2014 WORLD AIDS DAY MESSAGE FROM THE CATHOLIC HEALTH COMMISSION OF THE EPISCOPAL CONFERENCE OF MALAWI
THEME: GETTING TO ZERO
1.0 Preamble
Today in the liturgical calendar of the Catholic Church is the first Sunday of Advent. The Church begins a new Liturgical Year, a new journey of faith. The Advent season as we all know is the time when every Christian is to reflect on his or her spiritual life illuminated by the life and teachings of Jesus Christ, rediscovering the Christian journey and renewing the quality of our Christian life.. The season, this year begins on 30th November and will take us through to Christmas, 25th December, 2014.
As the Church begins this new Liturgical season with hope, she joins the rest of the world in commemorating the World AIDS Day, which is celebrated on 1st December every year. The World AIDS Day is dedicated to raising the awareness of the AIDS pandemic, caused by the spread of the HIV infection. The global theme for World AIDS Day from 2011 – 2015, as selected by the World AIDS Campaign, is “Getting to Zero”. Backed by the United Nations, the “Getting to Zero” campaign focuses on the goals of: zero new infections, zero AIDS related deaths and zero discrimination. In order to achieve these goals, United Nations Member States, Malawi inclusive, pledge to meet the following targets by 2015:
i. Reduce sexual transmission of HIV by 50%.
ii. Reduce transmission of HIV among people who inject drugs by 50%.
iii. Eliminate new infections among children and substantially reduce AIDS-related maternal deaths.
iv. Reach 15 million people living with HIV with lifesaving antiretroviral treatment
v. Reduce tuberculosis deaths in people living with HIV by 50%.
vi. Close the global AIDS resource gap and reach annual global investment of US$ 22–24 billion in low- and middle-income countries.
vii. Eliminate gender inequalities and gender-based abuse and violence and increase the capacity of women and girls to protect themselves from HIV.
viii. Eliminate stigma and discrimination against people living with and affected by HIV through promotion of laws and policies that ensure the full realization of all human rights and fundamental freedoms.
ix. Eliminate HIV-related restrictions on entry, stay and residence.
x. Eliminate parallel systems for HIV-related services to strengthen integration of the AIDS response in global health and development efforts.
The season of advent is indeed an opportunity to reflect on the HIV and AIDS epidemic with hope. It is a time when we look at the state of the epidemic, the challenges it still poses and what needs to be done with eyes of faith. As a Church, we reflect on “Getting to Zero” by following the footsteps of Jesus Christ who looked at his own suffering with hope and trust. It is an opportune time we reflect and renew our zeal, commitment, determination and level of efforts in responding to the HIV and AIDS epidemic and its various impacts on the society.
2.0 THE STATE OF THE HIV AND AIDS EPIDEMIC
Since the beginning of the HIV and AIDS epidemic, almost 75 million people have been infected with the HIV virus and about 36 million people have died of AIDS related deaths worldwide. At the end of 2012, there were about 35.3 million people living with HIV globally. The burden of the epidemic varies considerably between regions and countries. Sub-Saharan Africa remains the most severely affected, with nearly 1 in 20 adults living with HIV.
Malawi, being one of the Sub-Saharan countries, has not been spared. Since the first AIDS case was diagnosed in 1985, the HIV prevalence increased significantly and peaked around 16.4% in 1999 among persons aged 15 – 49 years. The prevalence has been declining steadily, reaching 10.6% in 2010 and estimated to be at 10.3% in 2013. It is estimated that about 1,100,000 people are living with HIV, 170,000 being children aged 0-14 years. In 2013, an estimated 48,000 people died of AIDS related illnesses and there are about 790,000 orphans aged between 0 – 17 years due to AIDS.
3.0 PROGRESS ON THE RESPONSE TO THE EPIDEMIC
The HIV and AIDS response in Malawi is guided by the revised HIV and AIDS policy. As a country, we have made remarkable progress in the response to the HIV epidemic. The HIV and AIDS programmes have grown in scale, effectiveness and impact such that positive results have been observed. For instance:
i. New HIV infections among adults and children are declining.
