[e-med] Les activistes du sida se font entendre à la conférence sur la santé

["remed" <remed@remed.org>]

AFRIQUE: Les activistes du sida se font entendre à la conférence sur la santé 

http://www.irinnews.org/Report.aspx?ReportId=71570

Des activistes du sida venus de tout le continent ont signé une pétition pour exprimer leurs préoccupations au sujet de la conférence sur la santé

JOHANNESBOURG, 11 April 2007 (PlusNews) - 

Les plans d?action en faveur de la lutte contre le VIH/SIDA, la tuberculose et le paludisme arrêtés l?année dernière lors de précédentes conférences, ne figuraient pas à l?ordre du jour de la troisième session de la conférence des ministres de la Santé ouverte lundi à Johannesbourg, ont déploré des activistes du sida. 

Prévue du 9 au 13, la conférence a été organisée par l?Union africaine (UA). Les participants examineront pendant cette semaine l?avant projet d?une stratégie de santé pour les huit prochaines années, afin de produire une feuille de route pour le renforcement des capacités des systèmes de santé en Afrique et d?aider le continent à atteindre d?ici 2015 les Objectifs du millénaire pour le développement fixés par les Nations Unies, dans le domaine de la santé. 

Mais selon une coalition de 53 organisations de lutte contre le sida et associations de la société civile, l?avant-projet n?inclut pas un certain nombre de plans d?action définis dans le cadre de l?objectif de l?accès universel à la prévention, aux traitements et aux soins contre le VIH/SIDA. Ces plans avaient été arrêtés et acceptés par les gouvernements africains lors du Sommet extraordinaire de l?UA sur le VIH/SIDA, la Tuberculose et le Paludisme tenue à Abuja, au Nigeria, en mai 2006. 

« Nous pensons que prendre de nouveaux engagements serait une perte d?énergie, alors que l?année dernière à Abuja, tous les participants à la conférence ont eu en leur possession un document bien pensé et très détaillé », a déclaré mardi à la presse Olayide Akanni de Journalists Against AIDS, une organisation nigériane membre de la coalition. 

« La stratégie de santé qu?on nous présente aujourd?hui ne comporte ni de chronogramme ni plan de suivi-évaluation, et il n?y a rien qui les obliger à la respecter ». 

Une pétition a été rédigée. Elle reprend toutes les préoccupations de la coalition et invite les participants à s?inspirer du document d?Abuja pour orienter leurs discussions à la conférence de Johannesbourg. En outre, elle exige des gouvernements africains qu?ils « traduisent leurs engagements en actes ». 

Selon Akanni, peu de progrès ont été réalisés jusqu?à présent par rapport aux plans d?action d?Abuja qui prévoit notamment un taux de couverture du traitement antirétroviral (ART) de 80 pour cent, d?ici 2010. Or, actuellement, la plupart des pays du continent présentent un taux de couverture d?ART inférieur à 30 pour cent. 

La pétition a également souligné, que les gouvernements africains, à l?exception de deux d?entre eux, n?ont pas atteint l?objectif de 15 pour cent fixé pour les dépenses de santé, comme convenu en 2001. 

Entre autres points, la coalition souhaiterait que la conférence de cette semaine traite de plans d?action régionaux pour lutter contre la violence basée sur le genre, développer les services de prévention du VIH et renforcer les règles de contrôle des médicaments afin de les rendre plus sûrs et plus abordables. Elle souhaiterait également que les délégués se penchent sur les implications sanitaires de la crise politique et économique au Zimbabwe. 

Se référant au thème de la conférence qui porte sur le renforcement des systèmes de santé, la pétition soutient que « le développement rapide des services de lutte contre le sida ne compromet pas les systèmes de santé, puisque le sida peut servir de vecteur au renforcement des soins de santé primaires en Afrique ». 

Alors que les groupes de la société civile avaient été étroitement associés au Sommet d?Abuja, Regis Mtutu de la South African Treatment Action Campaign, un groupe d?activistes impliqués dans la lutte contre le sida, a dit de la conférence de cette semaine qu?elle « ne repose sur rien ». 

« Nous ne sommes pas contre les gouvernements, mais nous avons le droit de nous opposer à eux. Nous voulons juste voir des vies sauvées », a-t-il déclaré. 

La pétition, signée par l?ensemble des 53 membres de la coalition, sera remise le mercredi au Palais des congrès de Sandton à Johannesbourg, où se tient la conférence de l?UA. 

****************************
Open letter to WHO Director General regarding Universal Access from ITPC
------------------------------------------------------------------------

Dr. Margaret Chan
Director General
World Health Organization (WHO)
Avenue Appia 20, CH 1211
Geneva 27, Switzerland

Dear Director-General Chan,

Thank you for meeting with representatives of the International Treatment
Preparedness Coalition (ITPC) last month. We are heartened by your words of
commitment to Africa , to women, and to primary health care. We are
encouraged that you embrace the legacy of Dr. Lee and his understanding of
the fundamental importance of universal access to AIDS treatment, care and
prevention. So in this letter we write not as adversaries but as persons
sharing a common commitment. We still believe that by working together all
of us can halt and begin to reverse the spread of HIV/AIDS by 2015.

We are gravely concerned that the world has lost the momentum of the 3 by 5
campaign and that WHO is on the brink of squandering its legacy of
leadership role in the battle to bring universal treatment access to people
living with HIV/AIDS.

In this letter we outline five reasons for concern, make six specific
demands to be met before the end of 2007 and give four commitments that ITPC
will fulfill to do our part in this most critical global effort.

