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Category Archives: HIV/AIDS & HUMAN RIGHTS

COURTESY VISIT BY THE HOPE SISTERS AGAINST HIV/AIDS, STIGMA AND DISCRIMINATION INITIATIVE

On the 29th day of August, 2018, the Hope Sisters Against HIV/AIDS, Stigma and Discrimination Initiative, a Women-Led Grassroot Civic Group in Makurdi, Benue State paid a Courtesy Visit to Lawyers Alert Head Office in order to identify with the LA and strengthen the existing working relationship between both Organizations.

 

The group was led Miss. Maria Okwoli, the Executive Director, she was received by Mr. Lazarus M. Ahangba, the Programs Manager of the Head Office. In her address, Miss. Okwoli prays LA for their assistance and support to the members of their group since the partnership started a few months ago. She said the visit was necessary owing to changes within the Organization especially at the leadership level. As a key partner and stakeholder to the Organization it becomes pertinent to formally visit and intimate the Organization of the changes that had occurred within the period. She went ahead to create the indulgence of LA to continue with the support it has always given to the group even with this new leadership that they look forward to a harmonious relationship with LA going forward.

In response, Mr. Lazarus, thanked the group for their visit and expressed delight over the group commitment to course of Women Human Rights especially those of the most vulnerable which they represent. He promised LA will continue to work and partner with the group particularly in areas of mutual interests. Furthermore, he told the group that the offer to build the capacity of its members on Monitoring/Documentation of Human Rights Violations, Gender Based Violence and Sexual and Reproductive Health Rights is still open and they can liaise with the appropriate officers in charge of those areas.

In addition, R.A. Hwande Esq, mentioned the efforts of LA in providing pro bono services to vulnerable women and how they can also explore same. He went ahead to give examples of past and recent incidences LA had offered pro bono to some members of their group in conflict with the law.

After this, the meeting came to an end with a vote of thanks by Miss. Okwoli. She thanked LA for finding time to host them and look forward to a better working relationship. Shortly after this, a group photograph was taken.

 

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Posted by on August 31, 2018 in HIV/AIDS & HUMAN RIGHTS

 

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LAWYERS ALERT RELEASES DATA ON HUMAN RIGHTS VIOLATIONS WITH REGARD TO HOMOSEXUALS IN NIGERIA

The report is a compendium of reported violations of sexual minorities in Nigeria between April 2017 to March 2018, with particular focus on Men who have sex with men (MSM). The data used in this report is drawn from inputs made into the online rights violation documentation tool developed by Lawyers Alert (http://colahr.org/lawyersalert/index.php ). The findings in this report cuts across the six geopolitical zones in Nigeria.

Key findings from the Data evidences that Men who have sex with men, MSM, suffer the highest form of violations amongst key population groups in Nigeria. Violations against MSM by State and Non-State Actors concentrated to an all high of 76% as against other groups. Reasons for this are principally embedded in the prevailing laws (especially the Same Sex Marriage (Prohibition) Law 2013

It is also instructive to note that 95% of reported violations/cases were resolved at police stations, with less than 5% going to trial, and even at that, prosecution is not diligent. This appears to validate the often held claim that arrests are basically to harass, intimidate and extort victims with no will for proper prosecution.  It should be added that approximately 75% of victims were supported with free legal representation either by Lawyers Alert or other organizations in Nigeria.

This report builds on our earlier report  that grouped sexual minorities into one group, http://lawyersalertng.org/resources/LAWYERS%20ALERT%20FINDINGS%20ON%20SRHR%20%20%20%20VIOLATIONS%20IN%20NIGERIA.pdf

With support from the Rapid Response Fund, Lawyers Alert customised the online tool to specifically speak to MSM, as against other key populations and other varying sexual orientations. The online tool automatically analyses data along age, location, types, trends etc.

Interventions for MSM actions and possible law reforms cannot be better informed than when situated against the data evidenced in this report.  The documented  violations were verified and  legal assistance proffered. With Nigeria committed to ending HIV, especially against the background of dwindling external funding, such data are very critical for targeted interventions given limited resources.

