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Ebola death toll reaches 2,288, says World Health Organization

The Ebola outbreak in West Africa has killed 2,288 people, with half of them dying in the last three weeks, the World Health Organization (WHO) says.

Ebola 1

It said that 47% of the deaths and 49% of the total 4,269 cases had come in the 21 days leading up to 6 September.

The health agency warned that thousands more cases could occur in Liberia, which has had the most fatalities.

The outbreak, which was first reported in Guinea in March this year, has also spread to Sierra Leone and Nigeria.

In Nigeria, eight people have died out of 21 cases, while one case of Ebola has been confirmed in Senegal, the WHO said in its latest update.

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'Latter-day plague'

On Monday, the agency called on organisations combating the outbreak in Liberia to scale up efforts to control the outbreak "three-to-four fold".

Ebola spreads between humans by direct contact with infected blood, bodily fluids or organs, or indirectly through contact with contaminated environments.

However, the WHO says conventional means of controlling the outbreak, which include avoiding close physical contact with those infected and wearing personal protective equipment, were not working well in Liberia.

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The reason for this remains unclear; however, experts say it could be linked to burial practices, which can include touching the body and eating a meal near it.

There are also not enough beds to treat Ebola patients, particularly in the capital Monrovia, with many people told to go back home, where they may spread the virus.

Sophie-Jane Madden, of aid agency Medecins Sans Frontieres, told the BBC that health workers at the largest treatment centre in Monrovia were completely overwhelmed: "Our teams are every day turning away people who are desperately seeking healthcare."

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Meanwhile, the US says it will help the African Union mobilise 100 African health workers to the region and contribute an additional $10m (£6.2m) in funds to deal with the outbreak.

The announcement comes as a fourth US aid worker infected with the deadly virus was transported to a hospital in Atlanta for treatment.

The identity of the aid worker has not yet been revealed.

Two other aid workers who were treated at the same hospital have since recovered from an Ebola infection.

Separately on Tuesday, the UN's envoy in Liberia said at least 80 Liberian health workers had died from Ebola, according to the Associated Press.

Karin Landgren described the outbreak as a "latter-day plague" that was growing exponentially. She added that health workers were operating without proper protective equipment, training or pay, in comments to the UN Security Council.

By BBC News Africa

9 September 2014


Ebola outbreak in DRC: same virus, but different


New cases of Ebola in the Democratic Republic of the Congo are raising fears that the virus will spread further across Africa. Yet the variety found in Central Africa might be of a different kind.


The Ebola River is a small stream running through the forests of the Equateur province in the northwest of the Democratic Republic of the Congo. It is in this region that the deadly disease was first recognized by Belgian scientists, who named the worm-looking virus after the river in 1976. Now, the virus has once again returned to the Equateur province with two confirmed cases of people who died from Ebola.


"In this region especially, the Ebola virus is circulating and has caused some smaller and larger outbreaks in the past", says Dr. Schmidt-Chanasit, head of the viral diagnostic unit at Hamburg's Bernhard-Nocht-Institute. "So this outbreak, most probably, is not associated with the outbreak in West Africa."


Less deadly


Almost 1,500 people have died so far in Liberia, Sierra Leone, Guinea and Nigeria in what has become the deadliest outbreak of Ebola in history. Yet the virus that has now caused an outbreak in the Democratic Republic of the Congo differs substantially from the one in Western Africa.


"Case fatality rate is much lower when we compare this to West Africa – it's around 20 percent," says Schmidt-Chansit. "So it might be possible that this is a different strain of the Ebola virus that is less pathogenic."


Some Ebola strains are even harmless for humans and will only cause disease in monkeys. The so-called Reston virus is such a mutation of Ebola. It has been found in China and the Philippines. The current strain that is wreaking havoc across West Africa, on the other hand, has a case fatality rate of up to 90 percent.


Confidence in Kinshasa


It might take another one or two days until laboratories have identified the exact strain of the virus that caused the two deaths in the Equateur province in northern Congo. The newest outbreak of Ebola would be the seventh recorded so far for the Democratic Republic of the Congo.


