Address on HIV/AIDS in Africa at TICAD III

The 3rd Tokyo International Conference on African Development (TICAD 111) was held in Tokyo, Japan from 3rd to 4th August 2003. One of the sessions was devoted to discussing HIV/AIDS in Africa, and was addressed by Mrs Morolake Nwagwu, HIV-positive speaker and coordinator of the Treatment Action Movement (TAM) Nigeria.

I want to start by thanking UNDP, Japan Ministry of Foreign Affairs and all organizers of the TICAD 111-Voices of African NGOs symposium, for sincerely committing to this process, for expending so much time, energy and resources. Bringing us from ten different African countries all the way to Japan is highly commendable - and the only reason this happened is because there is genuine sincerity on the part of the organisers and all collaborating NGOs to make the Tokyo Initiative to TICAD process work. The reason we are here is to partner and dialogue with Japan about your Initiatives on African development.

Development is absolutely impossible without human beings and HIV is about people. HIV, the Human Immunodeficiency Virus, is a human virus. It doesn't live in dogs or monkeys. It lives in human beings; it lives in my blood stream. When statistics say 70% of people living with HIV are in Africa, when they say that 30 million of the world s 42 million people living with HIV and AIDS are in Africa, when you hear that 3.47 million Nigerians have HIV, the reality of these figures is myself, Rolake. I am not a figure or a statistic, I am a human being. I am this supposedly healthy, tall, big, black, beautiful woman standing here before you.

If your thinking does not transcend figures and all your efforts are focused only on prevention programs that excludes care, support and treatment, then in three, five or maybe 10 years, I would become the frail, dying, skeletal image you re used to seeing on your TV screens popularly called AIDS victims.

Right now, I am not a victim. I am a woman with brains and skills, a woman with the will and zeal to live. But if nothing is done, if we all sit down, fold our hands and the only thing we think and talk and encourage is prevention and Voluntary Counseling and Testing (VCT), then I would become a victim. If I do not have access to life-saving medicines, to prophylaxis to prevent TB, to prevent transmitting this virus to my baby, if I have no access to essential drugs to treat my opportunistic infections and antiretroviral drugs to fight the virus in my blood stream, then I would become a victim of injustice, a victim of inequality, a victim of neglect. I would become a victim of bad policies; a victim of AIDS.

The TICAD 11 principal document adopted in this very same city of Tokyo, Japan in October 1998 talks extensively about ownership and global partnership. It says that priorities for Africa should be determined by Africa itself. TICAD 11 Initiative supports these priorities and I quote "Ownership is derived when development priorities as set by Africans are pursued". This sound to me like "He who wears the shoes knows where it pinches". On the issue of AIDS, it means that People Living with HIV and AIDS (PLWHA) play a great role in the fight against HIV/AIDS in Africa. If this is so, then we need to keep them alive so we can work hand in hand.

We need Greater (and meaningful) Involvement of PLWHA (GIPA). We need for our preventive measures to encompass treatment because for me and about 30 million others in Africa, prevention is too late. HIV is here already. That was the doctor s report in 1998 and the last time I checked 3 years ago, it was still there. GIPA will help make HIV a reality. By working with PLWHA at home here in Japan and abroad in Africa, we will have a comprehensive package that will help stop new infections and prevent needless deaths.

One of the goals and objectives of TICAD 11 is that by 2015, to reduce mortality rates for infants and children under the age of 5 to one third of the 1990 level. In 2003, 13 years after 2003 and 12 years to 2015, more children are dying. Our babies are dying because there isn't enough support for PMTCT. Our children are dying from Malaria, from opportunistic infections like TB. One way to strengthen preventive measures and integrate cross-sectoral HIV/AIDS strategies TICAD talks about is to educate and empower women, who in my country are six times more vulnerable than men are. The way is to go beyond VCT and move on to care, support and treatment, to enhance assistance for the prevention and treatment of parasitic and infectious diseases like TB and malaria. We can only create the much desired behavioral change through providing information and improving community activities for HIV prevention and treatment in local languages.

