The Sunday News
THE 18th International Conference on Aids and STIs in Africa (Icasa) has come and gone, and now it is time to take a retrospective look, monitoring and evaluating the event.
Over 5 000 delegates descended on Harare from all over the continent and beyond to be part to the biggest conference on Aids and STIs in Africa.
Owners of hotels, lodges, bars, restaurants and other service providers in Harare had more business in one week that they normally have in several months, thanks to the event.
Leaving the appraisal of the conference at that would not suffice in painting an objective picture of the extent to which the conference might have actually benefited the host country.
The conference as an event might have ended on Friday 4 December but there are obviously long lasting outcomes that organisers of the conference envisaged when they mooted the idea to host such an indaba.
Zimbabwe too as hosts had expected outcomes which were obviously far from those that made businesses in Harare glee.
One of the most apparent expectations from the country would be the benefits likely to be derived after hosting such a huge and prestigious event.
The conference provided a medium for African countries to exchange experiences and lessons on responses to HIV and Aids and STIs, tuberculosis and malaria.
Various sessions were held throughout the six days of the conference, where debates on a wide range of issues around HIV prevention, treatment and elimination ensued, and proffering possible solutions to the scourge which has decimated a substantive percentage of the continent’s population.
The conference also provided a platform for African countries to benchmark their HIV response strategies against each other and work on ways to improve the strategies towards meeting the 2030 goal of total elimination of Aids.
Zimbabwe ranks as one of the few countries in Africa who have made strides in domestic funding of HIV programming through the Aids levy which accounts for about 15 percent of the total HIV programming funding in the country.
Other countries, like Uganda, solely rely on donors to finance their HIV programming and have no mechanisms to tap into domestic resources to respond to their HIV challenges. Icasa was thus an opportunity for such countries and many others to borrow a leaf from Zimbabwe’s success.
While Zimbabwe stands out as an example in that regard, and was applauded by some foreign delegates at the conference, the country still needs to do more in coming up with sustainable ways of funding its HIV prgrammes.
During the conference Zimbabwean presenters also shared the enormous achievement the country has made in fighting HIV.
Zimbabwe has a generalised HIV epidemic, with exceptionally a high level of HIV prevalence in the past which has, however, significantly lowered over the past decade from 26,5 percent to 14,3 percent now.
In as much as the country might stand as an example with regards to domestic funding of HIV programming and lowering HIV prevalence, there are some areas where Zimbabwe lags behind and would want to learn from other polities.
Yet again there could be more that needs to be done even in those areas the country may be leading.
UNAIDS country director in Zimbabwe Mr Michael Bartos said despite the country having recorded milestones in certain aspects of HIV response, more still needed to be done to accelerate efforts in eradicating HIV by 2030.
He noted that Zimbabwe will only start realising the benefits of hosting Icasa if authorities and other local partners in the fight against HIV tap into the knowledge and experiences shared by other countries during the conference.
“The interchange has been enormously productive. There were a wide range of discussions and debate around the total eradication of HIV, and a lot of lessons will be learnt from there. The reality of it is that we will see the impact of hosting Icasa in the next three or four years. We will see an accelerated HIV response which is better, stronger more efficient if policy makers tap into the experiences shared.
“Zimbabwe’s HIV response programme ranks among the best and in some cases some of the country’s experiences lead the region. But there are certain areas which the country needs to learn from other countries,” he said.
Data from 17 countries and territories across America, including the United States, Canada and Chile, presented during one of the sessions at the conference show that the countries may have eliminated mother-to-child transmission of HIV and syphilis.
The countries, which also include Cuba, were able to cut mother-to-child transmission of HIV by improving pregnant women’s access to prenatal care, HIV testing and antiretroviral treatment.
Cuba’s representatives at Icasa shared their experiences in eliminating transmission of the HIV virus from mothers to their unborn babies, a presentation that was pregnant with lessons for Zimbabwe and other African countries that are still battling to eradicate mother-to-child transmission of HIV.
Zimbabwe’s HIV mother-to-child transmission rate has over the years fallen from 28 percent to 6, 7 percent, a remarkable achievement, albeit still falling short of what other countries in the continent have achieved.
Mr Bartos noted that more needed to be done in the country to increase accessibility of prenatal service to pregnant mothers in all parts of the country, as one of the major steps to eradicate mother-to-child transmission of HIV.
“Other countries have almost 100 percent coverage in terms of accessibility of prenatal care. We need to work on a model to improve pregnant women’s access to prenatal care, HIV testing and antiretroviral treatment. This conference has given us an opportunity to learn from other country’s models and see how best we can replicate them here and achieve similar milestones,” said Mr Bartos.