It is the country's history of Ebola outbreaks that makes Felix Kabange Numbi, health minister of the Democratic Republic of the Congo, confident.


"The experience we have gathered during the last six Ebola outbreaks will be helping us contain this disease now," he said in a televised speech on Sunday.


Numbi announced a multitude of measures to counter the outbreak, listing protective equipment for all medical personnel as a top priority. Moreover, he said his government would make sure "all burials are securely done for those confirmed cases, but also those unexplained deaths in the communities."


Experts needed at home


A country plagued by ongoing armed conflicts and a continual fight over natural resources, the Democratic Republic of Congo might be a place where one would suspect the disease to spread quickly – ever more so since it is a country the size of Western Europe with little developed infrastructure, be it roads of hospitals.


Yet this might not be fueling the disease, says Schmidt-Chanasit. Authorities have already imposed quarantine around the affected area in Jera in the Équateur province. "They are very well prepared. They know how to isolate the patients."


He adds that the outbreak occurred in a remote region, "So there is no chance that this outbreak will come into a capital like Kinshasa, because it is hundreds of kilometers away."


Just last week, Health Minister Numbi announced plans to send experts from Kinshasa to West Africa in order to help quell the Ebola epidemic there.


Now, it looks as if the Democratic Republic of the Congo will first have to deal with its own outbreak of the disease.


By Peter Hille


The silent crisis: Mental health in Africa

Steadily approaching the title of the second highest cause of disability in the world, mental health disorders are an international health concern that is gaining considerable attention.(2) Of the global burden of disease, 14% is attributed to neuropsychiatric disorders, indicating a 2% growth since the year 2000.(3) It is believed that the figure will have increased by another percent by 2020.(4) According to the Mental Health and Poverty Project, one in five individuals will suffer from a diagnosable mental disorder in their lifetime.(5) Among the adults who suffer from these disorders, 75% are found to have developed them in their youth.(6) In fact, sufferers of persistent mental disorders in adulthood tend to be those whose condition first arose between the ages of 12 and 24.(7)


The 2011 World Health Organisation (WHO) Mental Health Atlas reveals that 110 of its 184 member states have an identifiable mental health policy.(8) Of the 45 African member states surveyed, 19 reported to have mental health policies in place.(9) This paper discusses current deficits in mental health services in Africa, as well as the challenges faced by mental health patients and practising mental health professionals on the continent. The paper also illuminates strides made by groups in various parts of the continent in improving service provision to affected populations.


Services available


To describe the current accessibility of mental health services in the majority of African countries as deficient would be an understatement. The psychiatrist-to-patient ratio in Africa is less than 1 to 100,000,(10) and it is reported that 70% of African countries allocate less than 1% of the total health budget to mental health.(11) Liberia is a case in point. A 2008 report compiled by the WHO states that there are only 0.06 mental health professionals per 100,000 people in Liberia,(12) where, the S. Grant Mental Health Hospital is the sole inpatient facility for those suffering from mental disorders. A study conducted by the American Medical Association found that 44% of Liberian adults exhibit symptoms indicative of post-traumatic stress disorder (PTSD).(13) The likelihood that these individuals are receiving treatment is very low, when taking into account the scarcity of mental health facilities in that country. The Liberia National Mental Health Policy found that of those living in low income areas that need mental health services, only 15% actually receive treatment.(14)


Similarly, in Ghana only 1.17% of those who are suffering from mental health problems have received the required treatment.(15) There are only three major psychiatric hospitals in that country, all of them located in the southern region. Furthermore, there is only one psychiatrist allocated to 1.5 million people. With such limited accessibility, many mental health sufferers seek treatment from traditional and faith healers.(16)


Compared with the West African countries mentioned, the situation in East Africa is similarly dire. There is an evident shortage of mental health professionals in public practice. In 2001, Tanzania recorded 10 active psychiatrists catering to a population of 30 million. Of the 10, four work at Muhimbili, a teaching hospital, where patients with serious mental health disorders are referred.(17) Kenya is regarded as comparatively better prepared to cater for those suffering from mental health disorders, with 47 practising psychiatrists in the private and public sectors. Twenty-two physicians exclusively provide services in Nairobi, while the remaining 22 practise in other parts of the country.(18) Mathari Hospital, located in Nairobi, is the national referral and teaching hospital for mental health patients. Its 750-bed facility is divided into two wings, a civil wing for stable patients and a maximum security unit for those suffering from severe mental problems.(19) Middle and upper class citizens have the option of seeking services from psychiatrists in private practice.


