To Invest in Africa's Future, Finish the Fight Against AIDS

Africa is now poised to push towards a new vision of: zero new HIV infections, zero discrimination and zero AIDS-related deaths. And it needs everyone's support.
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Africa is breaking records. Its economy is growing at around 6% annually, comparable with many of the new emerging economies. Lack of roads is no longer a barrier to information -- mobile phones are the new drumbeat. Democracy is becoming firmly entrenched. More children are in school, especially girls, than ever before. Poverty is on the decline. Access to health care has increased. Polio is history in most parts of Africa. And now AIDS is beginning to recede, country by country, village by village.

Africa has not done it alone. Global solidarity, combined with strong political leadership and community action has produced results -- results unimaginable a decade ago. Millions of men and women are back to work -- healthy again and looking after their children and the elderly. Ten years ago, the roles were reversed; it was the elderly and children who were forced to look after people living with HIV, as AIDS decimated families.

In Africa, the number of people dying from AIDS has rapidly declined in the last five years. More than 5 million people are on antiretroviral treatment for HIV, the virus that causes AIDS. The rate of people becoming newly infected with HIV has dropped by more than 26%.

Africa is now poised to push towards a new vision of: zero new HIV infections, zero discrimination and zero AIDS-related deaths. And it needs everyone's support -- as an equal partner, with 'shared responsibility' as the guiding principle. President Obama believes. Africa's leaders believe. The AIDS community believes.

That is why the African Union at its summit meeting in January tasked the African Union Commission and its executing body NEPAD to work with UNAIDS to create a road map for shared responsibility. With a goal to "draw on African efforts for viable health funding streams with support of traditional and emerging partners to address the AIDS dependency response". Prime Minister Meles of Ethiopia is on the frontline of this call.

UNAIDS estimates that there is a gap of US $3-4 billion between what is available today and what is needed in 2015 for Africa. We can find this money.

African countries too have to increase their investments. UNAIDS recommends countries spend between 0.5% and 3% of government revenue on their AIDS response -- depending on the severity of the epidemic. Botswana, Malawi, Tanzania and Zimbabwe are some of the countries that meet this target. South Africa in recent years has increased its domestic AIDS budget by nearly 300% -- they invest more than US $1.5 billion on AIDS each year. Domestic investments in Africa have increased significantly in the last five years and there is scope for them to do more. Even with increased domestic investments few will be able to fully fund their AIDS response without international assistance. But the balance could be tipped by end of 2016, when most low-middle income countries can begin to fund the majority of their HIV programmes.

Investments in AIDS also have to be smart. Take our goal of eliminating new HIV infections among children by 2015. In the United States virtually all children are born free from HIV, thanks to effective maternal and child care and access to antiretroviral treatment. But elsewhere in the developing world, nearly 390 000 children are infected each year. More than 90% are in 22 countries of the world, 21 in Africa. By focusing on these countries and ensuring pregnant women living with HIV have access to antiretroviral treatment, you save both -- the mother and the child. African leaders are doing just that, with support from UNAIDS and United States' PEPFAR programme. New HIV infections among children in Africa are beginning to decline.

Finally, the increase in access to HIV treatment is also paying a prevention dividend. In South Africa, new research shows for the first time that in areas where more than one in three people had access to HIV treatment, the chance of a person becoming newly infected with HIV dropped by 40%. Similar observational effects are being seen in Namibia, Botswana and Zimbabwe.

Finally, the case for providing all eligible people with HIV treatment cannot be stronger. Yet there are about 5.3 million people who do not have access to HIV treatment today, even as the average cost of first line treatment has dropped to under US$ 150 per person per year.

Recent funding cuts have lengthened the waiting line for people who urgently need lifesaving treatment and assurance of treatment continuity is precarious. African leaders cannot guarantee availability of HIV medicines without predictability of international assistance and the continued ability of countries like India and China to produce generic drugs. Africa can also scale up local production capacity.

To continue to break records and sustain advancements, the results of the AIDS response must be an impetus for increasing investments, not decreasing them. Preventing AIDS is a smart investment that Africa and the world need to make.

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