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Date: Tue, 03 Sep 2002 13:49:24 +0000
From: Charlotte Utting <[log in to unmask]>
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Subject: [WASAN] FW: Africa: AIDS Treatment Declaration
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From: "Africa Action" <[log in to unmask]>
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Date: Tue, 3 Sep 2002 14:00:23 -0500
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Subject: Africa: AIDS Treatment Declaration
Africa: AIDS Treatment Declaration
Date distributed (ymd): 020903
Document reposted by Africa Action
Africa Policy Electronic Distribution List: an information
service provided by AFRICA ACTION (incorporating the Africa
Policy Information Center, The Africa Fund, and the American
Committee on Africa). Find more information for action for
Africa at http://www.africaaction.org
+++++++++++++++++++++Document Profile+++++++++++++++++++++
Region: Continent-Wide
Issue Areas: +political/rights+ +economy/development+ +health+
SUMMARY CONTENTS:
This posting contains a press release and the declaration from last
month's conference launching the Pan-African HIV/AIDS Treatment
Access Movement. The declaration sums up the present impasse,
reflected yet again in the minimal attention given to AIDS at the
Johannesburg Summit:
"We are faced with enormous barriers: national governments do not
prioritise HIV/AIDS treatment; donor countries refuse to fulfil
commitments to mobilise necessary resources; pharmaceutical
companies deny access to essential medicines and diagnostics by
charging exorbitant prices; structural adjustment programmes,
driven by the World Bank and International Monetary Fund, destroy
public health-care systems; and debt to rich countries hampers
financing of vital social services, including health-care.
Community mobilisation and civil society action are essential for
forcing action and ensuring greater accountability from all these
institutions."
+++++++++++++++++end profile++++++++++++++++++++++++++++++
Africa Action Note
See the September 3 Africa Action press release with a statement by
Salih Booker on Secretary of State Powell and the World Summit on
Sustainable Development: http://www.africaaction.org/desk/sb0209a.htm
------------------
Treatment Action Campaign
http://www.tac.org.za
For more information, please contact:
In Cape Town, Sipho Mthati +27 (0)72 424 7180 In Johannesburg, at
the WSSD Mark Heywood +27 (0)83 634 8806 In Johannesburg, at the
WSSD Winston Zulu +27 (0)72 267 9985
Monday 26 August 2002
Press release
AIDS Activists from 21 African countries launch Pan-African
HIV/AIDS Treatment Access Movement
26 August 2002 (Cape Town) - Against the backdrop of the World
Summit on Sustainable Development (WSSD) in Johannesburg, South
Africa, over 70 African AIDS activists from 21 countries met in
Cape Town from 22-24 August to inaugurate the Pan-African HIV/AIDS
Treatment Access Movement (PHATAM). PHATAM's co-founders are two of
the world's leading AIDS activists, Zackie Achmat of the Treatment
Action Campaign (TAC) in South Africa and Milly Katana, lobbying
and advocacy officer of the Health Rights Action Group in Uganda
and member of Board of the Global Fund to Fight AIDS, TB, and
Malaria. PHATAM is dedicated to mobilising communities, political
leaders, and all sectors of society to ensure access to
antiretroviral (ARV) treatment, as a fundamental part of
comprehensive care for all people with HIV/AIDS in Africa.
"We are angry. Our people are dying," said Milly Katana. "We can no
longer accept millions of needless AIDS deaths simply because we
are poor Africans. We know ARV treatment is feasible in our
countries and are launching a movement to demand ARV treatment that
won't take 'no' for an answer."
PHATAM representatives will attend the WSSD to submit a Declaration
of Action with demands of African governments, wealthy country
governments, multilateral institutions, and the private sector,
including the pharmaceutical industry. "The world leaders meeting
in Johannesburg must recognise that without a healthy population we
cannot have development. Health is a prerequisite for sustainable
development-and access to AIDS treatment in Africa is the key to
improving health," said Zackie Achmat. "We are united in our
commitment to ensure that millions of lives are saved on our
continent. The role of the Movement is to hold national and
international bodies accountable to obligations such as the
immediate development and implementation of national HIV/AIDS
treatment plans."
