we mark World AIDS Day. This year we are fo­cused on suc­cess and suc­cess starts with vi­sion. Ear­lier this year, lead­ers from around the world, in­clud­ing lead­ers from Le­sotho and the United States, agreed as part of the United Na­tions Sus­tain­able De­vel­op­ment Goals to sup­port an am­bi­tious and in­spir­ing vi­sion — that of end­ing the HIV and tu­ber­cu­lo­sis epi­demics by 2030.

UNAIDS has laid out a clear path to fol­low in or­der to end the AIDS epi­demic. That path is widely known in the pub­lic health world as the 90/90/90 path. In other words, the only way for coun­tries to achieve con­trol of the epi­demic is to en­sure that 1) 90 per­cent of all Peo­ple Liv­ing with HIV know they are HIV pos­i­tive; 2) that 90 per­cent of those who are HIV pos­i­tive are re­ceiv­ing life-sav­ing Anti-retro­vi­ral Treat­ment (ART); and 3) that 90 per­cent of those on treat­ment are vi­rally su­pressed, mean­ing the treat­ment is ef­fec­tive in keep­ing clients healthy and re­duc­ing the virus to very low lev­els. The United States Govern­ment’s theme for World AIDS Day is, “Time to Act Now.” And that is what is left for us to do. Act to make our shared vi­sion a re­al­ity.

The United States govern­ment, with the gen­er­ous sup­port of the Amer­i­can peo­ple, has been a ma­jor con­trib­u­tor to the HIV/ AIDS re­sponse in Le­sotho, through both mul­ti­lat­eral and bi­lat­eral chan­nels. Mul­ti­lat­er­ally, the U.S. govern­ment has com­mit­ted more than $11 bil­lion to the Global

Fund, in­clud­ing $1.35 bil­lion this year alone. Bi­lat­er­ally, our sup­port comes through the Pres­i­dent’s Emer­gency Plan for AIDS Re­lief (PEP­FAR).

Since the out­break of the epi­demic, through PEP­FAR, the United States has com­mit­ted $65 bil­lion glob­ally, in­clud­ing $250 mil­lion to Le­sotho.

The United States also sup­ports three ma­jor ini­tia­tives. Through the DREAMS Ini­tia­tive, Le­sotho has been awarded an ad­di­tional four­teen mil­lion dol­lars to cut new HIV in­fec­tions in ado­les­cent girls and young women, 15 to 24 years of age, by 40 per­cent in Maseru and Leribe dis­tricts by 2017.

This pro­ject will work with girls, their fam­i­lies, com­mu­ni­ties, and schools to em­power young women to stay free from in­fec- tion. With­out such at­ten­tion, they will re­main dis­pro­por­tion­ally at risk of con­tract­ing HIV.

They cur­rently ac­count for 35 per­cent of new HIV in­fec­tions though only make up 10 per­cent of the pop­u­la­tion in those dis­tricts. The U.S. is also con­tribut­ing 14 mil­lion dol­lars to sup­port the Ac­cel­er­at­ing Chil­dren’s HIV/AIDS Treat­ment (ACT) Ini­tia­tive and three mil­lion dol­lars to the Voda­fone and Min­istry of Health Mo­bi­liz­ing HIV Care and Treat­ment part­ner­ship. Both of th­ese pro­grams are in­tended to sub­stan­tially in­crease the num­bers of Hiv-pos­i­tive chil­dren on ART.

To stand a chance of achiev­ing the 90/90/90 tar­gets and end­ing HIV as a global pub­lic health threat by 2030, it is crit­i­cal that we fo­cus our ef­forts on get­ting as many peo­ple tested and on treat­ment as pos­si­ble.

Le­sotho is mak­ing progress, with sig­nif­i­cant in­creases in the num­ber of men and women test­ing for HIV but progress has been in­suf­fi­cient in ini­ti­at­ing peo­ple on treat­ment. With only 37 per­cent of HIV pos­i­tive adults and 40 per­cent of HIV pos­i­tive chil­dren on ART, we must do more now.

In or­der to in­crease our im­pact, the PEP­FAR pro­gram in Le­sotho is fo­cus­ing in­ten­sively on the cas­cade of care — from test­ing, to treat­ment, to vi­ral load sup­pres­sion.

First, we have mod­i­fied our geo­graphic fo­cus to match the bur­den of dis­ease. By 2017, we aim to en­sure that 80 per­cent of Hiv-pos­i­tive res­i­dents in Maseru, Berea and Leribe ini­ti­ate and re­main on ART. And by 2018, we plan to reach 80 per­cent ART cov­er­age in Mo­hale’s Hoek and Maf- eteng.

Se­condly, on Septem­ber 30, the World Health Or­ga­ni­za­tion (WHO) re­leased new guid­ance rec­om­mend­ing ART for all peo­ple liv­ing with HIV, in­de­pen­dent of the pro­gres­sion of their dis­ease. Sim­ply put, that means the WHO is ad­vis­ing that those who test pos­i­tive should im­me­di­ately go on treat­ment.

The ev­i­dence is clear that ini­ti­at­ing treat­ment ear­lier — the TEST AND TREAT model — helps keep peo­ple liv­ing with HIV healthy and, by re­duc­ing the level of the HIV virus in their blood, makes it less likely they will trans­mit HIV to oth­ers.

It also makes sense eco­nom­i­cally, as health­ier Ba­sotho con­trib­ute far more to the econ­omy than it costs to keep them on ART.

As Pres­i­dent Barack Obama said last year on World AIDS Day, “As a Na­tion, we have made an un­wa­ver­ing com­mit­ment to bend the curve of the HIV epi­demic, and the progress we have seen is the re­sult of count­less peo­ple who have shared their sto­ries, lent their strength, and led the fight to spare oth­ers the an­guish of this dis­ease.

To­day, we re­mem­ber all those who lost their bat­tle with HIV/AIDS, and we rec­og­nize those who ag­i­tated and or­ga­nized in their mem­ory. On this day, let us reded­i­cate our­selves to con­tin­u­ing our work un­til we reach the day we know is pos­si­ble — when no child has to know the pain of HIV/AIDS and no life is lim­ited by this virus.”

Suc­cess­fully turn­ing the cor­ner on HIV/AIDS in Le­sotho will take vi­sion­ary and en­gaged lead­er­ship, ac­count­abil­ity, strong part­ner­ships, and courage from govern­ment, from health work­ers, from com­mu­ni­ties, and from in­di­vid­u­als and their fam­i­lies.

End­ing the AIDS epi­demic by 2030 will re­quire a col­lec­tive de­ter­mined ef­fort from all of us. The vi­sion and the goals are there. The time to act is now.

l Matthew T Har­ring­ton is the United States Am­bas­sador to the King­dom of Le­sotho

Newspapers in English

Newspapers from Lesotho

© PressReader. All rights reserved.