   *_Five reasons for grave concern _*

  1.      Only 26 of over 100 countries have provided targets linked to
costed national plans for key HIV/AIDS interventions. This first universal
access deliverable was due in December 2006. A 75% failure rate to comply
with even the preliminary step makes us seriously doubt that national
leadership alone can sustain the momentum for the scale-up of antiretroviral
therapy or other interventions.

2.      By all accounts, WHO is not sufficiently funded to maintain a strong
focus on AIDS treatment scale-up while attending to multiple other critical
priorities. Without sufficient funding to fulfill your policy, normative and
technical responsibilities on a global, regional and country level, there is
no chance that near universal access to AIDS treatment will happen by 2010.

3.      The G8 countries have not adequately honored their 2005 Gleneagles
commitments to universal access to treatment, prevention and care.

4.      Some AIDS policy makers and advocates are pitting treatment and
prevention as competitors for resources, rather than understanding that only
a comprehensive response that integrates treatment, prevention and care will
reverse the pandemic.

5.      Parts of the United Nations system and many country governments are
not demonstrating the political will to sustain and build upon the momentum
and foundations of the 3 by 5 initiative.

   *_Six demands for action in the next six months_*

  1.      All countries must submit by June 30, 2007 their fully costed
universal access plans, including yearly targets and budgets.. These plans
should not compromise the goal of achieving quantitative 'near universal
access', but should also state clearly where there are deficiencies in
funding, human resources and health systems capacity. The G8 countries and
other donors must then be induced to take specific actions to fill gaps.

2.      WHO, in partnership with UNAIDS, must review the treatment scale-up
targets and plans, ensure that they are both ambitious and realistic, and
declare a single, unified global target for universal access to treatment by
2010 either as 9,800,000 (UNAIDS currently published target) or a number
based on WHO-approved cumulative country targets. The Global Fund and PEPFAR
each report their own quantitative global results but only WHO is charged to
be the focal organization with responsibility and capability to
systematically monitor top-level progress against global, regional, and
country treatment access and uptake targets.

3.      The G8, guided and encouraged by the WHO Director-General, must
deliver a funding plan for their commitment to universal access to AIDS
treatment, prevention and care at their meeting in Germany in June 2007.
This G8 funding plan should include specific resource commitments based on
fair share contributions and ensure additional, predictable and sustainable
AIDS funding to achieve the universal access goal by 2010.

4.      A Universal Access Strategic Planning and Monitoring Group must be
set-up as a standing committee of WHO, UNAIDS, the Global Fund, PEPFAR,
DFID, representatives of the other G8 countries, developing and
middle-income countries, PLWHA networks, treatment activists and
organisations representing key populations. It should hold its first meeting
by September 2007 and continue to convene and report semi-annually until
universal access to treatment, prevention and care is achieved. WHO should
assume active leadership for the treatment aspects of the integrated plan.

5.      Multilateral, bilateral and private funders must ensure that WHO has
the resources to fulfill its mission and leadership role on HIV/AIDS.

6.      WHO must ensure that its structures, human resources and performance
at global, regional, and country levels are adequate to fulfill its
universal access mission with particular emphasis on building on the
foundations, lessons learned, and momentum of the 3 by 5 initiative.
Regional and country WHO offices especially must be re-organized and
strengthened to be fully effective.

Specific outcomes should include: a) a robust plan on second line drugs, b)
a system to learn lessons in scale up and rapidly share them to improve
operations, c) improved technical support to countries to ensure GF and
other programs work, d) ensuring that the WHO human resources effort "Treat,
Train, and Retain" is fully operational and soon shows concrete outcomes.


   *_Four ITPC commitments to ensure demands are met_*

  1.      Monitoring and watchdogging - we will be active in critiquing,
cajoling and supporting WHO and the other multilateral and bilateral
agencies.

2.      We will partner to get WHO appropriate funding to do what you need
to do.

3.      Through 'Missing the Target' reporting and grassroots advocacy we
will continue our work on country and local levels - pointing out issues,
giving solutions and monitoring results. We will meet with you regularly to
share our findings with you and your team.

4.      We will increase our efforts on treatment literacy - helping people
understand that AIDS can be stopped only through integrated programs of
treatment, care, support, and prevention.

Director-General Chan, we believe that by making access to treatment a core
issue of your tenure, you are in a unique position to lead the HIV/AIDS
Millennium goal to control the pandemic and to fulfill your priorities for
Africa, for women, and for primary health care. We will be at your side in
this endeavor. Our lives and the lives of millions depend on it.

Please contact any of us for further discussion or comment.

Greg Gray, International Coordinator, International Treatment Preparedness
Coalition
Matilda Moyo, Zimbabwe representing ITPC African Region and Pan African
Treatment Access Movement
Obatunde Oladapo , Nigeria representing ITPC African Region and Treatment
Access Movement Nigeria
Rajiv Kafle, Nepal representing ITPC South Asia Region and Nava Kiran Plus
Frika Chia Iskandar, Indonesia representing ITPC Southeast Asia and the Asia
Pacific Network of PLWHAs
Rodrigo Pascal, representing CIAT (ITPC South America)
Solomon Adderley, Bahamas representing ITPC Caribbean Region
Polly Clayden, UK representing ITPC Western European Region and HIV i-Base
Gregg Gonsalves, USA representing ITPC North American Region and AIDS and
Rights Alliance for Southern Africa
Svilen Konov , Bulgaria representing ITPC Eastern European Region
Gregory Vergus, Russia representing ITPC NIS/Baltics Region Representing the
International Treatment Preparedness Coalition, a network of over 800 people
living with HIV / AIDS and their supporters from 125 countries.
Dgroups is a joint initiative of Bellanet, DFID, Hivos, ICA , IICD,
OneWorld, UNAIDS