Seminar on South-South Cooperation for HIV/AIDS in Africa
(Second Seminar on Development of Health and Medical Services for Africa)
November 1-2, 2000, Tokyo
The Second Seminar on Development of Health and Medical Services for Africa was convened in Tokyo on 1st and 2nd of November, under the co-sponsorship of the Government of Japan and UNAIDS. The purpose of the Seminar was to explore possibilities for furthering South-South cooperation to address the daunting situation concerning HIV/AIDS in the African continent. The Seminar was another initiative by the Government of Japan to encourage African countries and other development partners to take actions aimed at achieving shared goals and objectives for African development as set out in various internationally adopted documents, inter alia, "Tokyo Agenda for Action," that was adopted at the Second Tokyo International Conference on African Development (TICAD II) held in October 1998.
Government officials and experts with significant experience and responsibilities for HIV/AIDS-related issues took part in the Seminar, representing the Governments of Botswana, Brazil, Cambodia, Thailand, Central Africa, Kenya, Senegal, South Africa, Tanzania, Zambia and Zimbabwe, as did a number of officials of the Government of Japan. Experts from Uganda and Senegal also attended as facilitators. Many representatives of African embassies and embassies of G8 countries in Tokyo as well as of NGOs joined the Seminar as observers. Throughout the Seminar that lasted two days, they had intensive and inspiring discussions, for which all of them made a great deal of contribution based on their unique experiences related to the fight against HIV/AIDS.
It is difficult to summarize the content of all the discussions held over the past two days while still doing justice to all the points made by the participants. Therefore, the following is an account of only the salient points and the main thrusts of the discussions that took place.
Two days of informal but intensive meetings served as a valuable opportunity for all the participants to have a frank and in-depth exchange of views on the important question of how to enhance South-South cooperation concerning HIV/AIDS issues in the African continent.
The Seminar was primarily intended for deepening understanding among those with diverse views, and not for the adoption of any agreed documents or statements. However, the last two days of discussions were useful and rewarding in terms of deepening their understanding of important technical issues and in gauging the practicality of various ideas concerning South-South cooperation to address HIV/AIDS in Africa. It is hoped that the discussions in the Seminar will be conducive to further promoting our efforts to tackle this daunting problem.
The Seminar opened with keynote speeches given by representatives of the Ministry of Health and Welfare, the Ministry of Foreign Affairs of the Government of Japan and UNAIDS.
Mr. Kiyohiro Araki, Senior State Secretary for Foreign Affairs of Japan, who could not participate due to the Japanese Diet Session but whose statement was read by Ambassador Shinsuke Horiuchi on his behalf, expressed Japan's determination to implement its Okinawa Infectious Disease Initiative, announced on the occasion of the Kyushu-Okinawa G8 Summit of last July, of which HIV/AIDS is a major issue particularly with regard to development in Africa. The Senior State Secretary stated that, as a responsible leading donor, Japan would make its best efforts to address HIV/AIDS issues in the African continent, making it an area for one of top priorities in its ODA toward Africa.
Mr. Fumio Isobe, Director of the International Affairs Division of the Ministry of Health and Welfare, reviewed the international cooperation programs of Japan in the area of AIDS from the viewpoint of multi-bi collaborations and emphasized the necessity to make this seminar an opportunity to work towards the concrete steps to this end. He expressed the intention of the Government of Japan to invite African countries to the AIDS workshop which will be held in cooperation with UNAIDS in February or March next year in Bangkok.
Dr Peter Piot, Executive Director of the Joint United Nations Programme on HIV/AIDS (UNAIDS), said South-South cooperation is integral to the AIDS response and is at the root of good partnership and effective collaboration. It can be used to good effect in planning, mobilization, partnership building and capacity strengthening. The International Partnership, the largest example of intensified South-South cooperation in the response to the AIDS epidemic, is a coalition under the leadership of African governments, bringing them together with donors, the private sector, the community sector and the UN system around this single issue. Dr. Piot said it has proved a powerful level for generating a more effective and sustained national response to AIDS on the African continent, and today, AIDS figures as a national issue, no longer the exclusive responsibility of the health sector. South-South cooperation is a knowledge strategy, which recognizes that partners sharing knowledge become more powerful and effective, and this is demonstrated clearly for instance in the emerging influence of South-to-South contact as a strategy to drive down the price of AIDS drugs.