Risk factors in the African context


Mental health issues among African populations are instigated by an assortment of factors. The financial standing of populations in many African countries may be predisposing them to mental health problems. Various studies state that individuals of a lower socio-economic status are twice as likely to suffer from common mental health disorders, as compared to the wealthy.(20). Furthermore, populations in East African countries such as Somalia, Ethiopia, Sudan, Rwanda and the Democratic Republic of Congo (DRC) have encountered armed conflicts and natural disasters in varying degrees. This has resulted into the displacement of more than 1.5 million individuals from the East African region.(21) A consequence of these hardships may be the emergence of mental disorders. The WHO estimates that 50% of refugees have mental health problems ranging from post-traumatic stress disorder to chronic mental illness.(22) The rise in the numbers of individuals who present with mental health problems places an even greater burden on an already under-resourced healthcare service in Africa.(23)


Mental health stigma


In many African countries, communities are often not empathetic towards mental health patients. The mentally ill face discrimination, social ostracism and the violation of basic human rights, all due to an on-going stigma associated with mental health problems. Ironically, some of these violations occur in institutions where people with ill mental health seek treatment. Mental health facilities have been found with unhygienic and inhumane living conditions, such as the use of caged beds with netting or metal bars to restrain patients.(24) There are documented cases of individuals having been tied to trees and logs far from their communities for elongated periods of time without adequate food or shelter.(25) A study performed in Uganda revealed that the term ‘depression’ is not culturally acceptable amongst the population, suggesting that mental health issues are not acknowledged or considered a legitimate affliction.(26) In another study conducted in Nigeria, participants generally responded with fear, avoidance and anger to those who were observed to have a mental illness. The stigma linked to mental illness in that country can be attributed to a variety of factors, including lack of education, fear, religious reasoning and general prejudice.(27) When surveyed on their thoughts on the causes of mental illness, over a third of Nigerian respondents (34.3%) cited drug misuse, including alcohol, marijuana and street drugs as the main cause. Divine wrath and the will of God were seen as the second most prevalent reason (18.8%), followed by witchcraft/spiritual possession (11.7%). Very few cited genetics, family relationships or socioeconomic status as possible triggers.(28)


Challenges faced in improving services


There are many barriers faced by African mental health workers in their efforts to improve and increase the availability of services in their regions. As mentioned earlier, the lack of funds allocated by most African governments to the mental health field poses a problem in expanding services so as to adequately meet demand. Furthermore, difficulties such as finding adequate transportation and medication are general obstacles for health workers attempting to reach rural dwellers.(29)


Limited research in mental healthcare has also been cited as a major concern. A study spear-headed by the United States National Institute of Mental Health and the Global Alliance for Chronic Disease found that one of the biggest barriers in mental healthcare is the lack of global collaboration in the conduction of research.(30) Research is essential for determining general needs when treating mental health disorders, as well as for creating and monitoring cost-effective interventions.(31) A WHO mapping project on research capacity for mental health in low and middle income countries indicates that epidemiological studies focusing on burden and risk factors, health systems research, as well as social science, were regarded as most desirable by researchers and other mental health stakeholders.(32)


Emerging efforts


Despite the many shortcomings in their field, mental health professionals are resilient in their efforts to serve and challenge the status quo. For example, the Ministry of Health and Social Welfare in Liberia is working towards increasing access to mental health services throughout the country. The Ministry has partnered with organisations such as the Carter Center and Doctors of the World, with the intention being to establish wellness centres in each of Liberia’s 15 counties.(33) The Carter Center is also currently training 150 mental health clinicians in Liberia. Staffed with trained mental health workers, these organisations will offer treatment to mentally ill individuals in the affected communities. In the event of a case requiring knowledge beyond the expertise of clinicians at the centre, referrals will be made to specialists located in Monrovia.(34) Dr Meiko Dolo, the Director of the Mental Health Department in Liberia, is confident that these plans will come to fruition. A recently released draft of Liberia’s national budget for 2013 depicts, for the first time ever, provisions made for mental health.(35)