Lawyers Alert is indebted to several persons and organizations, who referred cases to us, assisted us technically and/or financially in the course of developing and putting up the online tool. We acknowledge the Rapid Response Fund for partnering with us this on work

The full report can be viewed at http://lawyersalertng.org/resources/Data%20on%20MSM%20Rights%20Violations%20in%20%20Nigeria.pdf

 

 

 

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Increase State Resource Allocation on HIV efforts: Lawyers Alert Tells the National Assembly at the Public Hearing on 2018 Federal Budget

The Nigeria Budget Proposals, or better properly called “The 2018 Appropriation Bill”  which encapsulates what and how the federal government will spend Nigeria resources is undergoing debate at the National Parliament.  A public Hearing  held by the Joint Committees of Appropriation  of the Senate and the House of Representatives  for Citizen groups  to make inputs  in helping  parliamentarians make proper resource allocations.
Lawyers Alert made  its presentation seeking  increased HIV funding in Nigeria given especially, the dwindling funding from the International community at the Hearing.  Our inputs follows a year of monitoring violations and related actions in this field in Nigeria, and offering free legal services to victims.

Our Ellen Onugha, Legal Officer, made the presentation of behalf of Lawyers Alert

Find Below full text of Lawyers Alert presentation.

RESPONSIVE BUDGETING: HIV AND AIDS INTERVENTIONS IN NIGERIA:  BEING A PRESENTATION OF LAWYERS ALERT NIGERIA, AT A PUBLIC HEARING OF THE 2019 BUDGET BY THE NATIONAL ASSEMBLY

PRESENTED THIS 28TH MARCH 2018

Nigeria is the most populous country in Africa with an estimated 175 million inhabitants. Research in 2013 showed that HIV constitutes a major public health concern in Nigeria and that the country has the second largest burden of HIV in Africa with an estimated 3.4 million people living with the virus in 2013.

Global Fund, an international financing organization that aims to attract and disburse additional resources to prevent and treat HIV and AIDS, tuberculosis and malaria, had invested a total of 24 grants in Nigeria since 2003, as part of efforts aimed at tackling the HIV threat. Indeed, as at June 2015, a total of 1.43 billion dollars had been disbursed for HIV programs.  Despite these investments however, in Nigeria, Global Fund faced a number of challenges leading to the sub-optimal grant performance shown below:

  • Poor quality health services including treatment disruptions
  • Inadequate monitoring and evaluation including poor data quality
  • Low financial absorption
  • Fraud, corruption or misuse of funds
  • Poor financial efficiency and reporting
  • Inadequate principal recipient governance and oversight.

Owing to these challenges, Global Fund reduced its funding to Nigeria, thereby making the management of HIV programs, ordinarily capital intensive, even more problematic.

In 2014, the federal allocation to health constituted just 6% of the national budget and was predicated to decline in the future. It has. Currently, state level allocations for health tend to be at an average of 3%. As at 2014, HIV intervention was underfunded by 4 billion dollars. This means there are presently minimal financial resources to make investments in health to significantly alter the course of HIV in Nigeria.

As a result of this paucity in funding the following results have been recorded:

  • Approximately 160,000 (one hundred & sixty thousand) people died from HIV and AIDS related illnesses in Nigeria in 2016.
  • About 220,000 (two hundred and twenty) new infections were recorded.
  • Out of 3,200,000 (three million, two hundred thousand) people living with HIV in 2016, ONLY 30% have access to antiretroviral therapy.
  • Only 21% of the estimated 270,000 (two hundred and seventy thousand children, ages 0-14 years) in Nigeria living with HIV have access to antiretroviral treatment.
  • Children, especially females, dropping out of school to cater to the needs of infected parents who are sick.

Simply put, the number of people living with HIV and those affected by it, is now disproportionate compared to the funds budgeted for treatment. This is a tide which must be stemmed and quickly too.

Note that an estimated 1.8 million children have been orphaned by AIDS, thereby taking a huge toll on their health, safety and wellbeing. In many instances, elderly grandparents, many of whom tend to be struggling with physical infirmities and financial challenges of their own, have to bear the responsibility for these children.

Incidentally, the National Strategic Framework, 2017-2021, aims (amongst others) at ending AIDS by achieving zero new infections and zero AIDS related deaths. This goal can only be described as utopian at the moment owing to the meager funds allocated to curbing the scourge.

2021 is just 3 years away. What successes have been recorded in tackling HIV? Do we have a tragic case here of “one step forward, two steps backwards”?

The adage “Health is wealth”, has never been more apt than it is now. Our biggest resource in Nigeria at the moment does not lie in the ground in the form of black gold, NO. It lies on the surface of the earth in the form living breathing beings, you and I, who form the bulk of the wealth of this great land. It lies in our human capital. Safeguarding the health of all Nigerians, especially from problems such as HIV, is therefore a task that the Federal Government must embark upon with all sense of urgency.

