By Samuel Mungadze
A NATIONAL Strategic Plan for HIV, tuberculous (TB) and sexually transmitted infections has been adopted on Friday, during South African National Aids Council (Sanac) meeting in Secunda, Mpumalanga, which was chaired by Deputy President Kgalema Motlanthe.
The National Strategic Plan has a target to have 3-million people on antiretroviral (ARV) treatment by 2015. South Africa currently has 1.9-million people on treatment.
The plan also aims to eliminate the transmission of HIV infection from mother to child by 2015 and to reduce AIDS-related maternal deaths. The country has in the recent past seen significant changes in the rate of mother-to-child HIV transmission.
Between 2008 and 2012, the rate of mother-to-child HIV transmission dropped from 8% to 2.7%. There was a leap in the percentage of HIV-infected women receiving ARV therapy between 2011 and 2012, from 87.3 % to 99%.
Similarly, 99 % of all infants born to HIV-infected women receive prophylactic ARV medication to reduce the risk of early mother-to-child HIV transmission in the first six weeks.
In this plan “Sanac aims to reduce TB incidence and mortality caused by TB in people living with HIV by 50 % in 2015″, read the statement from the council.
Sanac also approved plans to launch an HIV prevention programme aimed at sex workers. Details of the project were, however, not released with the council saying it would do so closer to the launch.
The National Strategic Plan is one of the many plans the government is implementing. Early, this month, Health Minister Aaron Motsoaledi announced the introduction of fixed-drug combination ARV therapy.
Patients living with both HIV and TB, have started being treated on the new therapy.
Fixed-drug combination therapy is a combination of three crucial antiretroviral medications in one tablet, taken only once a day.
This eliminates the need for patients to take three or more pills at various intervals per day.
19 April 2013
From the Business Day Live
By Daniel Wasonga
Non-communicable diseases (NCDs) are not passed from person to person, and include those such as cancer, diabetes and hypertension. They may be of long duration and slow in progression, or in some instances, result in rapid death. NCDs are categorized mostly by their non-infectious causes and not their duration. Like all diseases that develop slowly and worsen over a long period of time, NCDs require chronic care management.
Expectant mothers, especially those beyond the first 42 days, are uniquely vulnerable to NCDs and require proper maternal care at home or in healthcare facilities. Exposure of these women to any disease is detrimental to their health and that of their unborn babies. Chronic diseases increase the health risks of expectant mothers and without adequate care, maternal mortality will rise beyond the current undesirable levels, especially in the developing economies.
NCDs disproportionately affect the low and middle income countries, where 80% (29 million) of deaths related to these diseases occur. Women in general already bear the burdens of NCDs, which are compounded by myths and misconceptions. Social and cultural taboos often prohibit women from opening up about issues such as family planning and unwanted pregnancies, which impairs the few efforts being made at improving these conditions. Furthermore, the constant “blame game” has not really helped in bringing stakeholders together in finding solutions for the specific issue of maternal mortality related to NCDs.
The cost of treatment is high. For expectant mothers who are the sole breadwinners in their households, getting proper care for NCDs may be difficult. This is especially the case in Africa, where cancer, cardiovascular disease, chronic respiratory disease and diabetes are leading causes of death in women. Worldwide, these diseases kill 18 million women yearly.
The impact of these diseases on society as a whole is enormous – maternal mortality goes beyond its consequences on individuals. The loss of women who are at their prime would leave an economic and social gap in society. Ignoring this aspect of the link between maternal mortality and NCDs is a mistake our decision makers and policy formulators should not make.
The overwhelming emphasis on reproductive and maternal health has pushed the special focus on NCDs to the periphery, an approach that is not effective. Maternal mortality remains the least achieved of the Millennium Development Goals (MDGs) and multi-faceted solutions promise better returns. A comprehensive approach to women’s health that goes beyond the maternal focus is essential and much more sensible. The current interventions are too rigid and limited to the MDGs with little or no focus on post-MDG initiatives.
Although some achievements have been made in Africa on reversing maternal mortality, the progress has been limited and unequally distributed within and among countries. The upcoming Conference of African Ministers of Health should focus on compounding the gains made within countries and ensuring there is no disconnect between government and initiatives taken at the grassroots level. In the push towards achieving the MDGs, Africa needs renewed commitments from the governments and feasible, effective monitoring and evaluation mechanisms. Best interventions should also be shared between countries to underline the collective efforts in eradicating maternal mortality.
23 April 2013
After the March 2013 launch of AAI’s Country Coordinating Mechanisms (CCMs) Community Consultation Report entitled “Who is really affecting the Global Fund decision making process?” AAI has begun conducting advocacy around the findings. The objective is to use the research as an accountability tool, acting as a best-practice and gaps analysis evidence base for improving the meaningful participation processes of women, girls and those marginalized by their sexual orientation in Global Fund processes.
Download the full report: Who is really affecting the Global Fund decision making processes? A Community Consultation Report
Download the survey report: Who is really affecting the Global Fund decision making processes? A Quantitative Analysis of CCMs
Download the media release: AIDS Accountability International on the Global Fund
To achieve this, AAI conducted its Global Fund Advocacy Week at the Global Fund Secretariat in Geneva, Switzerland, from 15-19 April 2013, since engaging Fund Portfolio Managers and Senior Technical Advisors on gender and key populations is critical for holding both the CCMs and the Global Fund Secretariat accountable for their obligations to marginalized populations. AAI also endeavoured to connect with other partners in Geneva, such as the World Young Women’s Christian Association (World YWCA), the International Labour Organization (ILO) along with funding partners and independent stakeholders.