One of the major highlights at the conference was the new HIV treatment guidelines announced by WHO, which among other things raised the CD4 count by which people should be initiated on ART from 500. The new guidelines encourage a test and treat approach which encourages initiation of people on ART upon diagnosis.
Zimbabwe, like many other African countries, is still initiating ART at CD4 count of 500 and below and still contends with a backlog of people waiting to receive treatment. This is due to lack of resources.
The new WHO guidelines bring into question the country’s capacity to comply with the standard practice in HIV treatment and move with the rest of the world in meeting the goal of eradicating HIV by 2030.
Head of the local Icasa secretariat Mr Raymond Yekeye said the guidelines were welcome but the country would not rush into implementing them without addressing resource availability, which he said was critical in meeting the standards spelt out in the guidelines.
“WHO guidelines are exactly that are, they are guidelines. As a country we now have to sit down and look at how we can adapt them to suit our situation as a country.
“There are new medicines that are being talked about which need to be changed in terms of dosage and so on. Those kinds of things are very helpful for the country, not that we will change but we will know the direction things are going.
“As we plan our supply chain management, we take into consideration that there are these issues that are coming up. It gives us a head start in terms of preparing ourselves,” he said.
There were also discussions around reinvestment in HIV prevention. While the HIV incidence in the country remains low, it has been stagnant for a long time and may likely shoot up if the country does not remodel its HIV prevention programmes.
The conference also saw the launching of the UNITAID/PSI HIV Self Testing in Africa (STAR) which is expected to promote the immense exercise of HIV testing.
Following the launch of the programme, more than 750 000 self-testing kits will be distributed across Zimbabwe, Malawi and Zambia, with Zimbabwe expected to roll out its pilot self-testing project in February next year.
Mr Yekeye said the country was more than geared to roll out the programme and anticipated enormous benefits from the programme.
Icasa co-ordinator, Mr Luc Armand Bodes said the conference would count to naught if leaders in Africa do not step up to take the responsibility of fighting HIV and eradicating the virus by 2030.
He said the vision 2030 was attainable but needed political will as well as commitment from all concerned parties.
“Our leadership needs to take responsibility. We cannot achieve 2030 if our leaders don’t step up and take responsibility. This platform is the right platform to lobby leadership to wake up and take up their responsibility in Africa. We have done that and we will continue to do that until we achieve our target,” he said.
It is also important to note that the best brains in the world in HIV research were part of the conference.
A lot of new information and research findings were presented in front of close to 2 000 ordinary Zimbabweans, unlike in other conferences where only a few high ranking officials will be in attendance.
Content-wise the conference will certainly go a long way in bridging the knowledge gap that often exists among people, leading to misinformation and stigma among other issues that are counter progressive in fighting the virus.
On the last day of the conference a glamorous closing ceremony, befitting the magnitude and importance of the conference was held at the Harare International Conference Centre( HICC).
During the closing ceremony several moving speeches were delivered by high ranking officials who include the Minister of Health and Child Care Dr David Parirenyatwa.
However, the major highlight of the closing ceremony was the adoption of a 11-point declaration by leaders, decision makers, scientists and activists from across the African continent and beyond, which was dubbed the Harare Declaration.
Headlining the declaration was the call for the sustained, efficient and effective resourcing of the Aids response across the continent in the framework of global solidarity and shared responsibility.
While vision 2030 appears attainable, lack of resources has always appeared as a major threat to most African countries’ capabilities to achieve the target.
It is thus everyone’s hope that the call made in point number eight of the Harare Declaration will not fall on deaf ears and the continent’s leaders will harken.
The first step by leaders in ensuring adequate resourcing of the Aids response would be to dedicate 15 percent of total Government expenditure to health in line with the Abuja Declaration.
Point number three of the declaration was inspiring, as leaders, scientists and other stakeholders made a commitment to the vision 2030.
The point reads, “We embrace with enthusiasm and dedication the vision of the end of Aids and commit our wholehearted efforts at local, national and regional level to implement the Fast Track to ending Aids by 2030 and with it help achieve the world’s new 2030 Agenda for Sustainable Development.”
It is thus hoped that the Declaration will not become yet another document that will gather dust in the high offices, but will compel everyone to act towards eradication of Aids in the world.
Broadly, the conference which the organisers feel was a success, had intangible benefits which may take forever to elaborate.
Zimbabwe won the bid to host the Icasa conference ahead of four other countries after Tunisia, which had initially won the bid, failed to meet security requirements.
The country had only five months to prepare, but managed to attract over 5 000 delegates, a number higher than what other editions of the conference planned over two years could attract in other countries.