Of what use would any other achievements be if we were all too sick to benefit from them? If health, and by association, HIV and AIDS programs, are not adequately funded and managed with a view to prioritizing the well-being of citizens, all other budgets would amount to nothing because there might actually be no Nigerians left to enjoy them.

It is therefore imperative that this National Assembly pay heed to the neglect in this sector and take steps to redress the shortfall in funding. This is critical given that international support has drastically dropped as cited above. Failure to do this by the National Assembly could translate to an inability to meet the goal of the National Strategic Framework within the proposed time frame of 2017-2021.

Lawyers Alert therefore, seeks a proved and specific funding, beyond the health sector, for HIV and AIDS interventions by provision of adequate anti-retroviral therapy to enhance access for persons living with HIV. In addition, we seek adequate provision of commodities and services to promote absolutely free testing including the provision of effective mother to child transmission Medicare.

The National Assembly is so urged.

Thank you.

 
 

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Suit to challenge termination of employment on account on HIV status: Activists and PLHIV identify with Lawyers Alert

The suit challenging the termination of Mr X by his employers on account of his HIV status came up a fortnight ago  at the National Industrial Court in Abuja, and Activists including PLHIV were at hand to identify with the cause.  Persons from NEPWAN, APYIN, SOWCHAN, AHF, NINERELLA+, Heartland Alliance and ASHWAN flooded the court in show of solidarity. This followed advocacy efforts by Lawyers Alert in partnership with Enda Sante. The case of Mr. X, is lodged at the National Industrial Court Abuja by Lawyers Alert in partnership with Southern Africa Litigation Centre (SALC).

“PLHIV have the Right to Employment” adorned T-Shirts was everywhere at the Court premises. Mr X lawyers, Bamidele Jacobs and Sunday Adaji  of Lawyers Alert, were ready and prepared to proceed with the matter which was slated for hearing. The Defendants however sought adjournment to adequately prepare owing to late service of vital documents. The judge granted their request for time to prepare their response and fixed the case to 31st of October 2017 as the next hearing date.

 

Bamidele Jacobs Esq, speaking to Activists after the case.

Sighting the number of people in the court room with their T-shirts on, the Judge opined that probably at the next adjournment, hearing maybe in Chambers and advised supporters in solidarity to be within the court premises and not in the courtroom.

After the hearing, Activists converged in Lawyers Alert office, where Yemi Agoro gave a welcome speech and deliver the greetings  while  Bar. Bamidele gave the history of the case,  and update of what actually transpired in the court room.

Amber Erinmwinhe of NINERELLA+ spoke on behalf of the organizations and Activists present to appreciate the effort of Lawyers Alert in getting justice for the PLHIV community in the country and pledge  continuous support anytime the need arise.

 

 

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Lawyers Alert sensitize Journalists on Sexual Reproductive Health Rights

The training was organized by Lawyers Alert for journalists as part of a sensitization and advocacy drive within the media community. The objective is to educate journalists on the subject of SRHR and how they can effectively report violations of same and also getting the participants to cascade knowledge gained to other journalists.

Facilitators at the training were:

  1. Rommy Mom, Esq. – President, Lawyers Alert.

2.  Mrs. Abubakar Abubakar – Director, UNFPA.

3.  Charles – Director, UNAIDS.

SRH, HIV & GENDER ISSUES IN NIGERIA

Facilitator – Zubaida Abubakar, UNFPA

Topic – “SRH, HIV and Gender Issues in Nigeria.” (Focus: Key Populations)

She began by acknowledging the vital role journalists play as watchdogs of the society in ensuring the protection of Human Rights. “We need to engage the media,” she enthused, “our work is based on evidence. Children and girls are mostly victims of SRHR violations. They are victims of rape, violence, etc. We have to educate them and the media can help achieve this.”