On Monday 15 April 2013, AAI began its Global Fund Advocacy Week in Geneva by meeting with Nyaradzayi Gumbonzvanda (General Secretary) and Hendrica Okondo (Global Programme Manager SRHR & HIV Focal Point for Africa) at the World Young Women’s Christian Association (World YWCA). The discussion focused on reducing the distance for dialogue between young girls and policy makers, creating spaces of “conversational accountability” and “intergenerational dialogues” so that young girls can have the opportunity to engage with decision makers, but in less technical forums. Leadership was also a topic of strategic thinking, with AAI and the YWCA brainstorming around how to redefine leadership so that it does not rest on the pillars of education or income.
The following day, AAI met with a team of senior technical specialists at the Global Fund Secretariat. Speaking with Linda Mafu (Head, Political and Civil Society Department), Sara Davis (Senior Specialist in Human Rights and Equity), Motoko Seko (Gender and Human Rights Specialist) and Mauro Guarinieri (Senior Advisor, Community Systems Strengthening and Civil Society), AAI pushed for greater accountability towards Human Rights in Global Fund processes. It was agreed during the meeting that viewing human rights through a public health lens can often be highly effective in certain contexts where the rights and women, girls and LGBT people can be politically and culturally sensitive. This supports the research findings in AAI’s CCM Report. AAI and the Global Fund also discussed the new CCM guidelines (2010) which say that CCMs should demonstrate effort to include key affected populations in the country dialogue process. In terms of the way forward, it was raised that Fund Portfolio Managers might benefit from capacity building on how to engage better with civil society outside of the CCM, as well as on human rights and key populations issues.
Continuing with Global Fund Advocacy Week, AAI met with two Fund Portfolio Managers (FPMs), Richard Cunliffe (Botswana, Swaziland) and Viviane Hughes-Lanier (Niger). At these two meetings, AAI consulted with the FPMs about how best to strengthen Africa’s CCMs through improved participation of marginalized groups. The result was a recommendation from the Secretariat to build the capacity of civil society to become principal or sub-recipients, train key populations CCM members on how to influence a meeting, and train the CCM Chairs and Co-Chairs on how to run a meeting that includes discussions of strategic thinking around human rights considerations.
At the end of the week, solid plans had been made to move forward with the project in a manner that continues to involve the Secretariat in Geneva. This way, AAI can increase its impact in pushing for greater accountability to women, girls and SOGI groups from both the CCMs in country, and the FPMs and Technical Specialists at the Global Fund in Geneva.
SIGN-ON! Civil Society African Common Position Paper on The International Conference on Population Development.
This section provides recommendations that addresses key matters that affect gender equality, equity and empowerment for all
- Persons with disabilities,
- Lesbian, Gay, Bisexual, Transgender and Intersex Persons (LGBTI),
- Persons living with HIV (PLHIV),
- Older persons,
- Orphans, and
- Migrant populations.
6.1. Gender Equality, Equity and Empowerment of all women
6.1.1. Ensure human rights based approach and that women’s and girl’s perspectives and rights are observed in all national SRHR policies and laws, and that all legal and institutional barriers to women realising full equality, equity and empowerment are removed as a matter of urgency,
6.1.2. To advocate for comprehensive societal affirmative action that promotes gender equity and equality in all spheres of life, including in the labour market. This includes addressing all policies that do not favour the ability of women to engage successfully in socio-economic activities, as well as committing to and financing the economic, political and social empowerment of women and girls through deliberate national programs which also include increasing women’s access to capital, land and credit facilities,
6.1.3. Continuous development and implementation of effective monitoring and evaluation mechanisms that aimed at evaluating progress toward national gender programmes, including but not limited to the improvement of data quality collection and analysis.
6.1.4. Ensure that there is creation and implementation of the legal and institutional framework that protects the rights of woman and young girls from harmful traditional practices such as inability to inherit and Female Genital Mutilation (FGM).
6.1.5. Commit to addressing the definition of gender which is currently limited to the binary of male and female which excludes different identities. Therefore, there must be the promotion of a comprehensive and all inclusive definition so as to support the equality of all women regardless of sexual orientation or gender identity,
6.1.6. Create platforms for continuous, comprehensive, consultative, capacity building for all stakeholders including Civil Society Organisations (CSOs) on gender and its role within SRHR,
6.1.7. Provide quality education, including comprehensive sexuality and life skills education at early levels for all children to promote empowerment of both girls and boys as a means to promoting equality, equity and empowerment and ensuring boys and men also play a role in realising equality for women,
6.1.8. Expand decision-making opportunities for women by ensuring their meaningful participation in all stages of design, monitoring and implementation of sexual and reproductive rights policies and programs at national, regional and international levels.
