AFR/RC59/R7 4 September 2009
REGIONAL COMMITTEE FOR AFRICA Fifty-ninth session Kigali, Republic of Rwanda, 31 August–4 September 2009
ORIGINAL: ENGLISH
RESOLUTION CALL FOR INTENSIFIED ACTION FOR HIV PREVENTION AND TUBERCULOSIS/HIV CO-INFECTION CONTROL IN THE AFRICAN REGION The Regional Committee, Recalling Resolution AFR/RC55/R6, on Acceleration of HIV prevention efforts in the African Region; Resolution AFR/RC55/R5 on Tuberculosis control: the situation in the African Region; and the 2006 Abuja call for accelerated action towards universal access to HIV/AIDS, tuberculosis and malaria services in Africa; Recognizing that while substantial progress has been made towards some Millennium Development Goals (MDGs), many countries in Africa still lag behind, especially in MDG 6, “To combat HIV, malaria and other diseases”; Alarmed that sub-Saharan Africa continues to be home to more than 70% of all people living with HIV, and accounts for nearly a third of all new infections; that on average 35% of TB patients are co-infected with HIV in the Region; and that this impacts negatively on TB incidence and mortality and contributes to emergence of MDR and XDR-TB among people living with HIV; Bearing in mind the multisectoral nature of response to AIDS and the leading role of the health sector in effective scaling up of evidence-informed HIV prevention interventions; Aware that key obstacles which impede successful scaling up of HIV prevention and TB control include weak heath systems, difficulty in ensuring predictable and sustainable financing, persistence of stigma and discrimination, poor or inadequate coordination, weak linkages between HIV/AIDS and sexual reproductive health, weak collaboration between HIV and TB programmes, and absence of broad health system policies conducive to better care; Concerned that existing evidence-informed and cost-effective interventions for HIV prevention have not been adequately scaled up to make the desired impact, that new HIV infections are still occurring at unacceptably high levels, including among key populations at higher risk, and that essential TB/HIV prevention and care strategies are only partially implemented;
AFR/RC59/R7 Page 2
Mindful of the critical role of leadership and welcoming (a) the launch of the initiative “Champions for an HIV-free Generation”, led by His Excellency Festus Mogae; (b) the commitment of the UN Secretary-General’s Special Envoy to the Stop TB partnership, His Excellency Jorge Sampaio; (c) the African AIDS Vaccine Programme advocated by Her Excellency the First Lady of Rwanda, Mrs J Kagame; and (d) the commitment by the UNAIDS Executive Director to work together with WHO and other partners in providing support to countries; 1. URGES Member States: (a) to ensure effective leadership and governance and the establishment of mechanisms for accountability in HIV prevention and tuberculosis control with multisectoral participation at all levels; to support the initiatives “Champions for an HIV-Free Generation” and the “Stop TB Partnership” in their efforts to stimulate the emergence of national Champions for an HIVfree Generation and to attain the realization of the Stop TB goal; to address health system bottlenecks such as limited access to care, high cost of services, limited laboratory capacity, weak procurement and supply systems for medicines and other supplies and limited human resources capacity which impact negatively on the delivery of tuberculosis and HIV/AIDS services; to develop appropriate policies and legislation to create a supportive environment for scaling up HIV prevention interventions, including addressing issues of stigma and discrimination and harmful cultural values, and for the protection of vulnerable people and key populations at higher risk; to address sexual transmission of HIV by advocating for the reduction of concurrent multiple sexual partnerships, stopping sexual and gender-based violence and ensuring positive prevention; to promote the routine offer of HIV testing and counselling as an entry point to prevention, treatment and care, and build on the successful scaling up of antiretrovirals to strengthen HIV prevention interventions for people living with HIV/AIDS; to aim at the elimination of paediatric HIV in the African Region by achieving full coverage of voluntary HIV testing and counselling; prevention of mother to child transmission (PMTCT) services; HIV/AIDS care and treatment using integrated reproductive health, HIV/AIDS and TB services; and optimizing infant feeding and antiretroviral therapy prophylaxis to infants who are breastfeeding; to scale up innovative and evidence-informed HIV prevention interventions such as male circumcision; to work together in stimulating the emergence of a social movement for HIV prevention at national, regional and continental levels, with the involvement of civil society organizations; to fully implement the Stop TB strategy in order to increase access to TB/HIV prevention and care with special attention to building modern rapid diagnostic capacity for TB, MDR/XDR-TB and TB/HIV;
(b)
(c)
(d)
(e)
(f)
(g)
(h) (i)
(j)
AFR/RC59/R7 Page 3
(k)
to intensify delivery of interventions to combat HIV/tuberculosis co-infection, especially infection control; HIV testing and appropriate prevention, treatment and care for tuberculosis patients; TB screening and treatment for people living with HIV; and access to antiretroviral therapy for dually-infected patients; to strengthen surveillance of HIV/AIDS and tuberculosis, and monitor drug resistant tuberculosis in general and especially in people living with HIV;
(l)
(m) to commit more local resources for HIV prevention and TB control to supplement resources made available through global health financing initiatives; 2. REQUESTS the Regional Director: (a) (b) to provide guidance and support for the implementation of this resolution; to work with the UNAIDS Executive Director in organizing a regional conference on HIV prevention in order to provide strategic directions for the way forward, including on TB/HIV; to work with the UNAIDS Executive Director and co-sponsors for joint support to countries to implement this resolution; to work with the UNAIDS Executive Director to mobilize long-term support for scaling up effective HIV prevention programmes and addressing HIV and tuberculosis co-infection; as well as monitor progress of support by UNAIDS co-sponsors in scaling up HIV prevention programmes; to work with partners to improve harmonization and alignment with national policies, strategies and plans; encourage the provision by partners of predictable and sustainable funding to support the scaling up of effective HIV prevention programmes; and address HIV and tuberculosis co-infection; to monitor progress in implementing this resolution and report thereon to the Regional Committee every two years. Ninth meeting, 2 September 2009
(c) (d)
(e)
(f)