To buttress her claims that children and teenage girls were the most vulnerable in terms of SRHR violations, Mrs. Abubakar reinforced her facts with statistics shown below:

  • In Nigeria, girls particularly between the ages of 18-22 years of age are likely to get pregnant before marriage. The North has a preponderance of early marriage.
  • Female hawkers are particularly vulnerable to rape.
  • Owing to poverty, religious and cultural issues, girls are married off at the young ages of 9-22. They are most at risk of HIV and Vesico-Vaginal Fistula, a condition that frequently occurs when underage girls give birth. Nigeria has up to 600,000 cases of VVF. Girls with the condition tend to be stigmatised and isolated.
  • 47.6% of illiterate girls get pregnant early. They have no idea of the use of contraceptives.
  • Maternal and child mortality rate is high in Nigeria: For every 100,000 births, 576 infants die, while approximately 111 of the mothers die in childbirth.

Consequences

On the consequences of the violations of the SRHR of girls, Mrs. Abubakar pointed out that:

  • There is no opportunity for their being educated (attending school).
  • The vicious cycle of poverty is continued.
  • They are isolated.
  • 25% of the girls whose SRHR are violated contribute nothing to the economy.

What to Address

On what to address, Mrs. Abubakar explained

  • Girls should be kept in school to discourage child marriage.
  • Girls who do not get formal education should be empowered through vocational skills.
  • The health and well-being of children should be prioritised.
  • Girls should be trained in the use of contraceptives.
  • There should be a conducive environment for children and girls.
  • Keepers of the traditional institutions should be enagaged in these efforts to obtain their support which could in turn influence parents to change their beliefs.
  • Children and girls should be given comprehensive HIV education.
  • Young people should be co-opted into the information dissemination process.
  • Social could also be a useful tool in this effort.

UNFPA Projects

On the projects being carried out by UNFPA, Mrs. Abubakar noted:

  • 4,150 are being supported with the help of Canada. In Nigeria’s North, UNFPA provides support in the education sector. In Lagos (the suburbs of Lagos State), out of school children are being supported by training them in vocational work. 270 of the girls were able to impact 20,000 others.
  • Campaign launched last year to end child marriage in Nigeria.
  • A forum was set up to educate various communities on the negative effects of early marriage.
  • UNFPA collaborates with local NGOs to carry out their work with ongoing projects in Kaduna and Kebbi States.
  • Support is being provided for girls suffering from VVF

EFFORTS AT ENHANCING SRHR REPORTAGE IN NIGERIA

Facilitator – Charles, UNAIDS

Topic – “Efforts at Enhancing SRHR Reportage in Nigeria.”

Mr. Charles introduced a five-page news report culled from The Associated Press, which he distributed to all participants titled: “Rampaging Sudan Troops Raped Foreigners, Killed Locals.” Using the news report as a yardstick for measuring reports on SRHR, he asked participants to read the report and critique.

Most participants condemned the detailed style of reporting. They were of the view that The Associated Press was so detailed in the reportage that within days of publication, Sudanese citizens were able to identify victim of the gang rape perpetrated by 15 South Sudanese soldiers.

A participant, (a female journalist with the Daily Trust), was of the view that the victim’s identity ought to have been protected in line with the ethics of the profession. Though her name was withheld, the description of the location and the race of the victim, were so vivid that Sudanese citizens had no problem identifying the victim.

A few of the participants, however, had a dissenting opinion. One of them was of the view that the detailed reportage was what led to further investigations.

The Facilitator left the critiquing to the professionals only pointing out the following issues:

  1. The news is about sexual violence in the context of armed conflict.
  2. Giving tips (reports) to journalists helps with exposing SRHS violations.

HUMAN RIGHTS DIMENSION

Facilitator – Rommy Mom (Lawyers Alert President)

Topic – “Human Rights Dimension on Violations of SRHR,”

Citing the cases of the FSWs in Abuja and the suspected gay people in Gishiri village, in Abuja, Lawyers Alert intervened, Mr. Mom emphasized the need to protect key affected populations. To buttress his point, he cited the case of a Customs Officer who was accused of theft in a market in Jalingo, Adamawa state and subsequently beaten to death. It was only after the mob action that his identity was revealed.

Mr. Mom rounded off his session with a quote he once saw in a prison in a prison he visited. The placard read: “A society is judged by how it treats the weakest among them.”

QUESTION AND ANSWER SESSION

The issue of homosexuality in Nigeria is a touchy one especially since the country has enacted laws criminalising same sex relationship and marriage. It was no wonder therefore that the following questions came up:

Q – “If I heard you clear, you mean you offer free legal services to homosexuals?”

Rommy Mom – “Yes, if we offer 10 free legal services to victims of SRHR violations, including homosexuals.”

Q – “How do you marry this with the Nigerian laws which prohibit homosexuality?”