6.2. Persons with Disabilities
6.2.1. Ensure the development, implementation and financing of policy and strategies that eradicate all discriminatory practices against persons with disabilities and protect the rights of persons living with disabilities;
6.2.2. Meaningful engagement of persons with disabilities at policy and implementation level in order to develop non-discriminatory and comprehensive programs that are inclusive of their SRHR needs;
6.2.3. Create deliberate policy and implementation plans that address the sexual and reproductive health needs of persons living with disabilities and ensure universal access to accessible, acceptable, affordable and quality SRHR services, information and commodities whilst ensuring respect for persons with disabilities privacy and confidentiality in accessing services, and their capacity to make free and informed choices regarding their sexual and reproductive lives from childhood to old age in all their diversity;
6.2.4. Continuous development and implementation of effective monitoring and evaluation mechanisms that aimed at evaluating progress toward national gender programmes, including but not limited to the improvement of data quality collection and analysis;
6.2.5. Embark on awareness campaign programmes to dispel myths and misconceptions about the sexual and reproductive needs of people with disabilities and ensure that persons living with disabilities also enjoy healthy and fulfilling sexual lives;
6.2.6. Ensure the empowerment of persons living with disabilities by creating opportunities for economic development and self- reliance. Provide more possibilities for employment, credit facilities and land;
6.2.7. Create strategies that ensure the protection of women and girls living with disabilities against intimate partner violence and sexual violence;
6.2.8. Engage private and public structures to ensure that implementation of the regulations on the rights of persons with disabilities are fully adhered to;
6.2.9. Train health care workers on disability related health care, including service provision that is free from stigma, coercion, discrimination and violence, based on full and informed consent, and that affirms the right to pleasure.
6.3. Youth (including pre-adolescents)
6.3.1. Ensure that all aspects of the Convention on the Rights of the Child are recognised and implemented including the protection from child marriage and other forms of harmful practices as well as promote and implement laws, policies and programs that eliminate harmful practices such as early and forced marriage, rape, sexual and gender based violence, female genital mutilation, honor killings, and all other forms of violence against adolescents and youth;
6.3.2. Ensure that investments in health (including sexual and reproductive health), jobs, education and skills in youth development are made to position Africa to reap the rewards from the imminent demographic dividend;
6.3.3. Increase empirical evidence on how to address youth and pre-adolescent issues by strengthening research in academic institutions and greater inclusion of youth in the design, monitoring and implementation of policy, programming and implementation;
6.3.4. Ensure that cultural and religious barriers such as parental and spousal consent, and early and forced marriages, should never prevent access to family planning, safe and legal abortion, and other reproductive health services – recognizing that young people have autonomy over their own bodies, pleasures, and desires.
6.3.5. Provide quality education, including comprehensive sexuality and life skills education at early levels for all children to promote empowerment of both girls and boys as a means to promoting equality, equity and empowerment and ensuring boys also play a role in realising equality for girls; as well as remove any and all barriers to accessing quality education and ensure recognition, strengthening and utilisation of ICT in adolescents’ and youth development;
6.3.6. Create and sustain comprehensive, objective, and accurate sexuality education and information that is accessible and affirming for all children and youth in and out of schools, that includes but is not limited to the promotion of sexual and reproductive rights, gender equality, self-empowerment, knowledge of the body, bodily integrity and autonomy, and relationship skills development; are free of gender stereotypes, discrimination, and stigma; and are respectful of children’s and adolescents’ evolving capacities to make choices about their sexual and reproductive lives.
6.3.7. Prioritize sexual and reproductive rights issues in health systems strengthening and development programs so that integrated, high-quality services are available, accessible, and acceptable to all young people, particularly those most underserved. These services include but are not limited to comprehensive information on sexuality and contraception services and supplies (including emergency contraception, post exposure prophylaxis, male and female condoms); pregnancy care (antenatal and post natal care, skilled birth attendance, referral systems, and emergency obstetric care); safe abortion services and post-abortion care; access to assisted reproductive technologies; prevention, treatment, and care of sexually transmitted infections and HIV; prevention, treatment and care of reproductive cancers.
6.3.8. Greater recognition on the need for psychosocial support for adolescents and youth especially those in conflict areas;
6.3.9. Recognise and provide for the increased need for provision of SRH services and commodities in conflict and post conflict areas, where education of sexual and reproductive rights in post conflict regions must be aimed at reducing gender-based violence;
6.3.10. Protect young people’s human rights in sexual and reproductive health programs by guaranteeing that services are designed to respond to individual’s health needs and overcome barriers faced by marginalized groups, including through service provision that is free from stigma, coercion, discrimination and violence, based on full and informed consent, and that affirms the right to pleasure.
6.3.11. Ensure that programs show respect for adolescents’ and young peoples’ privacy and confidentiality in accessing services, and their capacity to make free and informed choices regarding their sexual and reproductive lives including parenthood, from childhood to old age in all their diversity; and pay special attention to marginalized groups of adolescents and young people, including those with disabilities, living with HIV and AIDS, and of all sexual orientations and gender identities as well as those in conflict areas;
6.3.12. Ensure routine monitoring of potential disparities in universal access to sexual and reproductive health information and services for adolescent and young people through regular collection and analysis of quality data;
6.3.13. Decriminalize abortion, and create and implement policies and programs that ensure young women have access to safe and legal abortion, pre- and post-abortion services, without mandatory waiting periods, requirements for parental and spousal notification and/or consent or age of consent.
