Remarks on HIV Prevention Strategies By Anders Pedersen, United Nations Resident CoordinatorNov 24, 2013
Launching of the Botswana Faith Based Organizations HIV/Aids Response Strategy 2011-2016, National Stadium, Gaborone
I am delighted and deeply honoured to be given the opportunity to speak as the representative of the United Nations at this event to launch various HIV prevention strategies.
Globally, efforts to halt the HIV epidemic are paying off as fewer people are acquiring HIV, fewer people are dying from AIDS-related illnesses and more people than ever before are accessing life-saving HIV treatment with a 40-fold increase from the 2002 levels. Nowhere in the world has this progress been more pronounced than in this nation of Botswana. For this, I highly commend the Government of Botswana, for its concerted and committed actions in eliminating mother to child transmission and achieving universal coverage in providing life-saving ARTs to almost all of the people in need.
The success we enjoy today has been the result of strategic partnerships between government and civil society, including the faith community, with the support of international partners.
The faith community in Botswana and around the world has been a pillar for passion and compassion that has provided the much needed care and support to those infected and affected with HIV; for men and women, rural and urban, rich and poor, the young and not so young.
But the fight must continue. The most recent sentinel surveillance among pregnant women attending ante-natal care conducted in Botswana in 2011 makes for some sober reading where almost 31%, or one in three, of pregnant women being HIV positive. And despite tremendous progress with treatment access, we are not there yet with more than 10,000 people getting infected every year. This translates to around 30 new HIV infections daily in Botswana. No doubt, more is required to achieve global targets of 50% reductions in new infections based on the 2011 incidence rates.
The biggest challenge we face in preventing new infections is the sexual practices and behaviours that put people at risk of HIV. We all know what it is all about: multiple and concurrent sexual partnerships, low correct and consistent condom use, inter-generational and transactional sex, teenage pregnancy, gender inequality and gender-based violence. With declining financial resources for AIDS work no country, not even Botswana, can uphold the ever growing financial burden of AIDS treatment. Therefore, it is all about prevention, preventing more people to get infected. And prevention cannot be delinked from the complex values of human relationships, of love and trust.
This is a place where the faith community can play a critical role in shaping attitudes, opinions and behaviour. Every week, thousands of Batswana listen to a faith leader and allow their lifestyles and choices to be shaped by what they hear from the pulpit, mosque or other religious platforms. This is a big responsibility. But also a big opportunity.
It is my hope that with the launch today of the Faith Based Organization’s HIV Prevention Strategy, the collaboration between the faith based organizations, the government and other partners will only be further strengthened.
Prevention of New Infections
Evidence informs us that, effective prevention efforts require a multifaceted and multipronged approach with 3-key elements: Behaviour change, biomedical and structural interventions. This is popularly known as combination prevention and I believe it is for this reason that the Ministry of Health has decided to launch the various prevention strategies in one event.
HIV testing and counselling remains the key to treatment and risk reduction. Low HIV testing uptake makes it difficult for the ART programme to run efficiently. I therefore commend the faith sector for mobilising their members to test for HIV during the month of Prayer in September. Furthermore, I would like to urge that this be a year-long campaign that culminates in September each year with possibly awards presented to the organisation with the most tested members
Correct and consistent condom use is by far the most effective prevention tool. The condom strategy being launched today provides guidance for programming and implementation of successful condom intervention. I would like to call on the faith community to continue the good efforts in mobilising for abstinence and faithfulness and also supporting all other government HIV prevention efforts. We need to cushion and extend our hands of compassion to protect these youths from HIV transmission and early pregnancies.
Safe male circumcision is another core prevention intervention. When done at scale together with other prevention measures taken, like reducing the number of sexual partners and increased condom use, it will yield very significant reductions in new infections. However, the programme has encountered challenges in reaching the desired targets due to uptake barriers related to community practices and beliefs. The National Communication and Advocacy Strategy for Safe Male Circumcision well captured the essence of effective communication aiming to promote much higher uptakes based on good analysis of the local context.
Youth prevention is at the heart of the national response. The declining prevalence among the 15-24 years is encouraging. HIV prevalence among 15 – 19 year olds has declined from a peak of 32% in 1995 down to 10% in 2011. However, in an era of social media and easily accessible internet, we need to use innovative methods to reach this generation that is bombarded with HIV misinformation at the palms of their hands from their peers around the globe. We cannot continue to only use traditional communication methods and expect to transform them. I call on the church and other faiths to adapt to their messaging and communication channels to the new technologies.
At the centre of the Combination Prevention approach is the role of leadership and communities. Only a community led and owned programme can truly resonate with the hearts of men and women in society and bring about the desired change within a short period of time.
Religious leaders are one of the greatest shapers of societal norms and beliefs. Hence, the faith sector can play an even greater and more pronounced role in moving communities from dialogue to action and creating demand for prevention, treatment, care and support services including integrated TB, Reproductive Health and HIV services, in addressing stigma & discrimination, and eliminating gender-based violence.
In conclusion, I want to reiterate that one key lesson that the AIDS response has taught us over the years, is that it is impossible to deliver HIV services without partnering with civil society, especially the faith community. The United Nations system are committed to stand beside you in your efforts and are proud of having been able to provide support in the development of the strategies which are launched today.
The scale-up efforts of the national response over the last decade has built a powerful momentum that can carry the nation closer to the goal of zero new HIV infections, zero discrimination and zero AIDS-related deaths.
We are getting closer. But we are not there yet. The imperative is on all of us to make it happen.I thank you for listening. PULA!