Following its 11-year civil war, Sierra Leone, established a child-solider rehabilitation project, providing counselling and other support to children living with war trauma.(36) In the DRC, women facing gender-based violence can now go to ‘listening houses’ where they can talk through their trauma in a secure setting.(37) In addition, the University of Cape Town in South Africa completed a project on mental health and policy, whose goal was to expand mental health research in Africa, evaluate existing mental health policies in Uganda, South Africa, Zambia and Ghana, as well as develop new ones.(38)




Though not as notorious as HIV/AIDS, tuberculosis and malaria, mental health is a global issue that is in need of more attention than it is currently being given. In 2003, 450 million people worldwide were estimated by the WHO to have some type of mental health issue.(39) Eleven years later, it is likely that this number has increased. The WHO also reports that expenditure on mental health is less than US$ 0.25 annually per person in low income countries.(40) Currently, Africa has the lowest rate of mental health outpatient facilities, at 0.06 per 100,000 people.(41) Given the steady rise in the number of mental health sufferers, African countries need to optimise the delivery of mental health care services and take steps towards making this crisis silent no longer.

By Modupeola Dovi


Malaysia Airlines Flight 17: A tragic loss for AIDS advocacy, research

Zuma Press

AIDS researchers and advocates are used to dealing with death, they say, but that hasn't made the last 48 hours any easier.


An estimated 12,000 scientists, medical workers, advocates and policymakers are traveling to the 20th International AIDS Conference in Melbourne, Australia — a “mega event” for their field — amid the grim news that dozens of their colleagues, including a top researcher, were killed in the downing of Malaysia Airlines Flight 17 over Ukraine.


The loss is certain to cast a shadow over the conference, members of the community said, calling the blow immeasurable and tragic.


“It's like a train has gone off the track,” said Terri Ford, chief of global advocacy and policy for the AIDS Healthcare Foundation, who arrived in Melbourne on Thursday. “It's hard to absorb what has happened.”


Confirmation of the names of the dead rolled in slowly, but by Friday, the conference attendees knew they had lost at least one superstar.


Joep Lange, a former president of the International AIDS Society and a professor of infectious diseases at the University of Amsterdam whose leadership spanned the history of the epidemic, was confirmed among the dead.


In addition to Lange, a colleague, Jacqueline van Tongeren of the Amsterdam Institute for Global Health and Development, was confirmed among those who perished; as was Glenn Thomas, 49, a spokesman for the World Health Organization. Both were headed to the AIDS conference.


The International AIDS Society late Friday confirmed the names of three more colleagues who were aboard Flight 17: Pim de Kuijer of Stop AIDS Now, and Lucie van Mens and Maria Adriana de Schutter, both of AIDS Action Europe.


Investigators were still sorting through lists to identify all 298 passengers and crew members who died when the Boeing 777 was shot down Thursday over eastern Ukraine en route from Amsterdam to Malaysia. The U.S. has said it appears pro-Russia Ukrainian separatists were responsible.


More than half of the victims were identified as Dutch, and one had dual American-Dutch citizenship.


They came from 10 countries and included scientists, amateur athletes, tourists and passengers heading home.


President Obama on Friday identified the only known American citizen on the downed plane as Quinn Lucas Schansman, who also had Dutch citizenship. Another passenger with American connections, Karlijn Keijzer, 25, of Amsterdam, was a doctoral student in chemistry at Indiana University and an avid rower.


Obama singled out the AIDS group as a special loss.


“On board Malaysian Airlines Flight MH17, there were apparently nearly 100 researchers and advocates traveling to an international conference in Australia dedicated to combating AIDS/HIV,” he said.


“These were men and women who had dedicated their own lives to saving the lives of others, and they were taken from us in a senseless act of violence.”