6.4. Lesbian, Gay, Bisexual, Transgender and Intersex (LGBTI) persons
6.4.1. Ensure human rights based approach and that lesbian, gay, bisexual, transgender and intersex persons perspectives and rights are observed in all national SRHR policies and laws, and that all legal and institutional barriers to LGBTI realising full equality, equity and empowerment are removed as a matter of urgency;
6.4.2. Ensure that the right to health, especially SRHR, is made available to all people regardless of sexual orientation or gender identity and that services are provided by sensitized and trained health care workers who provide health care that is free from stigma, coercion, discrimination and violence, based on full and informed consent, and that affirms the right to pleasure and privacy and confidentiality;
6.4.3. Increase empirical evidence on how to address LGBTI specific issues by strengthening research in academic institutions and greater inclusion of LGBTI in the design, monitoring and implementation of policy, programming and implementation;
6.4.4. Create deliberate policy and implementation plans that address the needs of sexual minorities as a necessary element to ensure universal access to quality SRHR services and commodities that are affordable, accessible and acceptable;
6.4.5. Ensure that there are national strategies and legislation to reduce stigma and discrimination toward LGBTI, and ensure the enforcement of these laws in accessing services and information;
6.4.6. Continuous development and implementation of effective monitoring and evaluation mechanisms that aimed at evaluating progress toward programmes aimed at providing human rights based equality, equity and empowerment of all people regardless of their sexual orientation or gender identity, including but not limited to the improvement of data quality collection and analysis.
6.5. Persons living with HIV (PLHIV)
6.5.1. Ensure human rights based approach and that perspectives and rights of people living with HIV are observed in all national SRHR policies and laws, and that all legal and institutional barriers to PLHIV realising full equality, equity and empowerment are removed as a matter of urgency;
6.5.2. Ensure that the right to health, especially SRHR, is made available to all people living with HIV and that services are provided by sensitized and trained health care workers who provide health care that is free from stigma, coercion, discrimination and violence, based on full and informed consent, and that affirms the right to pleasure and privacy and confidentiality;
6.5.3. Ensure routine monitoring of potential disparities in universal access to sexual and reproductive health information and services for people living with HIV through regular collection and analysis of quality data;
6.5.4. Create an enabling legal environment that will encourage pregnant women to under-go HIV testing, provide treatment care and support and ensure availability of antiretroviral therapy for all HIV pregnant women, especially those in rural areas;
6.5.5. Urgently put in place policy, programming and implementation strategies to ensure prevention of mother to child transmission;
6.5.6. Address HIV-related stigma and discrimination through education and awareness campaign programme;
6.5.7. Promote voluntary HIV counselling and testing in all public hospitals, including primary health care services;
6.5.8. Ensure that HIV prevention services form part of family planning services;
6.5.9. Allocate funds targeted to HIV that protect and empower young people, especially young women. In particular, guarantee funding for the provision of comprehensive sexual and reproductive health services that include comprehensive sexuality education; prevention, counselling, voluntary testing, treatment and care of HIV, as well as other sexually transmitted infections and reproductive cancers; and universal access to female and male condoms, microbicides and other female initiated prevention technologies and vaccines
6.6. Other especially vulnerable persons, including older persons, orphans and vulnerable children and refugees, asylum seekers and internally displaced persons and migrant populations.
6.6.1. Ensure human rights based approach and that perspectives and rights of vulnerable people are observed in all national SRHR policies and laws, and that all legal and institutional barriers to vulnerable people realising full equality, equity and empowerment are removed as a matter of urgency;
6.6.2. Ensure that the right to health, especially SRHR, is made available to all vulnerable people and that services are provided by sensitized and trained health care workers who provide health care that is free from stigma, coercion, discrimination and violence, based on full and informed consent, and that affirms the right to pleasure and privacy and confidentiality;
6.6.3. Ensure routine monitoring of potential disparities in universal access to sexual and reproductive health information and services for vulnrable people through regular collection and analysis of quality data;
6.6.4. Create awareness of the SRHR needs of older persons and develop policies and programmes that respect the sexual and reproductive health needs of older persons and include them in the process of decision-making as well as train health care providers to provide sexual and reproductive health services that are appropriate and acceptable to the needs of older persons;
6.6.5. Create national structures and laws that adequately evaluate andaddress pension payments and other support to older persons, especially those who are abandoned by their families and communities, and streamline the payment of pensions to retirees;
6.6.6. Assist African States interested in establishing support structures for abandoned old persons especially those who are also victims of discrimination (accused of witchcraft or other).
6.6.7. Create and support existing systems and structures which care for orphans and vulnerable children (OVC), ensuring quality services, education and other provisions are made to ensure their human rights are respected;
6.6.8. Ensure the provision of AAAQ SRH services, information and commodities in a timely manner including mental health treatment, care and support for all orphans and vulnerable children;
6.6.9. Facilitate the enactment and implementation of the Convention on the Rights of the Child in all countries to protect children and young people, especially orphans, from all forms of violence and harmful practices including early and forced marriages.
6.6.10. Ensure the provision of comprehensive sexuality education for orphans that promote sexual and reproductive rights, gender equality, self-empowerment, knowledge of the body, bodily integrity and autonomy, and relationship skills development; are free of gender stereotypes discrimination, and stigma; and are respectful of children’s and adolescents’ evolving capacities to make choices about their sexual and reproductive lives;
6.6.11. Guarantee universal access to comprehensive essential sexual and reproductive health services by providing sufficient and sustainable financing to achieve the training, deployment, and retention of necessary health workers; ensure equitable access and good quality services;
6.6.12. Ensure universal access to free (eliminating all forms of levies & user fees at all levels), quality, and comprehensive education at all levels in a safe and participatory environment.
