African Civil Society position paper on HIV and AIDS in Africa: Moving to Action

We, African civil society organizations comprising organizations and networks of people living with HIV, young people, women, religious leaders and community workers at the frontline of the fight against AIDS, met in Abuja, Nigeria on April 10 to 12 2006 to develop a consolidated position for use during the review processes of the Abuja Declaration and Framework Plan for action, and the United Nations General Assembly Special Session on AIDS (UNGASS) Declaration of Commitment (DoC), and to chart a way forward regarding access for all people requiring information and services related to HIV prevention, care, support and treatment.  This statement reflects the outcomes of these deliberations, as well as the sentiments of the undersigned African Civil Society Organisations.  

African Civil Society Organisations are: 

Unified in our commitment to working in partnership with all stakeholders who recognise the role of Civil Society as a force for change, and as a critical ally of communities affected by poverty, inequality and disease;

Concerned that although there are now more resources available to fight AIDS in Africa than there were five years ago, urgent action is needed to reach the millions of African people who are still excluded from access to life-saving prevention, care and support and treatment services;

Horrified by the fact that in some instances, corruption and mismanagement of funds have jeopardised the rights of people living with HIV and affected by HIV and AIDS to access prevention, care and support and treatment, and that in the absence of structures and systems to monitor the use of funds in a transparent manner, the continent will be unable to sustainably respond to the challenges of scaling up towards Universal Access; 
Outraged that two decades into the AIDS epidemic, Africans are faced with the reality that many of our health systems are buckling under the pressure of new AIDS treatment programmes; large portions of our budgets are externally-funded and subject to unacceptable conditionalities; many of our best, brightest and most educated are systematically poached by institutions based in the Global North; the rights of women and girls continue to be violated with impunity, further deepening their vulnerability to infection and stigma; young people remain on the margins of policy and programme design even as their vulnerability to infection has not yet been addressed; and people living with HIV in many communities remain unable to access basic services due to the stigma and discrimination that they face on a daily basis;

Alarmed that onerous debt repayment obligations and conditionalities by international finance institutions (IFIs) continue to undermine the capacity of most African governments to devote sufficient resources for HIV and AIDS including meeting the 15% Abuja commitment, we note that only two African countries reached the target of 15% of health spending within their national budgets and if debt repayments are factored in, not a single African country would have reached the target set in 2001;

Deeply disturbed by the fact that without a massive and sustained effort to meaningfully involve civil society organizations, the global difficulties that impeded the attainment of the “3 by 5” campaign will also be encountered in the push towards Universal Access in the next four years;

Dismayed that that despite the pledges made by states in the UNGASS DoC, not one single African country has met the target of  “reducing HIV infection amongst young people by 25% by 2005” nor have any African  countries managed to “ensure 90% access to information, education, services and life-skills,” or  reduce “by 20% the number of babies infected by HIV;”  

Strongly convinced that Universal Access to prevention, treatment, care and support can only be achieved where goals and targets are set: without goals there can be no progress towards access;

Unshakeable in our belief that comprehensive prevention, care and support and treatment are indivisible: action in one area without equivalent actions in the other areas is unacceptable;

Recommitted to moving beyond words to address the poverty, inequity and violence that drive and exacerbate the impact of HIV and AIDS on the communities that we represent and work with;
















































Within the Abuja Declaration and Framework Plan for Action, we therefore call for:

1.  Leadership, Partnership and Accountability
Enact domestic legislation to ensure that the Abuja Declaration is given effect in a manner that is commensurate with the State of Emergency declared by many countries;
Establish as a matter of urgent priority an inclusive and participatory process for the development of national targets and indicators which includes clear timeframes that will be reviewed on an annual basis;  
Include within the 15% health spending target, a specific set of separate targets for each of the three diseases: AIDS, Tuberculosis and Malaria;
Establish independent national oversight committees with active participation of civil society, to monitor the Abuja Declaration;
Ensure that there is adequate resourcing and planning to enable civil society participation in the processes outlined above;
Put in place explicit accountability mechanisms that address the allocation of responsibilities, timeframes, funding and access to information by civil society organizations involved in monitoring and reviewing progress;
Recognise the importance of building and maintaining partnerships with all stakeholders within civil society including people living with HIV, young people, the media, parliamentarians, the private sector, faith-based organizations, trade unions and community-based groups. 

2.  Sustainable Financing and Health Systems Strengthening
Work in partnership with civil society organizations to accelerate action on the removal of unfavourable conditionalities for accessing resources, particularly the removal of budgetary ceilings imposed by IFIs on social sector spending and the removal of odious debt repayments which are demanded at the expense of the health and human rights of African people;
Explore and support innovative means of mobilising additional domestic resources to secure sustainable and predictable financing for HIV and AIDS (such as the International Finance Facility and the Airline Solidarity Contribution), including reducing military spending in order to increase social spending, and ensuring that National Economic Planning Processes reflect the commitments made in the Declaration;

3.  Human Resources 
Ensure that health systems and infrastructure strengthening is supported by a commensurate investment into the human resources of Africa by putting in place long-term, comprehensive and fully costed Human Resource Plans at national and regional levels to address Africa’s primary challenge.
Specifically that all WHO guidelines for effective delivery of health care should be met by 2010, in particular the ratios recommended regarding the number of doctors and nurses per patient, the number of hospitals and clinics per population. 