At PHATAM's inaugural meeting, activists assessed the gaps in their
countries' HIV/AIDS policies and programmes, noting in particular
the scarcity of ARV treatment programmes. "It's true you have
African governments, even wealthy countries, talking about
mother-to-child-transmission prevention-which is vital as it
provides the entry point to both treatment and prevention-but we're
asking 'What about the mothers and the rest of the family?'"
continued Katana. "We need to find treatment for them quickly-like
yesterday-to save their lives and to reverse the tide of the
growing orphan epidemic in Africa."
PHATAM called for African countries to implement the World Trade
Organisation's Declaration, signed at the Doha Ministerial Meeting,
on the TRIPS Agreement and Public Health, and insisted that the
U.S. and other wealthy countries allow countries with limited
pharmaceutical manufacturing capacity to purchase low-cost, generic
versions of patented medicines from exporting countries once WTO
rules on patents have been fully implemented.
"Pharmaceutical industry profiteering and patent abuse has caused
enough death and suffering across our continent. Our governments
must take the cue from the WTO, which has finally put public health
ahead of the patent rights of the super-profitable pharmaceutical
companies," said Dr. John Wasonga of the Kenya Coalition for Access
to Essential Medicines. "But we need every possible option to save
our people, from local production of quality generic ARVs to buying
medicines in bulk that have been exported from generic companies in
Asia, Latin America and other places. We cannot afford to squander
money on costly patented medicines while our people are dying."
"While a necessary component of the response to HIV/AIDS,
prevention will never be enough," added Winston Zulu of the Network
of Zambian People Living with HIV/AIDS (NZP+). "When will the world
wake up to the fact that 16 million Africans have already died of
HIV/AIDS? This is only the beginning if we continue down the
prevention-only path. This movement will make treatment, which we
all know strengthens prevention efforts, our priority demand."
Delegates also emphasized the need for nutritional support,
treatment of opportunistic infections, rebuilding of public health
care and elimination of new HIV infections but agreed that
treatment with ARVs must be prioritised.
"HIV/AIDS treatment education is power," said Olayide Akanni of the
Nigeria Treatment Access Coalition. "Africans will work together to
create simple, accessible treatment information on all aspects of
HIV/AIDS care and treatment. We must be empowered with the
life-saving information we need to demand proper treatment from our
health-care providers, governments, and workplaces."
"People with HIV/AIDS in Africa are fed up with the international
community's broken promises," said Dr. Eric Goemaere, Head of
Mission for MTdecins Sans FrontiFres (MSF) in South Africa, which
is now providing ARV therapy in Khayelitsha, a poor township in the
Western Cape. "They are tired of hearing about pilot projects. The
time to scale-up is long overdue and this will only be possible
with political action at the national and international level. This
community-based movement must provoke the necessary political
response."
Immediate actions of PHATAM include:
9 October: PHATAM is calling for a Global Day of Protests to demand
that donor countries make contributions proportionate to their
wealth to the Global Fund to Fight AIDS, Tuberculosis and Malaria
(GFATM). Activists will also call for the prioritisation of
treatment by the GFATM and the active involvement of people with
HIV/AIDS in GFATM Country Coordinating Mechanisms.
17 October: PHATAM will participate in a Global Day of Action
Against Coca-Cola and other multinational companies to demand ARV
treatment for all HIV-positive workers and their families.
1 December, World AIDS Day: PHATAM is calling for a Global Day for
Access to HIV/AIDS Treatment.
Countries represented: Botswana, Burundi, Cote d'Ivoire, Democratic
Republic of Congo, Ethiopia, Ghana, Kenya, Lesotho, Malawi,
Mauritius, Mozambique, Namibia, Nigeria, Rwanda, South Africa,
Swaziland, Tanzania, Togo, Uganda, Zambia, and Zimbabwe.
Convening organisations: AIDS Consortium - South Africa; AIDS Law
Project (ALP) - South Africa; AIDS Law Unit: Legal Assistance
Centre - Namibia; Catholic AIDS Action - Namibia; Coping Centre for
People with AIDS (COCEPWA) - Botswana; Kara Counselling and
Training Trust - Zambia; MTdecins Sans FrontiFres (MSF); Network of
Zambian People Living with HIV/AIDS (NZP+) - Zambia; Network of
Zimbabwean Positive Women - Zimbabwe; Treatment Action Campaign
(TAC) - South Africa; and Women and AIDS Support Network (WASN) -
Zimbabwe.