The rate of new HIV infections among adults declined significantly by more than 50% between 2001 and 2011. The number of new infections among children 0 – 14 years fell by more than 50% between 2009 and 2012. This is due to wider access to antiretroviral therapy and increase in services to eliminate mother to child transmission of HIV.
ii. AIDS related deaths have declined
Since the increase in provision of antiretroviral therapy, the number of AIDS related deaths has been declining rapidly. The integration of HIV and Tuberculosis diagnosis and treatment has also contributed to the decline of AIDS related mortality. As a result, fewer children are being orphaned because of AIDS.
iii. The number of people receiving antiretroviral therapy has increased
As of 2013, 83% of eligible adults and children are receiving antiretroviral therapy compared to 63% in 2010. The total number of people living with HIV is rising as a result of more people being on ART and survival of those being infected is increasing. The life expectancy has also risen from 49 to 54.
The Catholic Church in Malawi has responded to the epidemic through; HIV prevention programs i.e. HIV Counseling and Testing and Prevention of Mother to Child Transmission; care and treatment programs i.e. Home Based Care, provision of antiretroviral therapy; support to orphans and vulnerable children through Community Based Care Centres and nutrition support programmes.
4.0 CHALLENGES
Despite the progress that Malawi has registered so far, there are still a number of challenges that we are still facing in the response to the epidemic.
i. Sexual transmission remains the highest mode of transmission of HIV infection
The majority of adults living with HIV in the country acquired the virus through sexual transmission. 88% of all new HIV infections are through heterosexual intercourse. Reducing the number of new adult HIV infections therefore demands reductions in the sexual transmission. If we are to meet the 2011 Political Declaration of reducing sexual transmission of HIV by 50% between 2011 and 2015, there is need for improved efforts and scale up of HIV prevention interventions.
The Church is further challenged with the fact that HIV transmission within couples is an important source of new adult HIV infections. 80% of all new HIV infections are occurring in couples in stable relationships. These infections are due to multiple concurrent sexual partners. Traditionally it has been thought that if one is uninfected with HIV at the time of marriage, then they have avoided the infection altogether. However research shows that marriage is not enough to protect one from HIV, whether men or women. The church therefore has a big challenge in HIV prevention.
ii. Women remain the most severely affected with the HIV epidemic
According to 2013 HIV estimates for Malawi, women make up over half of adults living with HIV aged 15 years and up. Women are not only biologically more susceptible to HIV than men, behavioral and social factors also increase their vulnerability.
iii. Youths continue to be infected with the virus
Youths, who make up a large number of Malawi’s population, continue to be infected with HIV. Infection levels among young women are particularly higher. This is affecting the efforts in HIV prevention.
4.0 APPEALS BY THE CATHOLIC HEALTH COMMISSION
“Getting to Zero” is a responsibility of every Malawian. The churches and the Catholic Church in particular, play an important role in the efforts on “Getting to Zero” by 2015. There is need for programs that particularly target couples, including HIV counseling and testing and education for men and women about social norms and how they negatively impact men’s and women’s health. The Church reminds us all that Scriptures teach us that family, as instituted by God himself, aims at promoting life and not death (bring forth life Gen.1:28). Let couples therefore; be mindful of not being a source of death to each other and family life should in no way become a death trap for those who have embraced this noble God-given vocation. The call for mutual love and faithfulness to each other between couples is one of the cornerstones for family life (Eph. 5:31ff). It is only when couples truly love and are faithful to each other that the family will lead to ‘zero infections’ and zero AIDS related deaths.
For the youth, Jesus Christ as youth should be the role model; he grew up both in stature and in wisdom and God’s grace was with him (Lk 2:52). Let the youth embrace the gospel values so as to be inspired and guided with proper moral and ethical norms that will lead to “Getting to Zero”.
5.0 CONCLUSION
It is our Christian responsibility to halt the negative impact of the HIV and AIDS epidemic on the society. Let us imagine a society in which there are lesser numbers of orphans, more numbers of healthy households that are socio-economically self-reliant, medical facilities that are only dealing with other diseases than HIV and AIDS. It is our duty to make this dream happen and we, in this Advent season, can make this determination a reality.