6.6.13. Commit to researching and better understanding the health needs and SRHR needs of refugees, asylum seekers and internally displaced persons and migrant populations and ensure their inclusion in the development of policies, programming and implementation of health care.
6.6.14. Ensure that there are national strategies and legislation to reduce stigma and discrimination toward refugees, asylum seekers and internally displaced persons and migrant populations, and ensure the enforcement of these laws in accessing services and information.
To download the full document click here: AAI AUC Ford Civil Society African Common Position Paper on ICPD 2013 April
SIGN-ON! Civil Society African Common Position Paper on The International Conference on Population Development.
5. Health morbidity & mortality
5.1.1. Renew commitment to reducing maternal mortality and morbidity as a matter of urgency and allocating financial resources to ensure the development and implementation of policy and clear policy guidelines that guarantee universal access to the provision of family planning and contraceptive services , with free or subsidized care for those in need and those most marginalised;
5.1.2. Understand and demonstrate that safe motherhood is a human rights issue and as such needs to be positioned as a key concern in national dialogue on sexual and reproductive health and requires a strong rights approach at all levels of the ministry of health;
5.1.3. Ensure the development and implementation of policy and clear policy guidelines that guarantee universal access to an integrated service package, including but not limited to: mental health care; the provision of SRH services and commodities, improved ante-natal care, and response and care for obstetric emergencies;
5.1.4. Incorporate evidence-based clinical protocols that improve the referral system, strengthen transport and communication networks, promote community mobilization, build bridges between health care providers and social networks, improving the clinical and communication skills of providers at the health care level, improving access to skilled health providers, increasing access to referral services, and prevention of unwanted pregnancy and care of post abortion complications;
5.1.5. Educate and empower women and men to present at health care provider for pre-natal care at an earlier stage of pregnancy and more regularly, as well as to adhere to medical advice to ensure a healthy pregnancy;
5.1.6. Provide, without fear of prosecution, criminalisation, discrimination or intimidation, quality and prompt post abortion care and counselling to women who have undergone unlicensed, incomplete and/or illegal abortions and who require medical attention;
5.1.7. Remove all obstacles, including payment of fees, for women seeking medical attention during pregnancy and ensure free or subsidized care for those in need and those most marginalised especially rural based women;
5.1.8. Research and better understand the role and knowledge of traditional birth attendants and traditional or indigenous medicine and ensure that where applicable the benefits can be maximised and the dangers minimised.
5.2. Child survival and health
5.2.1. Mobilize political leadership to end preventable child deaths as a matter of urgency;
5.2.2. Implement evidence based country plans that sharpen government led action plans, track and sustain progress against 5 year milestones and align development support with national strategies;
5.2.3. Build on mechanisms to monitor and report progress, compile and disseminate annual progress reports, and promote transparency and accountability through regional and global forums;
5.2.4. Ensure the availability and accessibility of immunization services for all children;
5.2.5. Build capacity of parents and caregivers on health issues for children and babies including but not limited to when to seek medical attention, which foods are most nutritious, needs of sero-discordant families, the strengths and weaknesses of breast and bottle feeding, and accessing uncontaminated water for drinking and protecting children from infectious diseases like malaria and pneumonia with vaccines, bed nets, and antibiotics.
5.2.6. Research and better understand the role and knowledge of traditional or indigenous medicine for child survival and health and ensure that where applicable the benefits can be maximised and the dangers minimised.
5.2.7. Provide accessible, affordable, acceptable quality health services and information and support, including mental health services to HIV positive mothers and fathers before, during and after the birth process to ensure the prevention of mother to child transmission of HIV.
5.2.8. Urgently put in place policy, programming and implementation strategies to ensure prevention of mother to child transmission, especially by designing and implementing PMTCT programmes that are directed at community level in terms of applicability, language, local traditions and misconceptions;
5.2.9. Create an enabling legal environment that will encourage pregnant women to under-go HIV testing, provide treatment care and support and ensure availability of antiretroviral therapy for all HIV pregnant women, especially those in rural areas;
5.3. Non-Communicable Diseases
5.3.1. Improve information and research on non-communicable diseases (NCDS) and develop policies and programmes that are up to date and will address the challenges posed by non-communicable disease;
5.3.2. Increase public awareness and education of non-communicable diseases, including life-style, environmental and occupational related NCDs, such as Type 2 diabetes, hypertension (high blood pressure), and cancer and to implement campaigns to use prevention methods as much as possible.
5.3.3. Ensure the better screening and proper management and control of non-communicable diseases by providing timely and AAAQ diagnosis, treatment and information;
5.3.4. Equip health care centres and train health care workers to provide services for complications arising from non-communicable diseases;
5.3.5. Allocate appropriate resources towards address the challenges pose by non-communicable diseases;
5.3.6. Create awareness among people especially those in rural communities on environmental cleanliness.
To download the full document click here: AAI AUC Ford Civil Society African Common Position Paper on ICPD 2013 April
SIGN-ON! Civil Society African Common Position Paper on The International Conference on Population Development.
4. Sexual and Reproductive Health and Rights (SRHR)
4.1.1. Prioritize sexual and reproductive rights in health systems strengthening and development programs so that integrated, high-quality services are available, accessible, and acceptable to all people, especially women and youths, and other marginalised groups as indicated below and particularly those most underserved.
4.1.2. Protect the population’s human rights in sexual and reproductive health programs by guaranteeing that services are designed to respond to individual’s health needs and overcome barriers faced by marginalized groups, including through service provision that is free from stigma, coercion, discrimination and violence, based on full and informed consent, and that affirms the right to pleasure.