********************************
PAN-AFRICAN HIV/AIDS TREATMENT ACCESS MOVEMENT: DECLARATION OF
ACTION
August 25, 2002
We are angry. Our people are dying.
Without treatment, the 28 million people living with HIV/AIDS
(PLWAs) on our continent today will die predictable and avoidable
deaths over the next decade. More than 2 million have died of
HIV/AIDS in Africa just this year. This constitutes a crime
against humanity. Governments, multilateral institutions, the
private sector, and civil society must intervene without delay to
prevent a holocaust against the poor. We must ensure access to
antiretroviral (ARV) treatment as part of a comprehensive
continuum of care for all people with HIV who need it. In this
regard, at a minimum, we call for the immediate implementation of
the World Health Organisation goal to ensure antiretroviral (ARV)
treatment for at least three million people in the developing
world by 2005. Together with our international allies, we will
hold governments, international agencies, donors and the private
sector accountable to meet this target.
We represent activists and organisations from 21 African
countries that met in Cape Town, South Africa, 22-24 August 2002,
and launched a Pan-African HIV/AIDS Treatment Access Movement
dedicated to mobilising our communities and our continent to
ensure access to HIV/AIDS treatment for all our people who need
it.
We have heard reports on the state of HIV/AIDS treatment and
prevention interventions throughout the continent. Remarkable
achievements have been registered in every region resulting in
some countries significantly reducing new infections and
improving care for individuals, families and communities affected
by HIV and AIDS. However, there was a consensus that current
efforts are insufficient. The AIDS epidemic has exposed many of
the problems facing Africa, including poverty, socio-economic and
gender inequality, inadequate health-care infrastructures and
poor governance. We insist that access to ARV therapy is not only
an ethical imperative, but will also strengthen prevention
efforts, increase uptake of voluntary counselling and testing,
reduce the incidence of opportunistic infections, and reduce the
burden of HIV/AIDS-including the number of orphans-on families,
communities, and economies.
The recognition of the human rights to life, dignity, equality,
freedom and equal access to public goods including health-care
are the fundamental principles of a successful response to the
epidemic. In this regard, we reaffirm the Universal Declaration
of Human Rights and the African Charter on Human and Peoples'
Rights. Furthermore, we recognise that the rights of women,
children and youth are particularly vulnerable in Africa.
Treatment and prevention strategies for HIV/AIDS must consider
their particular needs. Critically, the rights of people with
HIV/AIDS (PLWAs) must be protected, including equal access to
social services and to medical insurance plans. Discrimination
and stigmatisation threaten our dignity and hamper efforts to
address the epidemic. Our experience as African PLWAs has been
that of token involvement, not meaningful participation, in
decision-making processes. It is only through active involvement
of PLWAs in all policy and implementation decisions related to
HIV/AIDS that we will achieve our goals.
Alleviating the effects of the AIDS epidemic will require
political leadership and greater accountability from national
governments, international organisations, the private sector,
especially the pharmaceutical industry, and wealthy countries,
particularly the United States and the European Union. We are
faced with enormous barriers: national governments do not
prioritise HIV/AIDS treatment; donor countries refuse to fulfil
commitments to mobilise necessary resources; pharmaceutical
companies deny access to essential medicines and diagnostics by
charging exorbitant prices; structural adjustment programmes,
driven by the World Bank and International Monetary Fund, destroy
public health-care systems; and debt to rich countries hampers
financing of vital social services, including health-care.
Community mobilisation and civil society action are essential for
forcing action and ensuring greater accountability from all these
institutions.
Health is a prerequisite for sustainable development. The AIDS
epidemic presents an immense challenge to health-care systems in
Africa. Sustainable economic development can only be possible
through the implementation of sound social security policies that
target the poor and include HIV/AIDS treatment and prevention
programmes.