  1. M – “Years ago, in Gishiri village, a pastor mobilised a mob to attack some persons alleged to be homosexuals. They broke into their houses, assaulted them, took them to the police station, and they were detained. This to the Pastor and his believers was in keeping with the law. We urge you however to examine the process. It is an offence to break into a persons’ home, assault the person etc. Yet we choose to ignore this. It is so much as the law, the process. We don’t violate rights, in getting to the end of the law. Lawyers Alert is about rights of ALL. Remember again, it is the court that determines culpability at the end of the day. The law does not permit any person to break the doors of people on ground of suspicion of being homosexual. It is the court that will determine the guilt of any person alleged to have committed a crime. Homosexuals, like other groups be they Female Sex workers, Persons Living With HIV, Persons who use Drugs etc are the vulnerable people in the society. How we treat and relate with them is different with coloration of stigma and discrimination. Ours is to focus on the rights of these key population groups.”

Q – “Do you also offer services to children and victims of domestic violence?”

  1. M – “Yes, we offer free legal services to children and victims of domestic violence. A 10-year old girl was raped recently. Her mother could not afford to pay transport fare. We offered her free legal services and we also paid for her transport fares.”

WAY FORWARD

On way forward, all participants agreed that:

  1. We should keep journalist informed as journalists are human beings and not ghosts that should know everything that happens in the society.
  2. Outcome of meetings should be shared. It could be visual, audio or text.
  3. Lawyers Alert could organise meetings to keep journalists informed.

CONCLUSION

Mr. Mom thanked all participants and assured them that the training just held was just one of many more to be held, and that from time to time, Lawyers Alert will hold refresher trainings for those in attendance.

 

 

 

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NIGERIA: MANDATORY HIV TESTING AND DISMISSAL OF AN EMPLOYEE ON THE BASIS OF HIV-STATUS

http://www.southernafricalitigationcentre.org/cases/ongoing-cases/nigeria-mandatory-hiv-testing-and-dismissal-of-an-employee-on-the-basis-of-hiv-status/

 
 

Assessing the HIV/AIDS MDGs: Does this look like success or even progress?

As Kim et al. (2011) indicated, progress towards achievement of the Millennium Development Goals (MDGs) has been mixed. One of the MDGs is to reduce sexual transmission of HIV by 50 percent by 2015. New infections are outpacing scaled up treatment, basic knowledge about HIV is poor, only about 35 percent of those infected receive treatment, and only about 40 percent of people living with HIV know their status. AIDS has become and remains the leading cause of premature death in Sub-Saharan Africa. According to UNICEF (2015) Eastern and Southern Africa contain about 5 percent of the world’s population and about 48 percent of the world’s new HIV infections among adults. Nine African countries, discussed below, have adult HIV prevalence rates which are the highest in the world, over 10 percent. Of the 25 countries in the world with the highest HIV prevalence rate, 24 are African nations. This paper is only concerned with the HIV/AIDS objectives and does not address the other diseases included in Goal 6. It builds upon an earlier paper by Fry (2013), and extends the findings and conclusions of that paper from a single country, South Africa, to the African continent. To preview discussion and conclusions, some issues are raised and discussed that appear to have the potential to produce a better way forward for HIV prevention for all of Africa. These begin with the need to convince the average African citizen about the importance of the HIV/AIDS epidemic and the danger and threats to all Africans it actually represents. African governments must not only convince citizens about the importance of HIV/ AIDS but attacking the pandemic must become a national priority, with promotion of HIV/AIDS prevention as a top level priority. Also, HIV/AIDS must be made a separate issue, treated as a stand-alone disease, one that should not fall under the general rubric of health or be anchored in Health Departments.

In a seminal paper which highlights the first issue raised above, Caldwell, Orubuloye, and Caldwell (1992) pointed to what they called the under-reaction of those parts of sub-Saharan Africa most affected by the HIV/AIDS epidemic; this included both the public and private reaction to the seriousness of the HIV/AIDS phenomenon. One major theme in the subsequent studies has been that ordinary citizens in sub-Saharan Africa were more concerned with basic issues like jobs and poverty, and did not want governmental resources diverted to HIV/AIDS related programs (Whiteside et al., 2002). The title of Justensen’s (2011) paper made that point abundantly clear. “Too poor to care: the salience of AIDS in Africa.”

