COTE D IVOIRE: Addressing HIV/AIDS in a country in crisis
[This report does not necessarily reflect the views of the United Nations]
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Pauline Bax/IRIN
The conflict has thrown HIV/AIDS programmes into disarray
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ABIDJAN, 7 July (PLUSNEWS) - The political and military crisis in Cote d'Ivoire has thrown its HIV/AIDS programmes into disarray, prompting a UN official to warn that a plan for tackling one of the country's leading causes of death is urgently needed.
In an interview with PlusNews, Awa Diawara, head of UNAIDS in Cote d'Ivoire, stressed the need for a policy to address critical staff shortages in the health system.
According to a joint study in 2005 by the Swiss Centre for Scientific Research and the University of Abidjan, after the outbreak of conflict in 2002, healthcare workers fled and health facilities shut down in the north of the country, accelerating the spread of the disease.
A country progress report prepared for the recent UN High-Level Meeting on HIV/AIDS acknowledged that HIV/AIDS activities had ceased in the northern and western parts of the country, there was an increase in cases of physical and sexual violence as a result of the crisis, and prevention programmes and the care of people living with HIV/AIDS had declined or come to a halt.
Education campaigns used for preventing the spread of HIV/AIDS before the conflict broke out were no longer suitable, Diawara said. "In a crisis situation people have other priorities: they have to find shelter, food and health coverage. How can one send messages taking this into account?"
Officials working on a strategic AIDS plan for 2006-2010 were hoping to provide antiretroviral (ARV) medication to about 22,000 adults and 2 percent of the country's HIV-positive children by May 2006.
But it has been an uphill battle: the national care programme was interrupted in the areas under rebel control between 2002 and 2005, and people have only been able to start accessing ARVs since April last year. "How many people are really cared for, how many receive treatment? We do not know," Diawara commented.
The goal for health officials now is to make sure that 90 percent of those in need of the life-prolonging medication are receiving it by 2010, according to the strategic framework. Diawara said this might be possible with better and more transparent use of finances.
The US President's Emergency Plan for AIDS Relief (PEPFAR) and the Global Fund to fight AIDS, Tuberculosis and Malaria are the principal donors in Cote d'Ivoire, but a recent suspension of the second tranche of Global Fund money for 2004-2009 could make reaching this treatment target even more difficult.
Not only was there little data on how many people were on ARVs, but Diawara also noted that not enough information had been collected on the number of HIV-positive people in the country.
UNAIDS has estimated that the national HIV prevalence rate was 7.1 percent in 2005, but pointed out the difficulties of gathering updated data in its 2006 Report on the Global Epidemic.
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