A humanitarian crisis due to lack of food security presents an
immediate threat to many Africans and the gravity of this
situation is exacerbated by the HIV epidemic. We therefore call
for emergency food aid to address this crisis. The delivery of
this food aid should not be hampered by unreasonable conditions
imposed by donor or recipient governments. Food security requires
active intervention and planning from the state to ensure
sustainable production and equitable distribution in a manner
that benefits society. Farmers and other agricultural workers and
nutritional experts must be consulted.
We make the following key demands of national governments in
Africa, donor countries, multilateral institutions,
pharmaceutical companies, and the broader private sector:
We demand that National Governments in Africa:
* Create and implement clear, legally binding HIV/AIDS policies
and plans including antiretroviral treatment as part of a
comprehensive continuum of care, which should be brought to scale
and include:
* Prevention: Expand distribution of male and female condoms, and
invest in research for microbicides and vaccines.
* Voluntary Counselling and Testing (VCT): Ensure accessibility
to VCT centres in rural and urban areas. This will promote
openness and assist prevention and treatment efforts.
* Prevention of Mother-to-Child-Transmission
(MTCT)/Parent-to-Child-Transmission (PTCT): Immediately implement
programmes that integrate MTCT/PTCT into all antenatal care
facilities, as they serve as an important entry point for care.
Successfully implemented MTCT/PTCT prevention programmes should
be linked to existing and future ARV treatment programmes, and
must provide women with all information necessary to make
informed choices about feeding options.
* Post-Exposure Prophylaxis (PEP) for sexual assault survivors
and occupational exposure:
* Treatment of opportunistic infections (OIs): Treat aggressively
all OIs, including tuberculosis (TB), Kaposi's Sacoma, thrush,
and meningitis; expand access to key drugs such as fluconazole,
acyclovir, and cotrimoxazole; and monitor resistance and
side-effects (especially with cotrimoxazole).
* Treatment of TB: Revise diagnostic protocols; improve
diagnosis; devote resources to research for new, easier to use
drugs; and utilise existing TB clinics to scale-up ARV
programmes.
* Treatment of sexually transmitted infections (STIs): Ensure
access to appropriate, vigourous treatment of STIs and education.
* Nutritional support: Ensure adequate nutritional information,
education, and support to affected individuals and families.
* Palliative care: Ensure clinic-linked home-based end of life
care.
* Clinical trials: Ensure that all clinical trials abide with
universal ethical guidelines and that pharmaceutical companies
guarantee treatment for life for all trial participants. This
standard must be developed by the WHO
* Fulfil commitments made at the Abuja Summit to dedicate at
least 15% of annual national budgets to improve health,
particularly HIV/AIDS, TB, and malaria because of the
overwhelming burden of death and disease on our families,
communities and economies. This should include ensuring retention
of skilled health-care workers through sufficient remuneration.
* Implement the Doha Declaration on the TRIPS Agreement and
Public Health, and take steps to increase local production of
generics through south-south collaboration (including technology
transfer with Brazil, Thailand, India and other countries
manufacturing generic medicines)
* Ensure inclusion of ARVs on national essential drug lists at
primary care level
* Intensify treatment education and promote treatment literacy
for PLWAs, communities, and health-care workers
* Apply to the GFATM with comprehensive proposals that expand or
launch ARV treatment programmes using the lowest cost, quality
drugs available to ensure equitable and sustainable access
* Promote equity, transparency and accountability in the
allocation of national health and HIV/AIDS budgets. Non-partisan
resource allocation is indispensable for effective health care
interventions
* Eliminate taxes on all essential medicines and diagnostics
We demand that Donor Countries (members of the Organisation of
Economic Development and Cooperation or OECD and middle-income
countries):
* Fulfil existing commitments to adequately fund the Global Fund
to Fight AIDS, Tuberculosis and Malaria and other HIV/AIDS
financing mechanisms with at least $10 billion of new funding
annually as a proportion of GDP
* Implement the Doha Declaration in good faith and resolve the
problems of production for export in a way that ensures that
countries with insufficient manufacturing capacity have the right
to import quality generics in the most efficient manner
* Immediately stop pressuring developing countries to: focus
primarily on prevention interventions, procure drugs from
proprietary companies only, and scale back proposals to the GFATM
* Cancel debt and ensure reinvestment into social services,
particularly health-care
* Increase investments into research and development for better
drugs, diagnostics, vaccines and microbicides
We demand that Multilateral Institutions (including WHO, WTO,
UNAIDS, UNICEF, the Global Fund, etc.):
* Immediately develop a strategic plan including specific targets
and timelines to achieve the goal of providing ARV treatment for
at least 3 million people by 2005
* Provide technical assistance to African countries to develop
and implement sound treatment programmes and proposals
* Demand independence from member states to fulfil mandates
without political interference
* Define a research & development agenda that will meet the needs
of resource-limited settings including simplified treatment
regimens (ARV therapy, TB); simplified diagnostic and monitoring
tools (for ARV therapy, TB, management of OIs); microbicides; and
vaccines
* Develop international ethical guidelines for clinical trials
that guarantee life-time treatment free of charge for all trial
participants
Pharmaceutical industry profiteering and patent abuse has already
caused and continues to cause death and suffering across our
continent and elsewhere. Excessive prices have ensured that this
continent with the greatest disease burden has the lowest access
to essential medicines.