Justesen also indicated that over time HIV/AIDS in Africa has transformed from being mainly a health issue to being a major human and economic development issue, one with devastating effects on the lives of millions of Africans. Justesen also noted that in the African countries included in what are known as the Afrobarometer Project surveys, it would be easy to conclude people who mention “AIDS” and those who mention “health” issues are essentially describing the same problem. Yet this would miss some important subtleties. For instance, Afrobarometer surveys find that to the extent that people see the epidemic as meriting government action, they tend either to see it as an AIDS issue, or as a health issue, but not both. When asked to select their own country’s top three priorities, those people who mention health are less likely to cite “AIDS”; and national samples of respondents that collectively prioritize “health” are much less likely to prioritize AIDS.

In the earlier paper, Fry (2013) echoed what others have noted that may be called citizen under-reaction in their public as well as private reactions to the HIV/AIDS epidemic. The surprising finding was that the choice of health was such a strong predictor of not selecting HIV/AIDS as a national priority. The suggestion is that the placement of HIV/AIDS programs under the health rubric has had a negative impact on promoting the importance of HIV/AIDS and the need is to promote the importance of HIV/AIDS to all Africans as a major concern of government.

As Nattrass (2014)) suggested, Millennium Development Goal (MDG) 6, ‘to combat HIV/AIDS, malaria and other diseases’, is unique among the MDGs because it emerged in the context of unprecedented prior international mobilization, especially around HIV/AIDS, thus both reflecting and facilitating an expanding international health agenda. MDG 6 built on the idea of “health as development”, originally articulated at the 1978 conference on primary health at Alma-Ata, but was profoundly shaped by the political traction and fund-raising successes of AIDS activism and the international AIDS response. This underpinned the expansion of MDG 6 targets to include antiretroviral treatment, helped forge partnerships to reduce the prices of antiretroviral treatment and essential medicine, thereby contributing to MDG 8 (“building partnerships for development”) and, in high HIV-prevalence regions, also to MDGs 4 and 5 (maternal and child health).

The UN High-Level Panel on the post-2015 development agenda recommends setting country-level health targets to achieve healthcare for all. Targets can help citizens hold governments to account by providing a focus for mobilization and a yardstick to measure progress. The data collection and policy monitoring pioneered by UNAIDS, and the involvement and support for civil society organizations achieved through the AIDS response, must be continued for this broader health agenda to succeed.

METHODS

This paper utilizes multiple data sources, to identify the HIV/AIDS status of specific countries included in the research ( indexmundi.com2015), specific health related issues (AVERT,2015; UNAIDS, 2015). These sources also include Afrobarometer, which is a collaborative research effort produced by social scientists from over 30 African countries. The present paper is based on data collected during the project’s Round 5 surveys which took place in 35 countries between 2011 and September 2013. Interviews were conducted with persons 18 years of age or older; these are face-to-face interviews and were conducted in multiple languages. The sampling frame is such that each country’s final sample supports estimates of the national population of all adults that is accurate to within a margin of error of plus or minus 2 percentage points at a confidence level of 95 percent. Sample sizes are targeted at 1,200 or 2,400 respondents. The sampling procedures used in all of the Afrobarometer surveys are explained in detail in Bratton, Mattes and Gyimah-Boadi (2005). The survey used the same questionnaire which contains identical or functionally equivalent items in all 35 of the current Afrobarometer countries. The interviewer asks the respondent a series of questions in a face-to-face situation and in a language of the respondent’s choice.

The African countries included in this paper were chosen based on the fact that each country has an HIV prevalence rate of at least 10 percent; each of these countries were included in Afrobarometer’s Round 5. One study variable is the selection of AIDS as an issue the government should address, and is measured by the following question: In your opinion, what are the most important problems facing this country that the government should address? This question was asked in the same form three times. As Justesen (2011) indicated, one advantage of the wording of the ‘most important problem’ (MIP) question is that respondents can only name up to three problems, which forces people to prioritize and select those problems they consider the most important. In this study, the importance of AIDS is coded as a dichotomous variable: If a respondent mentioned ‘AIDS’ as one of the three most important problems, the variable is coded as one (1), and if not, zero (0). The choice of health as an issue the government should address was created in the same manner as the choice of AIDS. Respondents that picked health as one of their three important problems government should address were coded as one (1) and if they did not pick health zero (0) was recorded. A final Afrobarometer question asked respondent to indicate: How well or badly would you say the current government is handling the following matters, or haven’t you heard enough to say? Fixed responses were provided as follows: Very Badly; Fairly Badly Fairly well; Very well; and Don’t know/haven’t heard enough. These data are reported in Table 1, along with the HIV/AIDS Prevalence and AIDS related deaths for each of the 9 countries included in Table 1


