AFRICA: Interview with Michel Sidibe of UNAIDS
[ This report does not necessarily reflect the views of the United Nations]
MAPUTO, 2 April (PLUSNEWS) - Michel Sidibé is the director of the Department of Country and Regional Support at UNAIDS. He is also a member of the Commission on HIV/AIDS and Governance in Africa, established by UN Secretary-General Kofi Annan to offer analysis and recommendations on the pandemic to political leaders. He spoke to PlusNews about the challenges facing African governments and societies.
QUESTION: You have said that African governments have reacted slowly to the HIV/AIDS epidemic, can you comment?
A: Certainly. It's a serious challenge we're facing today. This epidemic has been growing unchecked, except for in a few African countries, where we have been able to see that the leaders' commitment has been translated into reforms: they have put enabling policies in place; they have reviewed budget allocations, making sure that the services will work for the poor; they are trying to build a bridge between civil society and government, so that they can expand alternative services delivery, but in most countries [in Africa] it didn't happen.
Q: What key policies should be in place, and how do you think we can get more commitment from the other governments to put them in place?
A: The governments need to address the capacity gap; they need to look at the reform of the labour market; they need to look at civil service salaries and all those things that can motivate them [civil servants]. But this change cannot come about without a change in donor policies. Over the years, most donor assistance has been underplaying human capital, and considering it as recurrent costs. So we have a dual lack of commitment: African governments have not put enough resources into human capital development, but neither has the whole donor assistance policy looked at human capacity development.
Today we have heard about the new resources that are coming into some African countries [for AIDS programmes], but the state's capacity to deliver is not there. My view is that we need to review the whole policy on how to make states function differently, and how to link with civil society.
The next point is very serious. We [in Africa] are in a situation, more and more, where we are looking outside for our solutions. This has been happening for many years. I am convinced that the world needs to be ashamed of the lack of global solidarity and the imbalance between the richer and poorer countries, especially the lack of access to treatment in Africa, the continent where we have the highest infection rates and most affected people. This is not acceptable. At the same time, we [Africans] need to question our own commitment. We are investing [hundreds of] billions in defence spending when we know that we need [tens of] billions to fight HIV/AIDS. What does that mean when we are setting priorities for the poorest parts of our society? What political choices are we making?
Q: Do you think, then, that the Commission on HIV/AIDS and Governance in Africa has the power to make governments more accountable?
A: The commission is like many commissions, except, it is playing in areas that are very sensitive. So in that sense it should see itself as an activist type of commission; in the sense that they are looking at areas where there are gaps, in terms of the commitment of leaders, and [the commission] should make sure [those findings are communicated] to the different sectors of society.
I think the commission can use the opportunity to come out with a league table, which shows the country with the least amount of commitment in different areas, and can push these countries to see themselves as part of some kind of healthy competition.
Q: Do you think this a realistic idea?
A: Yes, I think this was an idea coming up in our discussions [the commission met for the second time in Maputo 23 to 25 March 2004); it is an idea that is coming out more and more. It is not the time anymore to just produce reports about this [HIV/AIDS epidemic]; now we must try to mobilise the political leaderships in the countries; now is the time to translate our knowledge into action, pushing the leaders to go for implementation and expanding existing action.
Q: For example?
A: For example, on the African continent only 50 percent of the countries have some kind of legislation for people living with HIV/AIDS. The commission can make a list of the countries that don't have it.
Q: Where in Africa do you feel there is the political will, vis-a-vis the unrolling of ARV programmes? Mozambique seems to be one of those countries in the lead in terms of political will, is that so?
A: That is true. I think Mozambique's leaders have a clearer treatment plan and are building a good partnership with civil society; they are trying to look at alternative approaches to make sure more people have access to treatment - but the challenge remains the same. How can what we're providing today, be sustainable? If you put someone on treatment, then you should be prepared to look at treating him or her for at least 20 years. That must not stop. We must review our systems and projects in light of that person's right to be under treatment - it is not enough to think that just because we have some funds from outside, we will go ahead and see what happens later.
Q: There is a humanitarian crisis in some countries on the continent. In Mozambique, for example, there has been erratic weather, widespread absolute poverty and the HIV/AIDS epidemic. How can governments address all this together?
A: These are pertinent issues. The UN Secretary-General asked us to finalise a report on the link between governance, HIV/AIDS and food security. It is very clear that they are interlinked. When you have human capacity already weakened by HIV/AIDS, you have an increase in the death rate, and knowledge and skills are not passed down. And women are the ones, primarily, who are affected the most, and they are the ones involved more in agriculture, so that will have an impact on food security.
We need to find a system that provides opportunities for [economic] growth and re-distribution; we need to extend opportunities to people to maintain higher agricultural output, otherwise it will be a problem for the society generally, and will be a problem for the unrolling of the drug programme. There are people who are sick and don't have food. We cannot continue to maintain this artificial divide between developmental activity and emergency: HIV/AIDS is showing us that. We need to find a mechanism which can act on both [levels] at the same time.
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