“In this world today, we shouldn't forget that in the midst of conflict and killing, there are people like these — people who are focused on what can be built rather than what can be destroyed; people who are focused on how they can help people that they've never met; people who define themselves not by what makes them different from other people but by the humanity that we hold in common,” Obama said. “It's important for us to lift them up and to affirm their lives. And it's time for us to heed their example.”


AIDS researchers and advocates echoed his sentiments, calling the impact on their field “unquantifiable” and the loss of Lange particularly so.


Lange was best known for participating in work in the 1990s that helped discover the effect of combination therapy, the uses of multiple drugs to suppress HIV, which causes AIDS.


Today, millions of people around the world take a variety of antiretroviral medications in such drug cocktails to help keep the virus at bay.


Before such therapies were available, “AIDS was a death sentence,” said Thomas Coates, an expert on HIV prevention who directs the UCLA Center for World Health.


More recently, Lange's work had focused on improving access to HIV medication to disadvantaged populations around the world.


“His loss is more than just a summary of his efforts and his papers,” said Columbia University professor of medicine Scott Hammer, an advisor to several of Lange's projects. “He was not shy about speaking truth to power. He spoke softly and carried a lot of moral heft. He was equally compassionate, and driven for his mission.”


Hammer and other scientists said, however, that until it becomes clear who else was on the plane, it would be hard to assess the incident's broader impacts.


“It's hard to know what it means for the field,” said Dr. H. Clifford Lane, deputy director for clinical research and special projects for the National Institutes of Health's National Institute of Allergy and Infectious Diseases. “But typically at these meetings, we try to have the senior leaders and the leaders of the next generation. If some of the members of that next generation were on that plane, it's extraordinarily devastating.”


He added that he believed the tragedy would inspire remaining researchers, health workers and advocates to reexamine their goals, “remember what they've lost, and do their best to honor [colleagues'] memories.”


AIDS researchers and advocates who knew Lange said they remained anxious, awaiting further word on other colleagues who might have been on the flight.


Harvard School of Public Health professor Richard Marlink said he had spoken by phone with associates who were in Melbourne for the conference. They reported that “everyone is shocked and saddened, and the air is quiet, and small memorial signs are starting to appear,” he said.


Times staff writers Christine Mai-Duc and Maya Srikrishnan contributed to this report.

By Eryn Brown, Michael Muskal



Health experts call for integrated approach to HIV and TB in Zimbabwe


Zimbabwe is facing challenges in eliminating tuberculosis (TB) say health experts, who are calling for much greater integration of HIV and TB programmes within the healthcare system.


Tremendous progress has been made in minimising the spread of HIV while TB programming is weak in comparison, according to Michael Bartos, UNAIDS country director for Zimbabwe.


Strengthening coordination systems

Bartos told a recent workshop for Zimbabwean civil society organisations that there was an urgent need to strengthen coordinating systems across HIV, TB and malaria. The workshop was run by AIDS Accountability International in partnership with Southern Africa AIDS Trust and Zimbabwe AIDS network.


“We need, as civil society, to enhance HIV mobilisation to support TB. There is weak mobilisation of communities where it matters. The issue of resources also needs to be addressed if we are to succeed in eliminating the spread of TB,” Bartos said.


Civil society priorities

At the workshop, representatives from various HIV groups created a priorities charter as an ‘advocacy road map’ for the Global Fund to fight AIDS, TB and malaria. The top priority was the need for a coordinating mechanism for HIV and TB, according to Dr Gemma Oberth, senior researcher at AIDS Accountability International.


“This is because HIV coordinating structures are disproportionately strong, compared with TB civil society networks,” Dr Oberth said.


Some of the priorities identified include prevention, treatment, advocacy, care and support, mitigation and stigma reduction.


Increase in new TB cases

Zimbabwe is ranked 17 among the 22 countries in the world worst affected by TB, according to a research project commissioned by the World Health Organisation.