4.1.3. Programs must ensure respect for privacy and confidentiality of people in accessing services, and the capacity to make free and informed choices regarding their sexual and reproductive lives from childhood to old age in all their diversity; and pay special attention to marginalized groups.
4.1.4. These services include but are not limited to: comprehensive information on sexuality and contraception services and supplies (including emergency contraception, post exposure prophylaxis, male and female condoms); pregnancy care (antenatal and post natal care, skilled birth attendance, referral systems, and emergency obstetric care); safe abortion services and post-abortion care; access to assisted reproductive technologies; prevention, treatment, and care of sexually transmitted infections and HIV; prevention, treatment and care of reproductive cancers.
4.2. Safe & Legal Abortion
4.2.1. To make evidence based policy changes that recognise the cost-benefits surrounding providing women with access to safe and legal abortions on demand.
4.2.2. To immediately repeal all laws criminalizing, penalizing and/or restricting access to abortion services whilst formulating new laws and policies as a means to allow better access.
4.2.3. To specifically repeal laws that restrict young women from accessing safe abortion services on ground of requiring parental or spousal consent, age of consent or mandatory waiting periods.
4.2.4. To ensure women seeking abortion care are not subjected judicial and non-judicial persecution, including imprisonment or even harassment and degrading treatment in the health systems or by state authorities and institutions.
4.2.5. To implement right based laws and public policies that guarantee and uphold women’s access to safe abortion services without restriction.
4.2.6. To remove all non-legal and non-policy barriers to women gaining access to safe abortions on demand.
4.2.7. To ensure that healthcare workers and the health system are trained, sensitized and equipped with the necessary knowledge, equipment and resources to provide safe abortion services, including pre and post abortion services.
4.3. Freedom from forced sterilisation
4.3.1. Develop, promote and implement policies and clear policy guidelines with regard to sterilisation that protect the rights of women and men, including LGBTI men and women, based on a human rights framework and ensuring informed consent and free choice.
4.3.2. Monitor and document state and non-state violations around SRHR, and especially with regard to forced sterilisation.
4.3.3. Develop laws and policies that are be based on the right to health including freedom from non-consensual medical treatment or experimentation and develop laws and policies that will protect patients from non-consensual medical treatment
4.3.4. Provide on-going human rights training for health care providers, particularly in the context of forced medical treatment.
4.3.5. Establish accountability systems to monitor and ensure adherence of health care workers to human rights based laws on forced sterilisation, experimentation and non-consensual or non-informed medical treatments.
4.4. Accessibility, Acceptability and Affordability and Quality of SRHR services and commodities
4.4.1. Ensure the development and implementation of policy and clear policy guidelines that guarantee universal access to the provision of SRH services and commodities, with free or subsidized care for those in need and those most marginalised;
4.4.2. Inclusion and allocation of a specific SRH commodities budget within the country health budget;
4.4.3. Commit to and conduct effective monitoring and documentation of implementation strategies to minimise potential disparities and ensure universal access;
4.4.4. Support and promote an enabling environment that allows for continuous consultation, meaningful engagement and development across different and relevant sectors;
4.4.5. Commit to set up systems and structures for management, supply and timely distribution of SRH commodities so as to ensure no stock outs and no expired stock.
4.4.6. Commit to and finance the training, deployment, and retention of necessary health workers;
4.4.7. Ensure Inter and Multi-sector collaboration, learning and sharing within regional and sub-regional mechanisms of best practices and lessons learned on SRH commodity management;
4.4.8. Educate and inform citizens of their rights and responsibilities, so that they are better able to make informed decisions on their health choices, and better able to demand accessible, acceptable, affordable and quality SRHR services and commodities;
4.4.9. Recognise the role of the female condom as the only female initiated tool to prevent HIV, STI’s and unplanned pregnancies, and ensure access to quality and affordable female condoms are a reality for all women, as well as commit to funding for training and support for Female Condom Programming;
4.4.10. Recognise the need for further research into the role of anal and vaginal sexual lubricants for use as a tool to prevent HIV, STI’s and unplanned pregnancies, as well as its safety for users and compatibility with various other ingredients and condom varieties. Commit to making access to quality and affordable lubricants a reality for all people, as well as commit to funding for training and support for condom compatible lubricant use;
4.4.11. Train all health care workers, as well as procurement and head office ministry staff on new and evolving SRHR commodities especially with regard to HIV treatment and prevention technologies, this includes but is not limited to understanding the current vaginal and rectal micro-biocide and pre exposure prophylaxis fields in general and their specific programming implications for women and girls.
To download the full full document click here: AAI AUC Ford Civil Society African Common Position Paper on ICPD 2013 April
SIGN-ON: Civil Society African Common Position Paper on The International Conference on Population Development: 3. Population Growth and Structure
3.1. Fertility, mortality and population growth
3.1.1. Ensure that population growth and structure, and demographic work is approached with a human rights and gender responsive lens;
3.1.2. Guarantee that policies to address high fertility and rapid population growth, focus on enlarging, not restricting, individual choices and opportunities;
3.1.3. Ensure that clear policy guidelines are developed and shared and implemented so as to ensure that human rights and gender responsive lens is implemented through to clinic level and that abuse and misinterpretation is impossible.
