Message of the WHO Regional Director for Africa Dr. Luis G. Sambo, on the Occasion of World Aids Day 2008

Ladies and Gentlemen,

Today we commemorate the World AIDS Day 2008 which is the 20th such commemoration since its launch by the World Health Organization in 1988. As in 2007, the theme for this year is "Leadership: Stop AIDS, Keep the Promise".
This global theme is of particular importance to sub-Saharan Africa, the Region hardest hit
by the HIV/AIDS epidemic, accounting for more than two-thirds (67%) of all new HIV infections worldwide and for three-quarters (75%) of all AIDS cases in 2007. We also note with deep concern that an estimated 1.9 million new HIV infections occurred in sub-Saharan Africa in 2007.

Despite the encouraging signs that the epidemic is stabilizing and even declining in some countries in the Region, new infections continue to occur at alarming rate in the majority of countries. Southern Africa remains most severely affected in the Region, with as many as one in four adults living with HIV in many of its communities, and with women and girls being more affected. HIV/AIDS is therefore a serious developmental challenge, and we have to redouble our efforts in order to confront it adequately.

Access to antiretroviral therapy is increasing in sub-Saharan Africa where coverage of antiretroviral treatment rose from 21% in 2006 to 30% in 2007. Despite this progress, more than two-thirds of people in need of antiretroviral treatment in sub-Saharan Africa still lack access and the scale up of treatment is facing increasing challenges such as poor treatment compliance, stock outs of antiretroviral medicines, limited access and resistance to first-line regimens.

The momentum for accelerated HIV prevention is high. Coverage for prevention of mother-to-child transmission of HIV increased from 9% in 2004 to 34% in 2007, with subregional variations ranging from 11% in Western and Central Africa to 43% in Eastern and Southern Africa. In addition, the availability of HIV testing and counseling services in health facilities increased substantially between 2006 and 2007, and more and more countries are implementing innovative approaches to increase access to HIV testing and counseling. Although this is very encouraging, much more remain to be done, especially to address the needs of Mostat-Risk Populations including sex workers and their clients, drug users, prisoners and men who have sex with men.

Ladies and gentlemen,

These achievements became possible thanks to the increasing political commitment of leaders in the Region, the active involvement of communities themselves and the increased availability of financial resources. However, although significant resources have been allocated to HIV/AIDS response in recent years, countries continue to face a number of challenges in expanding and sustaining response to this pandemic. Weak health systems, critical shortage of human resources and lack of sustainable financing are critical challenges that need to be addressed.

As we reflect on the theme for World AIDS Day 2008, I would like to call upon decision makers at all levels of the health sector to fully exercise leadership bearing in mind that:
1. There is need for more strategic HIV/AIDS programming in order to make a greater impact. We must implement a combination of evidence-based strategies and interventions suited to local epidemiological contexts;
2. HIV/AIDS prevention and treatment have to be scaled up simultaneously in order to make the desired impact. The AIDS epidemic cannot be reversed, and universal access to ARV treatment cannot be achieved, unless more progress is made in reducing the rate of new HIV infections;
3. HIV testing and counseling is an entry point to HIV/AIDS prevention, treatment and care. Every effort must therefore be made to ensure that HIV testing and counseling services are routinely provided to all. In addition, couple counseling should be given much more emphasis;
4. As is already known multiple concurrent heterosexual partnerships remain the main driver of the HIV/AIDS epidemic in sub-Saharan Africa. That underscores the need to further strengthen safe sex counseling within the heath sector, using all points of contact with clients. However, we should remember that in settings of concentrated epidemics, injection drug use and unsafe sex between men who have sex with men are major factors of HIV transmission.

Ladies and gentlemen,

I would like to call upon the health sector to step up its pivotal role in providing response to HIV/AIDS. Other sectors also need to be mobilized to contribute towards health system strengthening. I would like, at this stage, to acknowledge the excellent working relations that have existed within the United Nations system in sub-Saharan Africa, and to thank all health development partners who are steadfastly supporting the scaling up of HIV/AIDS interventions.

More and more partners realize that the strengthening of health systems is crucial to defeat the HIV/AIDS scourge.
In order to halt and begin to reverse the spread of HIV/AIDS in all countries by 2015, the
intensity of our actions has to match or even surpass the intensity of the epidemic. Let us accelerate the pace! Let us do much more! And let us keep the promise!

I thank you.