Victoria James, director of New Dimension Consulting, which carried out the research, said: “The estimated incidence of new TB cases was 633 per 100,000 in 2010 compared to 97 per 100,000 in 1990, reflecting a growing trend. Seventy-five per cent of adult TB cases are reported to be HIV co-infected, while HIV testing in TB is 97 per cent. The treatment rate is very low and civil society needs to focus more on playing a role to address the issues.”


She also highlighted some concerns involving new TB diagnoses, which are reported to have increased from 35,340 in 2013 to 38,725 in 2012.


Lack of resources

According to Dr Charles Sandy, deputy director of AIDS and TB programmes at the Ministry of Health and Child Care, TB is managed through the routine health system. The government is faced with the challenge of a lack of resources, although it collaborates with local and international partners.


“We are dependent on the health delivery system for success of the TB programme. Although we have made some progress in trying to address TB, we are facing challenges of a demotivated health workforce and lack of optimum work performance,” Dr Sandy said.


He added that community awareness in addressing TB was low and more resources were needed to address the challenges. Sandy said the government worked with civil society organisations through the Country Coordinating Mechanism and invited them to make suggestions on how they could be more involved.


Image: Emmanuel Gasa, a young HIV/AIDS activist working within the civil society and attending workshop, Zimbabwe
© Wallace Mawire


Read the Zimbabwe Civil Society Priorities Charter


By Wallace Mawire

7 May 2014


Discrimination without Distinction of Any Kind?

Snapshot of African civil society demands versus Addis Ababa Declaration

Addis Declaration

This paper is a snapshot comparative analysis of the Civil Society African Common Position on International Conference on Population and Development (ICPD) and the official Addis Ababa Declaration. It provides a brief examination of the differences and similarities between these two documents, which were both produced during the African ICPD review process. It also seeks to examine where the Addis Declaration fell short of CSO demands and then whether country positions on human rights commitments such as the Maputo Protocol affected their position on the Addis Declaration.  This paper seeks to provide a snapshot of some of the obvious gaps in human, sexual and LGBT rights and accountability between what civil society demanded and what the Addis outcome provided.  Discrimination without distinction of any kind Munyati and Tucker

Malawi to prioritise gender-based messages in response to HIV and TB.


In Malawi, a new civil society charter to tackle HIV and TB is prioritising gender-based messages to help change people’s behaviour.


Malawi is the third country to set up such a charter in response to the Global Fund’s new funding model.


Working with men


According to the Malawi Demographic and Health Survey, data shows that in 2013 men were disproportionately likely to report having more than one sexual partner (9.2%) compared to women (0.7%).


To address this, non-governmental organisations well placed to promote community dialogue and carry out activities involving theatre for development, role models, and working with families, schools and churches.


The primary target group for such activities is men, but there will also be a focus on raising awareness of the risks of having multiple sexual partners with girls and young women.


Civil society intends to measure the impact of this activity through an increased number of men testing for HIV, men who seek circumcision, couples testing together and men using condoms.


Empowerment of women and girls


Poverty greatly affects the ability of young women to make choices about their behaviour. The charter prioritizes a two-pronged strategy to support young women through access to information and economic empowerment.


This means combatting issues of early child marriage, gender-based violence and transactional sex, which are all shown to be related to poverty and the economic circumstances of young women. Civil society organisations supporting the charter intend to scale up activities relating to village savings and loans associations for women.


This work will focus on young women aged 15 to 24. The charter has identified border towns and some lakeshore towns as hot spots where support for affected communities are needed and where impact will be greatest.


The impact of this activity will be measured in the short-term through the number of women engaged in village savings and loans schemes and fewer child marriages, and in the longer term through bylaws restricting child marriages.


Condom promotion


In Malawi, 80% of new HIV infections occur among partners in stable relationships (National AIDS Commission, 2012). This can be explained, in part, by negative perceptions about condom use within long-term relationships.


Work to address this issue will focus on rural women, as the issue of gender norms and power imbalances make it difficult for women to negotiate or introduce condom use within their relationship, especially the female condom.


The charter recommends the activities to be carried out in remote rural areas, as a three year programme from May 2014 – May 2017 with gathering people to sensitize on condom promotion, media reporting, education and communication campaigns, peer education as some of the activities.