There is a need for the poor, especially women, to access micro credit and employment opportunities. If we are committed to this goal, how come PLWHA are excluded from accessing micro credit to eradicate poverty? How come the developing partners say we cannot get credit because we have HIV? They say we cannot repay the money because we will soon die. We do not need to die if we have access to treatment!

TICAD as development partners says it is committed to assisting strengthening of training programs that enhance the capacity of communities to plan and manage their developmental activities. That is to say, there is the will to assist and strengthen people (regardless of their HIV status) to make right and informed decisions about their lives and health. Treatment Education programmes should be strengthened and this isn't just about ARVs. A comprehensive Treatment programme incorporates Good nutrition, Positive Living, use of supplements and prophylaxis, drugs to treat opportunistic infections and, ARVs which is the only class of drugs that fight HIV directly.

The Nigerian government provides ARV for ten thousand adults. My president has taken the first step, but we cannot do it alone. We need to scale up and include subsidized medical tests, and treatment education. If we are more than partners, if we have become friends like was mentioned on this podium today, we need your help to expand and strengthen this programme and others like it across Africa, and this is where you can help, this is where the Global Fund to fight AIDS, TB and Malaria (GFATM) comes in.

For the very first time, there is a global body, a Global Fund created specially for PLWHA, a fund to save our lives. GFATM has started work, money has been disbursed twice now, but the Fund is broke. Japan is the world s second largest economy, fourteen percent of the world s wealth resides in Japan, but where is the money? I make an appeal as an affected person to the government of Japan to please fund the Fund. Japan has committed $200m. This is highly commendable and it is a very big step, a step other rich nations can adopt and follow, and for this, we say: Thank you Japan, but more can be done. 14% of the Fund s 2003 budget is $815m, and Japan has given $200m. That means we need $600m more from Japan and subsequently at least $800m in the next years.

I asked in Nigeria and JICA says the government of Japan cannot support consumables because of its existing policies. OK then, give the money to GFATM and they will support consumables and invest in our lives. The Global Fund has no strings attached, their principles supports treatment and training. JICA supports VCT, but so does every other group.

Japan should dare to be different from the crowd. The more VCT is promoted and new centers opened, the more people will want to know their status. This is brilliant and we support VCT because the woman who is more likely to pass HIV to her baby is an untested one, and when you know your HIV status, you can take steps to ensure you remain healthy and live a qualitative life. However, if you encourage me to get tested, what then in the world do I do if my test comes out positive? Where is the back up and support service? Where is the care, the support, the treatment? VCT can never stand alone. It will cause more problems. It will lead to despondency and make people loose the will to live. It leads to suicide and insanity. We need VCT, but in addition to that, we need the back up of care, support and treatment. Policies are man made so the government and people can revise those laws and policies.

Finally, what can we do? What can those of us in this room do? What can the NGOs, Business Conglomerates, Researchers, Development Partners, Government workers, Media, Private Consulting Companies, African Diplomats, JICA, and PLWHA do? We can break the silence. HIV is not an African health problem; it is a global developmental issue. It is not just my problem, it is our collective problem. Thanks to the technology of great countries like Japan, the world has become a global village: all walls, barriers and boundaries have been broken down and HIV needs neither a visa nor a permit to come in.

Let us all join in the international fight and advocacy. Our babies are dying, our sisters, mothers, brothers, fathers, friends and communities are dying. Let us wake up, raise awareness and money to stop needless deaths. In my country Nigeria alone, there were 170.000 reported deaths caused by AIDS in 2001 alone. That means that more than 465 people died everyday from an AIDS related disease. I do not want to be a figure. I do not want to die or pass this virus on to my baby. I want to live; I want access to treatment, access to unrestricted travel, access to life. What we need in Africa isn't quarantining, stigma or discrimination but support to live a meaningful qualitative life and contribute our quota to the development of our country, our continent and the world at large.

Thank you. Arigato.

Morolake Nwagwu

Treatment Action Movement Nigeria

tam@nigeria-aids.org