As heads of the world's major humanitarian agencies1,2
, we call on the international community to respond appropriately to the human tragedy now unfolding in Southern Africa. While the world's attention is currently gripped by events in other regions, Africa is in crisis with thousands of people dying silently each day. While exact figures of morbidity and mortality are difficult to gauge, all indications point towards nothing short of a decimation of populations in their most productive years, and the prospect of economic collapse and insecurity in the foreseeable future. The disease is now hitting women the hardest. It is the war against further, preventable deaths that must now be waged in Africa.
Famine is but one symptom of a crisis that has been exacerbated by the scourge of AIDS and increasing poverty. The concomitant collapse of health and social services considerably increases the death toll amongst those suffering from common and easily treated diseases like diarrhoea, malaria, pneumonia and tuberculosis. The compounded impact of HIV/AIDS and mentioned factors is rapidly eroding the coping strategies used by communities to survive and destroying human capital necessary for the recovery from frequent drought and natural disasters. AIDS kills young adults, especially women, who are the backbone of their families and communities. It leaves behind orphans in large numbers with few prospects for a healthy future. Entire communities are collapsing under the strain of caring for the ill while maintaining productive livelihoods. Problems in governance, lack of appropriate agricultural policies and pervasiveness of poverty all contribute towards compounding the effects of the severe drought.
Without a massive infusion of money and a greatly expanded effort by the affected countries in collaboration with the international community, the future prospects for the 60 million people living in Southern Africa hold little hope. Unless prompt and decisive action is taken now, it is estimated that, just due to HIV/AIDS 20 % of the adult population will die prematurely. This number will definitely increase with the combined impact of food shortage, malnutrition and weakened health services.
We are committed to redoubling our individual and joint agency responses to promote a comprehensive, multi-faceted approach to this unprecedented crisis. The response must combine food assistance and new approaches to farming, along with prevention and treatment of HIV/AIDS.
The following essential elements must be pursued in tandem:
- Ensuring the timely and effective delivery of adequate amounts of appropriate and nutritious food to identified vulnerable groups.
- Improving access to safe drinking water in ways that take account of needs of people living with and affected by HIV/AIDS.
- Strengthening health services that tackle common illnesses including malaria, tuberculosis, and vaccine preventable diseases and providing comprehensive reproductive health care-including management of sexually-transmitted infections.
- Ensuring equal access to health care and medicines to manage people with HIV and AIDS.
- Making HIV rapid testing easily available on request to individuals and couples and providing advice and support for those choosing to live openly and responsibly with HIV/AIDS.
- Providing means to prevent transmission of HIV, including transmission from mother to child, by ensuring universal access to HIV/AIDS related information, testing and counselling, goods and services including male and female condoms, clean needles and gloves, safe blood transfusions and medicines.
- Protecting women and young people against exploitation and sexual violence.
- Helping communities cope with large numbers of chronically ill people, young people and those orphaned by AIDS through strengthening of social support and volunteer groups.
- Promoting cost-effective and sustainable labour-saving agricultural practices.
- Incorporating HIV considerations into all sectoral responses to the crisis.
We, the heads of agencies, call for a concerted effort by the affected governments, donor governments and humanitarian and development agencies to:
- Encourage leaders to adopt policies and strategies for the prevention and treatment of HIV/AIDS that reach all segments of the population with particular focus on vulnerable groups, women, refugees and internally displaced persons.
- Raise awareness of the links between HIV/AIDS epidemic and famine.
- Encourage access to HIV/AIDS treatment, including anti-retroviral drugs for those infected with HIV, as feasible.
- Promote the human rights of people living with and affected by HIV/AIDS including through strategies to combat stigma and discrimination.
- Consider incentives to encourage essential personnel to work in area of HIV/AIDS treatment and prevention including salary supplements and access to HIV transmission prevention methods and AIDS care.
- Support Government policies that encourage good governance, sound agricultural approaches and equitable sustainable development.
We welcome the joint mission this month to the Southern African region by Mr. James Morris, Special Envoy of the Secretary-General for Humanitarian Needs in Southern Africa, accompanied by Mr. Stephen Lewis, Special Envoy of the Secretary-General for HIV/AIDS in Africa. The mission will consult widely with humanitarian and development agencies to determine how best the United Nations system and international community can assist those at risk, especially women. It will also examine strategies to support Governments in the region in their efforts to address structural weaknesses in the provision of social services.
AIDS is changing the fundamental approach to emergency assistance and its effectiveness in Africa. Failure to adjust the international response will waste scarce resources and cost millions of lives. The continent will need many decades to recover.
The struggle against preventable deaths requires resources. The heads of agencies remind the international community that good will alone will not save lives. Let us not turn our heads away and become tacit accomplices in an otherwise preventable tragedy.
Footnotes:
* Several Catholic Agencies who are members of either/both ICVA and the SCHR wish to be disassociated with the statement.
- This statement is supported by the heads of the agencies represented in the Inter-Agency Standing Committee (IASC) and UNAIDS. IASC is comprised of both members (FAO, OCHA, UNDP, UNFPA, UNICEF, UNHCR, WFP, WHO) and standing invitees (ICRC, ICVA, IFRC, InterAction, IOM, SCHR, RSG/IDPs, UNHCHR, and the World Bank).
- As Standing Invitee, the ICRC keeps its independence towards policy statements issued by the IASC and its subsidiary bodies.
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