One of the ways in which civil society will measure impact of this intervention will be through monitoring the number of rural women using the female condom.


Availability and accessibility


Condom use is higher in urban areas than it is in rural regions of Malawi and this can be partially explained by the fact that health centres and hospitals are some of the only places where condoms can be accessed in rural areas, yet evidence shows bottle stores are much more popular places to get condoms, especially among groups most at risk of HIV such as sex workers (FPAM & UNFPA, 2011).


Civil society intends to increase condom distribution points and lobby different community and religious leaders around accepting use of condoms. It will also pair access to condoms with lubricants, particularly for key populations such as men who have sex with men. A three year programme is expected to start from 2014 up to 2017, with focus on marginalised people such as rural women and people with disabilities.


Key populations


There is a need to scale up existing programmes targeting groups most at risk of HIV. Creating demand for health services among such populations is a high priority because data shows HIV prevalence among sex workers in Malawi is 70.7% (National AIDS Commission, 2012) and 15.4% among men who have sex with men (“HIV among men who have sex with men in Malawi” Wirtz et al., 2013).


Civil society is best placed to access people most at risk of HIV through peer education and outreach work. The target group will be primarily men who have sex with men and sex workers, though prisoners are also identified as a key population in this context, especially in connection to their vulnerability to TB. People with disabilities and refugees were also identified.


The outcome will be measured by reductions in HIV prevalence and increases in health seeking behaviour among key populations.


CLICK HERE to view the Malawi Civil society Priorities Charter


Image: Members of the market theatre group perform an HIV awareness drama to village members, Chipemberemchere, Malawi
© Nell Freeman for International HIV/AIDS Alliance
By Owen Nyaka
April 23. 2014


African civil society needs to improve strategizing and organizing



It became clear from discussions at the 6th ACSHR that CSOs on the continent need to organise themselves better in order to gain meaningful and effective outcomes on ICPD at country level and during Regional Conferences. A need for CSO mapping in the continent was also expressed so as to give an indication of what the different CSOs are working on as well as to identify areas for collaboration. The lack of research and documentation of good practices was cited as a gap in that if addressed would help strengthen the work that CSOs are doing. CSOs called for government accountability and transparency in ensuring CSO inclusion in government platforms and processes pertaining to ICPD.


AIDS Accountability International (AAI) participated at the 6th ACSHR held in Cameroon –Yauonde on 03-07 February, 2014, the theme of which was “Eliminating Women and Girls Sexual Reproductive Health vulnerabilities in Africa”.


ICPD beyond 2014 and Post 2015 with specific focus on the roles for CSOs in Africa


The following issues were raised by AAI during the above plenary session and led to lively and constructive debate:


·         CSO role at country level, regional level and global level- overall role for CSOs: Opportunities and barriers;

·         Relationship between national governments and CSOs was discussed with specific attention paid to the lack of this relationship at country level and the impact thereof on implementation and sustainability of the ICPD goals;

·         Government Accountability: The need for government to create spaces and systems to enable CSO engagement with government on ICPD; and

·         Way forward: How do CSOs begin to organise themselves in influencing country positions, especially from the countries that had reservations in the adoption of the Addis Declaration in October 2013 during the ARCPD as part of the preparations for CPD 47to be held in New York from 04-07 April, 2014.


Intergenerational Youth Dialogue on ICPD beyond 2014 and Post 2015


AAI facilitated this discussion which mainly focused on youth engagement on the following:

·         Challenges faced by the youth in the continent

·         Responses needed for implementation in order to address youth challenges and their needs pertaining to the goals of ICPD and the Post 2015 developmental agenda.

·         The youth at this discussion came from the different CSOS in the continent and other delegates in attendance were from intergovernmental agencies – UNFPA , CSOs from Africa and different multi-sectors as well as implementing partners.


Outcomes of the discussion were that a need for a youth stand – alone goal was identified in order to address the youth needs in a more effective manner going forward to the Post 2015 agenda. A call was made by the youth for governments and other role payers to include them in discussions and decisions that seek to respond to their needs. The conference in its entirety provided a good networking platform for CSOs in the continent as well as a space for sharing and dissemination information. 