3.1.4. Improve data collection, quality and analysis to ensure that targeted and evidence based policies are developed, implemented and then closely monitored and evaluated for necessary adjustments.
3.2. Demographic Dividends
3.2.1. To commit to researching, understanding, and investing in the possible dividends to be gained from the pending youth bulge;
3.2.2. To ensure that the population is able to contribute and benefit from potential gains of the demographic dividend by ensuring the following criteria are met:
22.214.171.124. Youth have universal access to quality education, including but not limited to alphabetical and numerical literacy, secondary and tertiary education, comprehensive sexuality education and citizenship and human rights education. This must be equally provided to all, without gender or geographical, religious or other discrimination.
126.96.36.199. Youth have access to programmes which provide entrepreneurship and profit-generating activities training and provided with structural support to implement business ideas;3
.2.2.3. Youth are enabled to make informed and educated decisions on their health, including sexual and reproductive health and rights, and able to access quality health services and information;
3.2.3. Reinforce universal and country specific policies with proven results to spur future job creation and economic growth.
3.2.4. Ensure accountable and transparent leadership to manage demographic change.
DOWNLOAD THE AFRICAN COMMON POSITION PAPER HERE: AAI AUC Ford Civil Society African Common Position Paper on ICPD 2013 April
Health Minister Aaron Motsoaledi has described the launch of the new triple combination antiretrovirals as a revolution.
Johannesburg — The Minister of Health, Dr Aaron Motsoaledi says the roll-out of the Fixed Dose Combination (ARV) during the 2013/14 financial year as announced last year is on track.
The Minister will formally launch the programme on the 8th of April 2013 at Phedisong 4 Clinic – Ga-Rankuwa, north of Pretoria.
“We will be starting with newly diagnosed HIV positive persons eligible for treatment, HIV positive pregnant women and breast-feeding mothers” said Motsoaledi.
Other Patients currently on ARV’s will be switched to the Fixed Dose Combination after clinical assessment by their health care providers.
There are about 1.9 million patients on ARV treatment in South Africa.
5 April 2013
By South African Departmment of Health
SIGN-ON to the African Common Position on ICPD
We have finally completed the Civil Society African Common Position on the International Conference on Population Development (ICPD)!
As many of you know in 2012, AIDS Accountability International (AAI) and The African Union Commission (AUC) recognised the need for greater African civil society organisation (CSO) representation in the International Conference on Population Development (ICPD) process.
It was decided to create the African Common Position (ACP) on ICPD to reflect and include the perspectives, recommendations and expertise of African stakeholders.
To sign on and endorse the Civil Society African Common Position please click here
DOWNLOAD THE AFRICAN COMMON POSITION PAPER HERE: AAI AUC Ford Civil Society African Common Position Paper on ICPD 2013 April
Join these organisations who have already endorsed the African Common Position on ICPD:
List of Organizational Endorsements
1. Action Health Incorporated (Nigeria )
2. Action Visant l’Education et Valorisation des Enfants Non Assistés (Congo)
3. African Council of AIDS Service Organizations (Senegal)
4. Alliance Of Solidarity For the Family (Seychelles )
5. Asian-Pacific Resource & Research Centre for Women (Malaysia)
6. Associação Angolana para o Bem Estar da Familia (Angola)
7. Associação Caboverdiana para a Proteção da Familia (Cape Verde)
8. Associação Mocambicana para o Desenvolvimento da Familia (Mozambique)
9. Associação Santomense para a Promoção Familiar (Sao Time & Principe)
10. Association Beninoise pour la Promotion de la Famille (Benin)
11. Association Burkinabe pour le Bien etre Familial (Bukina Faso)
12. Association Centraficaine pour le Bien-etre Familial (Central African Republic)
13. Association Central Africa Against AIDS (Central African Republic)
14. Association Comorienne pour le Bien etre de la Famille (Comoros)
15. Association Conogolaise pour te Bien-etre Familial (Congo)
16. Association Guineenne pour le Bien-etre Familial (Guinea)
17. Association Ivoirienne pour le Bien-etre Familial (Ivory Coast)
18. Association Malienne Pour La Promotion Et La Protection De La Famille (Mali)
19. Association Nigerienne pour le Bien-etre Familial (Niger)
20. Association pour le Bien-etre Familial/Naissances Desirables (Democratic Republic of Congo)
21. Association Rwandaise pour le Bien-etre Familial (Rwanda)
22. Association Senegalaise pour le Bien-étre Familial (Senegal)
23. Association Togolaise pour le Bien-etre Familial (Togo)
24. Association Burundaise pour le Bien-etre Familial (Burundi)
25. Association Tchadienne pour le Bien-etre Familial (Chad)
26. Botswana Family Welfare Association (Botswana)
27. Cameroon National Association for Family Welfare (Cameroon)
28. Chama cha Uzazi na Malezi Bora Tanzania (Tanzania)
29. Chargée de mission International (France)
30. Communication for Development Centre (Nigeria)
31. Community and Family AID Foundation (Ghana)
32. FAMEDEV-Inter Africa Network for Women, Media ,Gender and Development (Senegal )
33. Family Guidance Association of Ethiopia (Ethiopia)
34. Family Life Association of Swaziland (Swaziland)
35. Family Planning Association of Liberia (Liberia)
36. Family Planning Assoication of Malawi (Malawi)
37. Femmes et Droits Humains (Mali)
38. Fianakaviana Sambatra (Madagascar)
39. Gender Equality Watch / Center for Media Studies (Mozambique)