EXPERIENCES AND BEST PRACTICES IDENTIFIED
In the plenary, participants presented their unique experiences in the fight against HIV/AIDS. Participants from Asian and South American countries introduced their assiduous efforts to control and contain the epidemic and to care for those affected by the disease. African participants also explained situations concerning HIV/AIDS in their own countries. At present, about 70% of those infected with HIV/AIDS live in Sub-Saharan Africa. Obviously, in many African countries, the implications of this epidemic are so far-reaching that it even threatens to undermine and could even wipe out the result of decades of efforts for social and economic advancement. At the same time, experiences of success are present in some African countries, too.
The experiences in Asia and Latin America vividly demonstrated the potential of South-South cooperation among neighboring countries as well as regions from distant continents.
In the face of the rapidly growing HIV/AIDS epidemic in Cambodia, participants from Cambodia stated that the country's national response built upon many lessons learned in Thailand where the epidemic had an earlier onset. The main strategies adopted (i.e. condom promotion, information and education, and home care for people living with AIDS) have begun to show encouraging results. While calling for the increased mobilization of external resources, they emphasized the value of lessons learnt from experience by another country in the South as an external non-monetary resource.
They also noted that the slight difference in the onset and progress of the epidemic makes the experience of one country particularly relevant to others some years later and highlighted the adhesive effect of socio-cultural similarities on cooperation between countries. This cooperation has also contributed to strengthening the relationship between neighbor countries, especially since they share common interests and would mutually benefit from region-wide HIV/AIDS prevention. It was also noted that on a wider scale, ASEAN countries have started working together on "regional common goods," such as increasing the accessibility of drugs and addressing cross-border issues like the trafficking of women.
Cited as a "role model" in the region, the participant from Thailand has demonstrated the effectiveness of the 100% condom use policy, voluntary counseling and treatment, prevention of mother-to-child transmission, AIDS home care, and the development of a network of people living with HIV/AIDS. He elaborated on the essential ingredients of Thailand's response to the epidemic, particularly its multi-sectoral nature, the importance of national leadership, and the provision of national resources to match donor assistance.
The participant from Brazil showed several examples to demonstrate that it is possible to initiate and pursue South-South cooperation despite language and cultural barriers. With varying levels of success, Brazil has undertaken cooperation with countries not only in South America but also in Africa.
Representatives from 8 African countries (Botswana, Central Africa, Kenya, Senegal, South Africa, Tanzania, Zambia, Zimbabwe) reported their policies, specific interventions and measures for controlling and preventing HIV/AIDS, social and economic effects of HIV/AIDS problems such as AIDS orphans, decline in agricultural production, death of teachers and social behaviors. Committed by the highest level of the government are resources which would be mobilized as much as possible. It is clear that a number of countries have accumulated experience and expertise in dealing with the epidemic which could promote South-South cooperation which could benefit all countries. To date, major areas of South-South cooperation have been more on bilateral arrangement, NGO-to-NGO basis, and it has provided learning experiences and technical support in dealing with the epidemic. The SADC has made commendable efforts to promote South-South cooperation within the SADC region. The region has developed an SADC Strategic Plan on HIV/AIDS and has common policies on issues like ARV drugs. However, the initiative is still confined to the SADC region and may need to be expanded beyond the region and beyond Africa.
The areas of South-South cooperation identified so far include research, training, institutional capacity, community work, multi-sectoral approaches, planning, procurement of drugs, consultation and education for vulnerable people, and elimination of stigma.