Therefore, we demand that the Pharmaceutical Industry:
* Unconditionally reduce prices of drugs, diagnostics, and
monitoring tools
* Immediately stop blocking the production and importation of
generic drugs by developing countries
* Issue non-exclusive voluntary licenses upon request
* Provide free treatment for life for all participants in
clinical trials and abide by international ethical standards to
be developed by the WHO
We demand that the Private Sector (including multinational
corporations, parastatals, large corporations, and other private
sector entities):
* Contribute to the social good through social investments to
address HIV/AIDS
* Implement comprehensive HIV/AIDS workplace policies, including
provision of HIV/AIDS education, VCT, psycho-social support, and
provide treatment, including ARV therapy, for all workers
* Adopt non-discriminatory hiring and promotion policies and
practices
* Ensure that private medical insurance provides appropriate care
and treatment for PLWAs
AND we commit ourselves to:
* Develop a community-based response to the AIDS pandemic in
Africa that places PLWAs at the centre and ensures the
involvement of PLWAs in key decision-making processes that will
affect our lives
* Mobilise our communities, our political leaders, and all
sectors of society throughout the continent to ensure access to
ARV treatment for all who need it, starting with the immediate
implementation of the WHO goal to ensure ARV treatment for at
least three million people in the developing world by 2005
* Work with our governments, wherever possible, to develop
national treatment plans that include ARV treatment as part of a
comprehensive continuum of care, with the concrete goal of
providing ARV treatment for at least 10% of the predicted number
of PLWAs by 2005
* Advocate for local production and importation of generics,
regional procurement of medicines, and other strategies to ensure
equitable and sustainable access to the lowest cost quality
drugs, diagnostics, and monitoring tools
* Hold our governments, donors, international agencies, and the
private sector, particularly the pharmaceutical industry,
accountable to implement sound policies and programmes and meet
identified targets by carefully monitoring progress and raising
our voices in protest when necessary, together with our
international allies
* Promote treatment literacy for PLWAs, communities, and
health-care workers by developing and disseminating simple,
accessible treatment education information on all aspects of
HIV/AIDS care and treatment
* Share information and expertise with each other to support
capacity-building for increasing access to treatment at the
local, national, and regional level
* Mobilise for a Global Day of Action on the Global Fund to Fight
AIDS, Tuberculosis and Malaria on 9 October 2002 to demand more
money from donor countries, prioritisation of treatment in
national proposals and funding decisions, increased transparency
and monitoring of fund disbursements, and active involvement of
PLWAs in Country Coordinating Mechanisms
* Mobilise for a Global Day of Action Against Coca-Cola, the
largest private employer in Africa, and other multinationals on
17 October 2002 to demand ARV treatment for all HIV-positive
workers and their families
* Mobilise for a Global Day for Access to HIV/AIDS Treatment on 1
December, World AIDS Day, 2002
We know this is an immense challenge. Millions of lives are at
stake. We must succeed.
************************************************************
This material is being reposted for wider distribution by
Africa Action (incorporating the Africa Policy Information
Center, The Africa Fund, and the American Committee on Africa).
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information and analysis in order to promote U.S. and
international policies toward Africa that advance economic,
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