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Friday 11 August 2006
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DRC: Hoping to counter the war legacy of rising HIV/AIDS

[This report does not necessarily reflect the views of the United Nations]

©  Hugo Rämi/IRIN

Most health infrastructure has been destroyed by years of civil and regional conflict

KINSHASA, 1 August (PLUSNEWS) - After years of conflict, the Democratic Republic of Congo (DRC) is now faced with a new challenge: to prevent the number of HIV infections from escalating to those in neighbouring countries.

According to the national AIDS programme (PNLS), there were about 1.2 million HIV-positive people in the country in 2005, about four percent of the population.

Although the HIV prevalence rate appears to have been stable for the last 10 years, health experts have noted that stabilisation can disguise the worst phase of the epidemic, when roughly the same number of people is being newly infected as is dying of AIDS. An estimated 100,000 people died from AIDS-related conditions in 2005, when there were around 155,000 new HIV infections.

"I do not believe that the epidemic is stabilising - on the contrary, it is more likely that there will be a very active and even very explosive epidemic," cautioned UNAIDS country coordinator Pierre Somse.

Most health infrastructure has been destroyed by years of civil and regional conflict in a country the size of Western Europe, yet which has only a few hundred kilometres of roads.

The PNLS feels the HIV infection rate could be higher in rural areas, which "have been the worst affected by the conflict, population movement, soldiers and by violence, especially sexual violence, from which the inhabitants of these areas have suffered, [where] ignorance about the epidemic is the greatest and where access to health care is the most difficult to obtain".

Peace, the opening up of the country, and the first democratic elections since 1960 could bring a surge in prevalence figures. "One of the repercussions of peace could well be the risk of spreading HIV if there is not a vigorous reaction," Somse commented.

The government will also have to deal with a legacy of widespread sexual abuse of women, often used as a weapon of war: the PNLS has found that 20 percent of rape survivors are HIV positive.

Dr Jo Bakualaufu Ntumba, who works with AMACONGO, an AIDS NGO that supports more than 8,000 orphans and vulnerable children and their families throughout the country, believes the state should be playing a far greater role in responding to the pandemic.

The sheer size of the DRC - 2.5 million square kilometres bordering nine countries - has made it even more difficult to address HIV/AIDS. "We are victims of the size of our country. The government is far from those it governs. In the [southeastern] province of Katanga, for example, Kalémie [town in the north of the province] is 1,000 kilometres from the provincial capital, Lubumbashi."

Nevertheless, financial resources are slowly trickling into the country. almost two years ago in 2004,, the DRC received a US$113 million HIV/AIDS grant from the Global Fund to fight AIDS, Tuberculosis and Malaria, spread over five years, and will also benefit from US$102 million in World Bank financing between 2005 and 2009.

The money has been used to launch condom distribution programmes, provide free antiretrovirals (ARVs) in several parts of the country, and tackle the inadequate capacity in the healthcare sector. About 13,000 HIV-positive people were on ARVs in March 2006, but the PNLS said an estimated 200,000 were still in need of the medication.

At the end of 2005, 73 sites, 28 of them public facilities, were distributing ARVs in just seven of the country's 515 health areas, mostly in urban centres. "The fight needs a lot of money and there is not enough," PNLS director Dr Augustin Okenge told PlusNews.

NGOs complain that the national strategic AIDS plan, drawn up in 1999 to cover the following nine years, has become obsolete and, consequently, most HIV/AIDS interventions are unevenly distributed and largely benefit urban areas.

A new monitoring body has been set up to coordinate HIV/AIDS efforts, with a '2006 roadmap' to update the strategic plan.

"Everyone sees AIDS as his own affair," said Pierre Somse. "The coordination is still not very good, but it seems to be improving."

//This is part of series of reports on AIDS and communities in crisis by IRIN's HIV/AIDS news service, PlusNews. www.plusnews.org //


Recent DRC Reports
Help and justice for raped, displaced women,  1/Aug/06
ARV distribution hindered by the war,  4/Mar/05
Help victims of sexual violence among expelled Congolese, OCHA says,  28/Apr/04
Government, University of North Carolina sign technical agreement,  14/Apr/04
US official in pledge for more aid to combat HIV/AIDS,  16/Mar/04
· AIDS Media Center
· The Global Fund to fight AIDS, Tuberculosis & Malaria
· International Community of Women Living with HIV/AIDS
· International HIV/AIDS Alliance

PlusNews does not take responsibility for info in links supplied.

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