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Responding
to HIV/AIDS in Africa: a comparative analysis of responses to the
Abuja Declaration in Kenya, Malawi, Nigeria and Zimbabwe
ActionAid
International
June 2004
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Executive
Summary
The devastating impact of HIV/AIDS has been felt most severely in
Africa. HIV-AIDS is the leading cause of death in Sub-Saharan Africa
and the paramount threat to the region's development. More than
20 million Africans have now died, and 12 million have been orphaned
by AIDS. Those living with the virus number 29.4 million, the vast
majority in the prime of their lives as workers and parents.1
The challenge
of tackling these diseases was taken up by African Heads of State
at their summit in Abuja in 2001. This lead to the Abuja Declaration,
the primary goal of which is to reverse the accelerating rate of
HIV infection, TB and other related infectious diseases.
As part of its
international campaign on HIV/AIDS, ActionAid International commissioned
a series of studies in 2003 and 20042
to discover the extent to which the Abuja commitments were being
realised in African countries.3
This report
is based on the research carries out in Kenya, Malawi, Nigeria and
Zimbabwe and provides a comparative analysis of the achievements
and challenges faced by these four African countries in relation
to the Declaration.
Two and a half
years after the Abuja Declaration there has been some progress in
all four countries in implementing the agreed strategies. But much
remains to be done. Political commitment is increasing and some
progress has been made in the area of mobilising formal and informal
education sectors. Progress on the protection of human rights has
been limited and everywhere stigma and discrimination remain a problem.
All four countries have attempted to address the need for care,
support and treatment, but there are major gaps in delivery, particularly
with regard to antiretroviral (ARV) treatment programmes. With the
advent of the World Health Organisation's initiative to treat three
million people by 2005, care and treatment should improve but this
will require a large investment in health service infrastructure,
not least the development of human resources.4
The lack of sufficient and sustainable resources is a critical issue
that continues to pose challenges for all four countries, aggravated
by weak infrastructure, poor legislation and policies, and lack
of effective coordination of HIV/AIDS-related activities.
As countries
continue to work towards meeting the commitments made in Abuja,
it would be helpful to revise the framework for action and express
the commitments in more specific terms. This, combined with greater
transparency regarding budgets, increased participation from civil
society, especially women, people living with HIV/AIDS (PLWHA) and
community based organisations, will allow all sections of society
as well as government and the international community to monitor
progress more effectively.
Visit the ActionAid
fact sheet
1 http://www.worldbank.org/afr/aids/
2 ActionAid International Nigeria (2003): Matching words with action:
monitoring the HIV and AIDS Commitments in Nigeria, Nigeria. October;
Action Aid Kenya, (2004): Report of the study on the implementation
of the Abuja Declaration 2001 on HIV/AIDS in Kenya, March 2004, Nairobi,
Kenya; ActionAid International, Malawi, (2004): Monitoring HIV/AIDS
commitments of the Abuja Declaration: Malawi CSO Report 2004, Lilongwe,
Malawi; ActionAid Zimbabwe (2003), Monitoring the Abuja Commitments:
Harare, Zimbabwe. 2003
3 ActionAid International is grateful to the John Lloyd Foundation
for its generous support which allowed these studies to be conducted.
4 For further discussion of financing for HIV/AIDS programmes and
the 3 by 5 initiative, see ActionAid International, Commitment to
Care? The Role of Donor Countries and Multilateral Institutions in
Financing HIV/AIDS Programmes, June 2004; and 3 by 5: ensuring HIV/AIDS
care for all?, June 2004.
Please credit www.kubatana.net if you make use of material from this website.
This work is licensed under a Creative Commons License unless stated otherwise.
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