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After Barcelona: where to Zimbabwe?
SAfAIDS Discussion Forum Review
Southern Africa AIDS Information Dissemination Service (SAfAIDS)
September 19, 2002

The SAfAIDS monthly discussion forum for August 2002 was specially arranged to give feedback on the XIVth International AIDS Conference, held in Barcelona on 7th -12th July 2002.

The Theme for the Barcelona Conference was: Knowledge and Commitment for Action

Barcelona attendees were invited to bring their posters to display at our Discussion Forum. A complaint from international conferences is often that we don't get a chance to view what is being presented from our own country. To address this the Forum gave Zimbabwean stakeholders who did not go to Barcelona feedback on the key issues discussed at the conference and presented a unique opportunity for them to air their views on the way forward for Zimbabwe in responding to the HIV/AIDS epidemic. In all we had 14 posters and 3 oral presentations from the country. The following key issues were reported to have been raised in Barcelona:

Lack of Commitment
Described by some of the attendees as having shown a "spirit of humanism" and supportive environment for HIV+ people to be open about their status without feeling stigmatized, it emerged that underneath this spirit lay huge discontentment with the lack of commitment and action by the various stakeholders in the world in responding to the pandemic.

Access to Treatment
Summing up the lack of commitment in making treatment available and affordable in Africa one delegated is reported to have said: "How can we have Coca cola in every corner of the world and not have the same for AIDS Drugs". Amongst some of the barriers cited as contributing to lack of access to treatment such as Anti-retroviruses (ARVs) were:

• Licensing and procedural issues within countries, which prohibit easy importation of drugs
• Global Health Fund requirements for its beneficiaries to purchase drugs direct from the manufacturers instead of purchasing generic drugs, which are much cheaper.
• Conflicting interest with other public health issues such as malaria, tuberculosis etc.
• Lack of foreign currency

Lack of support to PLWAs
The Global Network for People Living with AIDS GNP+ and the International Community of Women Living with AIDS (ICW) registered dissatisfaction with the support they had been offered in this particular conference.

The Brazilian Experience
With this strong emphasis on access to treatment there were clear calls for care to go hand in hand with prevention efforts although it remains a challenge for most countries how to balance resource allocation for these two. Brazil showcased its own approach, which emphasizes human rights.

Less Rhetoric, more action
Nigeria-AIDS an e-mail discussion list for journalist in Nigeria called for less rhetoric and more action after the major AIDS conferences. Other issues discussed at the conference included:

• Youth participation in prevention programs
• Food and Nutrition insecurity
• HIV/AIDS and governance
• Stigma and discrimination
• Microbicides
• Voluntary Counselling and Testing
• Workplace Programmes

The following key oral presentations that were presented in Barcelona were featured at the forum:

A programmatic model for scaling up the response to HIV/AIDS in highly affected countries in Africa by Dr Mike St Louis
There is need for scaling up the response to HIV and AIDS by allocation of more international resources and building up of effective public health systems

National Survey of STDs and HIV prevalence among residents in rural growth point villages in Zimbabwe by Dr Kasprzyk
Women emerge to be much more at risk of HIV infection and have little control over their risk for infection. Interventions targeting men are more likely to reverse the HIV/AIDS pandemic

Innovative approaches to encourage doctors in Zimbabwe to refer clients in Zimbabwe for HIV counselling and testing by Dr Sunanda Ray
Doctors have professional obligation to give the best information possible to their clients and should take up a leadership role in addressing HIV. One way is by encouraging clients to go for voluntary counselling and testing

The afternoon offered a very interesting poster presentation (Market place) followed by stimulating discussions on the presented posters. The following posters were featured:

• Influencing policy change around men and HIV/AIDS in Southern Africa q Information and Communication technologies: the case of Southern Africa
• Social Workers in the context of HIV/AIDS
• Youth: critical voice for HIV/AIDS communication
• Performance of Different New Start Voluntary HIV Counseling and Testing (VCT) Service Delivery Models
• Evaluation of the performance of Non Laboratory Staff in the Use of Simple Rapid HIV antibody assays at New Start Voluntary Counseling and Testing (VCT) Centers
• What makes a national HIV/AIDS response truly comprehensive?

Development, implementation and evaluation of a program to counsel women about infant feeding in the context of HIV in Harare, Zimbabwe.

Where to Zimbabwe?
Through discussion from the oral and poster presentation the following recommendations were made:

• Need for scaling up the response to HIV and AIDS based on the various research findings done in Zimbabwe i.e. incorporating research result into action
• Need to disseminate research findings widely through discussion fora and electronic means
• Need to target men in particular in prevention efforts and come with interventions for both men at work and out of work
• Involvement of partners (men) in counselling and support groups for couples
• Involvement of youth in prevention programs
• Use of voluntary counselling and testing as a conventional health service and more VCT services in rural areas
• Effective dissemination of research results through discussion fora.
• Use of Information and communication technologies to disseminate research findings and participation in discussion
• Need to clearly communicate messages through posters and other media

*Electronic copies of presentations, posters and Barcelona Abstracts available in SAfAIDS Resource Centre. Southern Africa HIV/AIDS Information Dissemination Service

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