Based on exchanges of views concerning each country's experiences to fight the epidemic, participants were convinced that the experiences of East Asia and Latin America as well as of some African countries are profoundly important to address HIV/AIDS in the African continent. It was felt that, when international partnership was mobilized in the form of South-South cooperation, the reward could be enormous and highly cost-effective. At the same time, it was noted that this potential had not been fully tapped.
With such views in mind, participants discussed ways to further promote South-South cooperation for Africa. On many occasions, they concurred in the need to identify and study "best practices" and work out specific modalities for South-South cooperation to learn from others' experiences. Also, some noted that, where possible and appropriate, elements for South-South cooperation should be included in various existing frameworks and projects to address HIV/AIDS.
In their efforts to identify keys to success, participants discussed possible common elements among "best practices," and in this connection emphasized the importance of:
- ensuring commitment and strengthening ownership by all strata of the government in the effort to tackle HIV/AIDS
- ensuring HIV/AIDS control as a priority issue in government development policy
- investing in education on HIV/AIDS, including the area of reproductive health, to provide a mechanism for effectively reaching the younger generation
- maintaining partnership with the local community, including civil society
- ensuring community participation in government policy-making
- emphasizing the importance of coordination among stakeholders, including national and local governments and NGOs
- improving the health system and public health services at the community level
- involving people living with HIV/AIDS
On the other hand, several constraints related to South-South cooperation were indicated. They involve lack of smooth exchange of information, high dependence on donors, and language barriers. It was also emphasized that, while the political stability of African countries is required for successful South-South cooperation and best efforts could be made to place high priority on HIV/AIDS problem in the allocation of resources in the individual budgets of them, international support would be critical in utilizing South-South cooperation for the implementation of these practices.
MODALITIES FOR SOUTH-SOUTH COOPERATION
In the last part of the Seminar, participants discussed possible modalities to promote further South-South cooperation for Africa. Ideas raised included the following:
- human resources development and institution building in African countries. In this connection, reference was made to the potential of assistance by donors.
- placement of experts, including volunteers. Experiences of UNV were introduced in this respect.
- participation of African officials and/or experts in various meetings convened and/or projects implemented in other regions of the world.
- exchange of information on prevention and care of HIV/AIDS.
- networking among all those working in the area of HIV/AIDS, some work of which has already been started by UNAIDS.
- cooperation in the area of research and survey on HIV/AIDS.
- development of strategic plans at sub-regional levels. For instance, SADC has been developing such a plan, and their health ministers meet regularly to review the HIV/AIDS programs.
- sub-regional approach to address HIV/AIDS in high transmission areas, such as transport corridors, focusing on vulnerable groups.
- cooperation in an effort to seek support in a variety of ways from the private sector to expand the horizon of South-South cooperation, in addition to government-to-government assistance and assistance from NGOs.
Participants welcomed Japan's commitment to placing special emphasis on HIV/AIDS in its assistance for Africa and to exploring further possibilities for South-South cooperation in this respect.
Many participants expressed their high expectations for Japan's initiative on infectious diseases, including HIV/AIDS. They hoped that discussions at this Seminar would be duly taken into account in the implementation of the initiative.
With regard to the forthcoming Okinawa International Conference on Infectious Disease scheduled in December, participants further expressed their view that this gathering will be a very important opportunity to strengthen efforts by both African countries and development partners to tackle HIV/AIDS in the continent. They hoped that the issue of South-South cooperation would be further addressed in the Conference and the result of discussions at the present Seminar would make a significant contribution.
There was also obvious expectation among participants that South-South cooperation would be emphasized as a promising way to deal with issues related to HIV/AIDS as the United Nations would convene a Special General Assembly devoted to HIV/AIDS issues next year.
Finally, participants expressed their appreciation to the Government of Japan for its efforts in poverty reduction and economic growth in Africa through the TICAD process, as development will enhance the ability of the people in the region to fight against HIV/AIDS.
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