4.  Comprehensive Prevention, Care, Treatment and Support
Urgently scale up prevention efforts in order to meet the DoC targets agreed upon in 2001, with particular emphasis on sexuality education and life-skills and specific efforts aimed at decreasing the vulnerability of women and youth, and promoting their ability to fully enjoy their sexual and reproductive health and rights;
Accelerate action on lifting tariffs on cost and price of medicines and trade rules and mechanisms that impede access to affordable medicines; creating an enabling environment for local production of medicines;

5.   Research and Development 
African states must urgently commit build and strengthen national and regional research capacity and infrastructure so as to lead HIV research efforts that Africans will directly benefit from – including treatment, prevention, indigenous African traditional medicines, and behavioural and social science; 
African states must urgently commit to financial and human resources for the research, development and planning for future access of vaccines, microbicides and other female-controlled methods of preventing new HIV infections – nationally and regionally;

6. Women’s Rights and Gender Equality
Through policy, institutional and legal frameworks, develop a policy, legislative and administrative environment in which the rights of African women and girls, especially those living with HIV are actively promoted, fully enjoyed and protected within and through the ratification and domestication of international instruments such as  CEDAW, the Protocol to the African Charter on Human and People’s Rights on the rights of Women in Africa; Solemn Declaration on Gender Equality in Africa (2004);

7. Human Rights
Create enabling environments through policy, institutional and legal frameworks at national level that promote and protect the human rights of those living with and affected by HIV and AIDS, and that further reduces their vulnerability to stigma and discrimination through the enactment of Human Rights legislation;
Ensure that the rights of orphans and vulnerable children are promoted and protected through the massive scaling up of efforts aimed at providing children with the protections outlined in the Convention on the Rights of the Child, to which all African states are signatories;


Within the UNGASS DoC and the Declaration Statement on Universal Access, we further call for Heads of States and government to adopt the following: 

1. Explicit Targets 
At the Abuja Summit, and again at the UNGASS Review, ensure that the following targets are inserted into any document that is adopted in regards to Universal Access: 

“By 2010, ensure that at least 10 million people have access to HIV treatment – including 7 million Africans - through an acceleration of HIV treatment scale-up efforts by all stakeholders, including civil society, people living with HIV, member-states, donor countries and multilateral institutions. In order to ensure that this target is reached equitably, Member States should develop, in an inclusive manner, specific targets for the inclusion of vulnerable populations in national treatment plans, including, for example, active injecting drug users, children, men who have sex with men, women, and migrant populations.” 

“By 2010, ensure that all pregnant women living with HIV have access to information and ARV therapy to prevent mother to child transmission.”

“By 2010, ensure that the information and means to avoid HIV infection is available to all citizens through an accelerated effort by civil society, people living with HIV/AIDS, member states, donor countries and multilateral institutions.”

2.  Commitment to Tracking Progress on Universal Access
At the Abuja Summit and again at the UNGASS Review, ensure that African states commit to the review of progress towards the prevention, care and support and treatment targets contained in the DoC and outlined above.  This should be done in a High-level Joint Publication developed by key stakeholders within civil society in partnership with the African Union. The Summit is requested to adopt the following recommendation: 

“By June 2008, ensure that the African Union Commission, in close collaboration with civil society organisations and other key stakeholders, produces a High-level Review of Progress towards the goals of ensuring that a minimum of 7 million Africans have access to treatment services related to HIV and AIDS; ensuring that all pregnant women living with HIV have access to information and ARV therapy; and ensuring that all Africans have access to the information and means to avoid HIV infection.”  

ENDS. 


For steering committee of the African Civil Society Coalition on HIV and AIDS:

ActionAid International - Africa
African Council of AIDS Service Organisations (AfriCASO)
African Microbicides Advocacy Group (AMAG)
Central African Network of AIDS Service Organisations (CANASO)
Eastern African Network of AIDS Service Organisations (EANASO)
Global Youth Coalition on AIDS (GYCA)
Journalists Against AIDS (JAAIDS) Nigeria 
Network of African People Living with HIV/AIDS (NAP+)
Treatment Action Campaign (TAC)
Open Society Institute for Southern Africa (OSISA)
Oxfam International
Panos Institute GAP
Southern Africa AIDS Information Information Dissemination Service (SAfAIDS)
Society for Women and AIDS in Africa (SWAA)
World AIDS Campaign

Abuja, Nigeria, 12 April 2006












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