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					      ROBERT CHIZIMBA
MALAWI AIDS COMMISSION




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•   Broad responses for accelerating UA to HIV and
    AIDS prevention, treatment, care and support

•   Share experiences from Malawi in accelerating UA
    to HIV and AIDS prevention, treatment, care and
    support




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•   Located in Southern
    Africa, bordered by
    Zambia, Mozambique
    and Tanzania

•   13.1 Million people

•   40% Youth aged 10-
    29 yrs

•   12% Prevalence 15-49
    years




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   Around Year 2000 Millennium Development Goals developed
   Aim was to fight poverty, accelerate human development and
    facilitate gradual but efficient integration of developing world
    particularly Africa into global economy
   Goal 6: Combat HIV and AIDS, TB, malaria and other diseases.
   June 2001 Declaration of Commitment on HIV and AIDS made
    Some targets were:
       WHO 3x5 Initiative
       By 2010 Universal access to HIV prevention, treatment, care and
        support
       By 2015 begin to halt or reverse the spread of HIV


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   Member states developed UA Frameworks to accelerate HIV
    prevention, treatment, care and support
   Malawi developed her Framework and launched in May 2006
   UA set targets
   Most countries including Malawi unlikely to achieve set targets
    due various vices/challenges




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   Inappropriate policies, National Action Frameworks, strategies
    and guidelines
   Weak leadership at various levels (not strong, not visible)
   Poverty /limited resources
   Weak partnership and networking
   Limited multisectoral approach to HIV and AIDS programming
   Limited mainstreaming of HIV and AIDS
   Continued stigma, shame, discrimination, inaction and misaction




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•   Develop polices, frameworks, strategies, in participatory
    manner and based on local evidence
•   Engage influential leaders in HIV and AIDS at various levels
    • Involve prominent political and religious leaders in HIV
       and AIDS e.g. campaigns, HIV testing, resource
       mobilisation
    • Use traditional leaders as agents for change in HIV
       prevention e.g. speaking against stigma, harmful cultural
       practices and being role models in promoting practices
    • Mobilise public, private institutions and communities to
       play active role


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   Promote and strengthen partnerships and networking
    ◦ Establish coordinating structures with clear mandate
    ◦ Allows institutions with comparative advantage lead specific
      interventions
    ◦ Allows sharing of experiences, minimises duplication of
      efforts and resources
   Malawi Case
       Department of Nutrition, HIV and AIDS in OPC
       National AIDS Commission, Malawi Partnership Forum
       Malawi Interfaith AIDS Association; MANARELA+
       Malawi Business Coalition Against HIV and AIDS
       MANET+ ; MANASO; TWGs

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   Partnerships and Networking with Faith Community in
    Malawi:
    ◦ Formed National State/Faith Task Force
    ◦ Established Malawi Interfaith AIDS Association
      (MIAA)
    ◦ Government (NAC) provides financial, material and
      technical support to MIAA, religious mother bodies,
      FBOs and CHAM for ART programme
    ◦ Government incorporated District Interfaith AIDS
      Coordination Committee in Local Authority
      structures
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   Mainstream HIV and AIDS in daily work and operations
    ◦ Employees and spouses effectively targeted
    ◦ HIV and AIDS becoming core business of faith leaders in
      their work
    ◦ Cost-effective in addressing SSDDIM and S.A.V.E.
    ◦ Highly sustainable
   Malawi case:
    ◦ Illovo Sugar Company
    ◦ Electricity Supply Commission of Malawi
    ◦ Malawi Defence Force
    ◦ Malawi Police Service

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   Follow public health approach in HIV and AIDS programming
       Need to reach many people at once and within given time for impact
   Malawi case:
    ◦ In HIV testing introduced National Week; Door to Door,
      Mobile Vans
    ◦ In ART Malawi introduced free ART in both public and
      private hospitals and clinics
    ◦ Uses WHO clinical staging; More sites for PMTCT established
    ◦ Intensified interactive education sessions-theatre, audio visual
      shows
    ◦ Community-based advocacy campaigns e.g. WAC and
      Candlelight Memorial

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   Campaign against stigma, shame, discrimination,
    inaction and misaction should be audience specific

   Malawi Case:
    ◦ Specific professional groups forming associations for PLHIV
      e.g. T’LIPO, PLHIV Nurses, PLHIV journalists, COWLA,
      Youth Ambassadors




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   Make available financial and material resources from Govt and
    development partner to implementing agencies in transparent
    manner
   Malawi Case:
    ◦ Develop robust sub-granting mechanisms
    ◦ Develop and widely disseminate sub-granting guidelines
    ◦ Follow decentralised system (Local Authorities, CBOs) for
      ownership, accountability and sustainability
    ◦ Provides grants to faith community
    ◦ EngageAnti-Corruption bodies to check and follow up
      malpractices


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   Monitor interventions at every level
   Evaluate outcomes and impact made
   Continuously build capacity at every level in various areas
    of need




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INDICATOR                         Baseline   Universal    2008
                                  Target     Access       Achievement
                                  (2005)     Target
HIV prevalence among people       14%        12.8%        12%
aged 15-49 years
HIV prevalence among              14.3%      12%          12.3%
pregnant women aged 15-24
years
Percentage of sexually active     47% male   60% male     57% male
population using condoms at       30%        40% female   37.5
last high risk sex                female                  female
Number of sites offering HTC      146        600          698
services
Number of people counseled        482,364    1,000,000    1, 606, 195
and tested for HIV and received                            (4 million
results                                                   cumulative)
INDICATOR                        Baseline   Universal   2008
                                 Target     Access      Achievement
                                 (2005)     Target
Percentage of HIV+ pregnant      5.4%       65%         75%
women and their infants
receiving a complete package
of PMTCT
Number of people ever started    37,840     208,000     245,247
on ART
Proportion of those on ART who   5%         12%         9%
are children below the age of
15 years
Percentage of orphans and        32.5%      80%         53.3%
vulnerable children whose
households receive support to
care for the child
•   Let the conference generate recommendations for
    addressing these challenges




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I THANK YOU FOR YOUR ATTENTION




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