40. Generation Initiative For Women and Youth Network (Nigeria)
41. HEDECS (Cameroon)
42. ICHANGE CI (Cote D’Ivoire)
43. Kids & Teens Resource Centre (Nigeria)
44. Lesotho Planned Parenthood Association (Lesotho)
45. Malawi Network of AIDS Service Organisations (Malawi)
46. Mauritius Family Planning Assoication (Mauritius)
47. Mouvement Gabonais pour le Bien-etre Familial (Gabon)
48. Namibia Planned Parenthood Association (Nambia)
49. Namibia Planned Parenthoodd Association (Namibia)
50. Nelson Mandela Metropolotan University (Lesotho)
51. ONG Femmes-Santé-Développement (Cameroon)
52. People for Peace and Defense of Rights (Uganda)
53. Planned Parenthood Association of Seirra Leone (Sierra Leone)
54. Planned Parenthood Assoication of Ghana (Ghana)
55. Planned Parenthood Assoication of Nigeria Nigeria
56. Planned Parenthood Assoication of Zambia (Zambia)
57. Queer African Youth Networking (Burkina Faso)
58. Reproductive Health Uganda (Uganda)
59. Responsible Programmes Femmes (Cameroun)
60. Rwandese Association for Familiy Welfare (Rwanda)
61. SAFAIDS (Zambia)
62. Sahayogi Samaj/Blue Diamond Society (Nepal)
63. The Family Health Options of Kenya (Kenya)
64. Uganda young positives (Uganda)
65. Unité de gestion de coordination des programmes gouvernement-Système des Nations Unies (Togo)
66. Women’s Global Network for Reproductive Rights (Tanzania)
67. Women’s Promotion Centre (Tanzania)
68. Young Beninese Leaders Association (Benin)
69. Zimbabwe National Family Planning Committee (Zimbabwe)
List of Individual Endorsements
1. Madzikanga Maxwell (United Kingdom)
Government’s annual death report has confirmed the trend that fewer South Africans have been dying of HIV/AIDS-related diseases. However, more people are dying of non-communicable diseases such as diabetes.
Released in the Free State yesterday morning (THURSDAY), the Statistics SA report Mortality and causes of death in South Africa, 2010: Findings from death notification, records and analyses deaths reported in 2010 as it is written on death certificates completed by doctors and others certified to do so. The findings were released in Thabo Mofutsanyane district in Phuthaditjhaba, which recorded the highest death rate in the country. KwaZulu-Natal and Gauteng had the highest overall number of deaths in 2010.
In summary, the number of deaths processed by Stats SA in 2010 was 543 856, a 6.2% decline from the year before with the highest number of deaths among those aged 35-39 and 30-34. Overall, there were slightly more male than female deaths.
In 2010, the average age at death was estimated at around 48 years, which has increased by about five years since 2004.
Tuberculosis was the leading cause of death (11.6%), a spot it has held for a number of years. Influenza and pneumonia is in second spot followed by intestinal infectious diseases. However, the number of deaths attributed to these three conditions has consistently and significantly decreased, while those due to diabetes are increasing – 3,8% in 2010.
Looking at the report from an HIV point-of-view, University of Cape Town (UCT) actuary and epidemiologist Leigh Johnson, says the report shows evidence of continued declines in HIV-related mortality, which is likely to be a reflection of the success of the antiretroviral treatment programme.
“Although there has been a slight increase in the number of deaths that are recorded as being due to HIV when comparing 2010 to 2009, there have been very substantial reductions in deaths reported as being due to TB, pneumonia, influenza and intestinal infectious diseases,” says Johnson.
These three diseases are causes to which HIV deaths are most frequently mis-attributed, in other words they are recorded as such on death certificates instead of being noted as HIV deaths.
Johnson notes that there have also been relatively large reductions in mortality in young adults (roughly 30% reduction in overall mortality rates in the 30-39 age group between 2006 and 2010). “All of this is consistent with what we would expect with declining AIDS mortality,” Johnson adds. Rob Dorrington, Professor of Actuarial Science at UCT says it is “good” that the report has been released because mortality rates and patterns are changing quite rapidly, particularly due to the huge increase in the provision of antiretrovirals.
In addition estimates of mortality rates are important for checking the sensibleness of the 2011 census results.
However, he expressed concern that the report is almost five months late. “This is only acknowledged deep within the report and the explanation for the delay (as “improvements in data processing methodology and processing systems”) leaves one worrying about when future reports will become available.”
Dorrington agrees with Johnson that it is “hugely apparent” that HIV/AIDS deaths are hidden as a cause of death, which distorts the interpretation of rankings of the causes of deaths hugely – not only contributing to the ranking of TB at the top of the causes, but also contributing to the high ranking of some other causes.
Dorrington said that although the total number of deaths has fallen, much as expected, the numbers of deaths have increased in the 1-14 age range and the 80-84 age group (particularly for females).
“Although the report acknowledges that not all deaths in South Africa are captured by the system, the estimate of 93% completeness that they cite applies only to adults. A higher percentage of child deaths, particularly those under age 5 go unregistered,” Dorrington points out.
The report also reveals that almost half of the deaths took place in health facilities. Free States and North West had the highest proportion of children dying in infancy while Western Cape and Eastern Cape had the highest proportions of deaths occurring in old ages. – Health-e News Service
By Anso Thom
11 April 2013