Civil Society in Malawi emphasize rural women and LGBT as national priorities


On 13 February 2014, AIDS Accountability International hosted a workshop in Lilongwe, Malawi for civil society organizations to come together and create a set of priorities for the Global Fund New Funding Model. Gathering at the Sunbird Capital Hotel, 45 participants from 37 partner organizations worked in collaboration to create the Malawi Civil Society Priorities Charter.


Delegates traveled from Blantyre, Chitipa, Karonga, Mchinji, Mzuzu, Nkhotakota, rural Ntcheu, Ntchisi, Thyolo and Zomba to advocate on behalf of their constituencies. Organizations present included those that represent people who are marginalized by their sexual orientation and gender identities (SOGI), sex workers, people living with HIV, women, young girls, youth, the TB community, people with disabilities, the faith-based community and academic institutions, among others.  


At the top of civil society’s priority list were behaviour change interventions, particularly those that involve gender targeted messages and economic empowerment for young women and girls. Also topping the list were priorities which aimed to improve acceptability of condom use in relationships, especially the use of the female condom in rural areas.


Key populations, particularly men who have sex with men (MSM), also received consensus from the room as one of civil society’s top priorities for Malawi’s Global Fund programming in 2014. Civil society brought the latest evidence to bare (December 2013), demonstrating the significantly increased risk of HIV infection among MSM in Malawi, as well as sex workers.


Click here to read Malawi’s Civil Society Priorities Charter.  

UN Envoy for AIDS in Africa Must Go


Dear Mr. Secretary-General,

We write to you out of deep concern regarding Ms. Speciosa Wandira-Kazibwe, UN Special Envoy for HIV/AIDS in Africa. In the wake of Uganda’s passage of a law criminalizing homosexuality, Ms. Wandira-Kazibwe’s reprehensible silence, and her ongoing position as a senior advisor to President Museveni, threaten to undermine the credibility and independence of the United Nations. We urge you to terminate her position as Special Envoy and appoint an impartial advocate for the rights of all Africans.

As you are aware, President Museveni of Uganda signed a bill into law this week that institutionalizes discrimination and punishes homosexual relationships with life imprisonment. UN High Commissioner for Human Rights Navi Pillay denounced the law as a violation of “a host of fundamental human rights” that “will have a negative impact on efforts to prevent transmission and provide treatment for people living with HIV.” Through your spokesperson, you indicated that you shared these views and are “seriously concerned” about the negative impact of the new law.

In the weeks and months after Parliament voted in favor of the destructive, retrograde bill, Uganda’s LGBT and HIV activists mobilized a massive effort by advocates, organizations, and leaders from around the world appealing to President Museveni to withhold his signature. Yet amidst the chorus of condemnation, and in the face of the profound damage this law will cause to HIV service provision throughout Uganda and the continent, Ms. Wandira-Kazibwe lurked in the shadows, never using the public platform given her by the United Nations. No speeches were made and no press statements were given. In fact, we understand that when asked to intervene on behalf of a prominent gay Ugandan seeking asylum in South Africa, Ms. Wandira-Kazibwe privately asserted that she could not, because there is no proof that gay activists in Uganda are being persecuted. In the hours since then, a major newspaper in the country has published a long list of Ugandans who are open about or “suspected of” being gay. Ms. Wandira-Kazibwe’s public silence throughout speaks volumes.

Mr. Secretary-General, your chosen messenger’s failure to denounce her president’s odious actions and stand up for the rights of LGBT living at risk of and affected by HIV casts a pall over the United Nations. It impugns the impartiality and credibility of the office of Special Envoy. If her position as special advisor to President Museveni precludes such a public stance, then she must leave that government role immediately. If she refuses to resign, then you must divest her of her UN role. Ms. Wandira-Kazibwe’s split loyalty presents an obvious conflict of interest that has damaged her credibility. Continued inaction by your office risks damaging yours as well.


Paula Donovan and Stephen Lewis
Co-Directors, AIDS-Free World

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Christina Magill

26 February 2014