The global HIV and Aids pandemic is affecting all levels of society, creating orphans and deepening levels of poverty, threatening to reverse years of development efforts. It lurks the human resource which forms the heartbeat that drives any national development agenda.
Sub-Saharan African is the worst affected. By 2001, the region was host to 28.5 million people living with HIV and Aids representing 70 percent of the 40 million affected persons worldwide. It is here where 90 percent of children orphaned due to the epidemic.
Malawi, like its region’s neighbours, has been harshly affected by the epidemic. Since identification of the first case in 1985, epidemiological data has continuously indicated a rapid surge in the number of new infections, 55 000 annually. The national HIV prevalence rate stand around 12 percent as 1.1 million of the 16 million population live with the virus.
Children are at the wrong end of the equation. Poverty levels in many homes have been worsened by large numbers of orphaned children. Orphanages continue to sprout. Philanthropists’ help remains dwarfed to meet the growing needs of destitute and vulnerable children.
During this year’s World Aids Day to be commemorated on December 1, countries will be reflecting on progress towards curbing the spread of HIV and care to those affected. Themed—Getting to Zero: Zero New infections, Zero Aids-related deaths and Zero Discrimination—it is a last episode before passing final verdict on Millennium Development Goal (MDG) target six aimed at halting and beginning to reverse the spread of HIV and Aids, malaria and other diseases by 2015.
And yes, the theme should be a bad monitoring and evaluation tool for organisations working on HIV and Aids in Malawi. With 55 000 people contracting the virus yearly, there is a lot to ponder on.
Maybe it is neither the NGOs nor the civil society at fault, but lack of political will from the national government. Despite the rampant spread of HIV and Aids, the country has no specific law addressing the epidemic apart from some references to sexual and reproductive health (SRH) issues in the Public Health Act. The only existing regulatory tool responsive to the epidemic is the HIV and Aids National Strategic Frameworks (NSF).
Adding to the NSF, the country has signed several international agreements of relevance to HIV and SRH linkages such as Maseru Declaration on HIV and Aids; the Southern African Development Community (Sadc) treaty on human rights; Sadc protocol on gender and development.
However, when it comes to elevating the HIV and Aids discourse on the national scale, the approach has not been inclusive. Technocrats have been given acres of space to mumble jargons. Some have bothered the nation with statistics. Others have held workshops whose resolutions only their computer rams remember.
The affected person, the susceptible youth, and the ordinary citizen only listen.
Another area of concern is how the epidemic is creating its easy way to plunder lives in the urban areas. The 2010 Malawi Demographic and Health Survey, show HIV prevalence rate is 21.7 percent higher than 14.5 percent in the rural areas despite having 16 percent of the country’s population living in the urban areas.
It thus comes as an irony owing to the fact that most urbanites have better access to quality health services, including access to HIV and Aids information.
But, miserably, most urban dwellers do not enjoy the anticipated economic benefits the cities and towns ought to offer. Instead they opt for alternative illegitimate ways of surviving urban poverty such as theft and prostitution.
On investment, National Aids Commission (NAC), in partnership with other development organisations like the Global Fund, World Bank, and the United Nations (UN) agencies, are tirelessly coughing out billions of financial aid to help win the fight against the pandemic, but the outcomes are still not very inspiring. These HIV trends are not just mere records; they point to the risky environments Malawi may evolve into.
Perhaps the present challenges do not only require correct policy and strategic responses, they also demand a sustained elevation of the development agenda in the national dialogue. In a nutshell, to realise sustainable results in this process, people must be at the centre. Focus should be on what is working of course based on informed research evidence. Malawi should strengthen ‘inclusivity’ in its development activities.
—The author is a research and policy advocacy officer for Urban Research Institute.