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Table 1 clearly shows that HIV/AIDS is not seen as a national priority in the 9 countries with the world’s highest prevalence rates. Swaziland is a good example. In the country with the world’s highest prevalence rate, only 3 percent of respondents listed HIV/AIDS as a priority and they had three times to register their choices. Health did rate higher as at 14.3 percent and over 92 percent indicated they thought the government was doing a good job combatting the epidemic. South Africa gave HIV/AIDS the highest priority rating and a lower approval rating for the role of government. Mozambique and Lesotho’s scores reflected a high percentage of do not knows.

Note that Zambia perfectly fits the model of the choice of health over HIVs as a priority. Out of 1,200 respondents, only 5 listed HIV/AIDS, 2 as their first choice and slightly over 40 percent picked Health as their priority.

DISCUSSION

While Table 1 is interesting, the real purposes of this paper is to address two issues highlighted in the call for papers. The first of these questions is whether Africans were effectively involved in the creation of the MDGs? Do limitations in this involvement explain the failures? At what level and how should Africans have been more involved? The question going forward is how can Africans be more involved? The second is whether it is possible to have one Global South voice, or even a single African voice? The rest of this issue was framed as, is it necessary to be heard in this process, in the hope of taking into account the real genuine aspirations of Africans, or is it always a fool’s game?

The simple answers to both of those question is a resounding, NO, and there is the need to discuss how do Africans go forward from here? The literature review made it clear that the MDGs were implemented after the pandemic had struck Africa and, if there was African involvement in the creation of the HIV/Aids involvement, it probably was not of any consequence. It would appear that there have been successes, particularly regarding maternal and child health, but that raises the question as to whether those populations are as important as thought to the HIV/AIDS goals for all of Africa. This paper would argue that the maternal population falls within the scope of what should be the target of HIV/AIDS policy, but the adult older group of HIV positive citizens should be the target; they are the primary source of new infections.

To begin to address an answer as to how to go forward, there is the need to look at Uganda as the proper case-study to answer both of these questions (Wikipedia, 2015). Once portrayed as the shining light of African initiated HIV/AIDS policy, Uganda appears to have gone downhill more recently, the prevalence rate returned to former levels, and now whether the original optimism was justified has been severely questioned. In the beginning in Uganda, everyone seemed to work together quite well, and then politics entered the picture.

HIV testing is critical to a new beginning to address HIV/AIDS in Africa. As Fry and Hernandez (1994) discovered, that means testing procedures that begin from the bottom up. The issue here is that even if taken, there is strong evidence that a number of those tested never return to receive testing results. The evidence suggests that the majority of Africans do not know their HIV status. Testing must be culturally sensitive and promoted by persons who understand the language and customs of targeted groups. Fry and Fernandez found that in the US, minority populations needed to be brought in to the testing process early, and not after the fact. There is a vast and growing literature about domestic violence and revealing HIV status. The role of testing is almost always neglected in that process, and can be the key factor in generating domestic conflict. In some cultures, the spouse may go home and say they took an HIV test, often at the request of treatment personnel. Some spouses believe that either you, the one tested, are accusing me of something (cheating) or you are admitting you did something, (cheating.) Africa, with its ethnic systems, makes the development of culturally appropriate testing even more difficult, but a ground up approach means working with indigenous persons, and promoting a self-help approach.

Again with Uganda as the example, the latest conflict regarding treatment approaches is self-help advocates and their anger over governmental policy. This approach actually negates a regional or even national approach, and cries out for local control, with maximum support from all government agencies and NGOs.

There is the need to learn from failures beyond the kinds of data presented in Table 1. Treatment programs fail because they are not implemented properly, and this depends upon whether programs were created based on proper planning. Simply this means back to the drawing board for HIV/AIDS programming in Africa. If that creates another fool’s paradise, the fools have the right to make their own mistakes.

* Lincoln J Fry holds Ph.D. degrees from the University of Southern California and Mississippi State University. He is currently an Academic Member of the Sociology and Health Research Units at ATINER (Athens Institute for Education and Research) Athens Greece) and has over 65 academic publications.

 
 

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