The Organisation of African First Ladies Against HIV/AIDS (OAFLA) recently met in New York to discuss how they can scale-up their efforts towards ending the AIDS epidemic in Africa.

The First Ladies met at the Ford Foundation in New York on the sidelines of the 69th session of the United Nations General Assembly where they deliberated on effective solutions to maintain high-level commitment to ending the AIDS epidemic.

The First Ladies highlighted the need to scale-up comprehensive maternal and new-born health services which integrate HIV testing for pregnant women and provide access to antiretroviral medicines during pregnancy, delivery and which extend through the breastfeeding period.

OAFLA has recently launched a new strategic plan which highlights the urgent need to integrate HIV services into existing sexual and reproductive health services. The First Ladies agreed that targets related to stopping new HIV infections among children cannot be met if the wider context of preventing new HIV infections among women and girls is not addressed.

OAFLA was originally established in 2002 as a collective voice to support people living with and affected by HIV. Over the last 12 years, the first ladies have engaged in awareness raising campaigns and advocacy initiatives in their respective countries.

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UNAIDS Executive Director Michel Sidibé met with the President of South Africa, Jacob Zuma, on 4 September at the President’s official residence in Pretoria, South Africa. During the meeting, Mr Sidibé congratulated the President on his re-election and praised the government’s leadership in the country’s HIV response.

Mr Sidibé called on President Zuma to support countries affected by western Africa’s current Ebola virus outbreak. The lack of a locally produced serum to respond to Ebola illustrates the need for African research and drug production for this and other diseases affecting the continent, including HIV.

President Zuma and Mr Sidibé agreed that the local production of antiretroviral medicines is critical, as of the 35 million people living with HIV worldwide, 24.9 million live in Africa. South Africa can lead the way and play a critical role in ensuring that all countries have access to cheaper generic drugs.

Mr Sidibé also made a plea to President Zuma to address HIV prevention among populations at higher risk of HIV infection in South Africa, including sex workers and young people, particularly young women and girls.

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The First Lady of South Africa, Thobeka Madiba-Zuma, pledged to improve the health of young women and girls in South Africa during a meeting with UNAIDS Executive Director Michel Sidibé on 4 September at the President’s official residence.

Mr Sidibé acknowledged the First Lady’s role in lobbying for a price reduction for the human papillomavirus vaccine and ensuring better access to the vaccine in developing countries. The First Lady works extensively on health issues related to breast and cervical cancer and  HIV, including prevention initiatives for young women and girls.

During his four-day visit to the country, Mr Sidibé also met with the South African Minister of Health, Aaron Motsoaledi, to discuss Africa’s response to the Ebola virus outbreak and the lessons African leaders can learn from the AIDS response. Mr Sidibé said that strengthening health systems and bridging the gap between health systems and the community are critical to addressing the outbreak effectively.

In a round-table dialogue with Mr Sidibé, members of the South African National AIDS Council’s Civil Society Forum reiterated the need to form a stronger and strategic partnership with the Government of South Africa and the critical role that civil society plays in creating demand for the services that the government provides to respond to HIV and tuberculosis. 

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The President of Madagascar, Hery Martial Rakotoarimanana Rajaonarimampianina, pledged to do what is necessary to overcome the AIDS epidemic and move towards reaching zero new HIV infections, zero discrimination and zero AIDS-related deaths. Meeting with UNAIDS Executive Director Michel Sidibé on 16 April in Antananarivo, the President said, Madagascar can eliminate new HIV infections and in particular ensure all babies are born free from HIV, with the support and goodwill of UNAIDS and the United Nations family.

Madagascar has recently come out of a period of political unrest. Since the January 2014 elections, the new government has been working on improving access to health care services. Mr Sidibé congratulated the President and the strong commitment his government has shown to rebuilding partnerships. He said it was time to put in place an effective HIV response which committed to social justice and eliminated discrimination towards people living with HIV.

Current data suggests Madagascar has an AIDS epidemic which is concentrated among people who use drugs. An estimated 59 000 people were living with HIV in 2012 and 4000 new HIV infections occurred that same year. According to government figures, an estimated 519 people living with HIV accessed treatment at the end of 2013—this represents less than 1% of people who were eligible for treatment under the World Health Organization’s 2013 guidelines. In 2012, only 3% of pregnant women living with HIV had access to services preventing transmission of the virus to their child. AIDS-related deaths increased since 2001––from 4 600––to 6 200 in 2012.

During his two-day official visit to Madagascar, Mr Sidibé met with the country’s Minister of Health, Minister of Youth, President of the National Assembly and representatives from civil society to push for a stronger and more sustainable AIDS response. He also participated in the official inauguration ceremony for the new Prime Minister, Kolo Christophe Laurent Roger, which took place on 16 April at the Office of the Prime Minister. 

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The President of Mauritania and new Chair of the African Union (AU) will support African leaders in increasing action in the response to HIV.  President Mohamed Ould Abdel Aziz met with the Executive Director of UNAIDS, Michel Sidibé on 20 March in Nouakchott, Mauritania.  Mr Sidibé congratulated the President on his recent election to the rotating presidency of the AU and urged him to lead efforts to accelerate transformative reforms in the responses to AIDS, tuberculosis and malaria.

In 2012, African leaders committed to a Roadmap on Shared Responsibility and Global Solidarity for AIDS, TB and Malaria Response in Africa, charting a new course for the continent’s response to the three diseases. Mr Sidibé stressed the urgent need for African countries to take ownership of their epidemics and reduce dependency on international financing. He also reiterated the need to produce antiretroviral and other essential medicines on the continent and build capacity and knowledge on the production of medicines.

As well as playing a leading role in the African Union, Mauritania is also a member of the League of Arab States, which earlier this month endorsed a highly innovative strategy to halt the AIDS epidemic in Arab countries.  Mr Sidibé pointed out that while Africa is the region most affected by HIV in the world, the Arab region has one of the fastest growing epidemics globally. Since 2001 the number of people newly infected with HIV in Arab countries has increased by more than 47%. He called on Mauritania to leverage its unique position and act as a bridge between African and Arab institutions, spurring the transfer of key know-how and technology in the AIDS response.

Mauritania recently adopted a law which protects the rights of people living with HIV and provides free antiretroviral therapy to people eligible for HIV treatment. According to national authorities the number of people accessing life-saving treatment increased from 1 866 in 2012 to 2 400 in 2013, an increase of 27% in just one year.

During his official visit, Mr Sidibé also met with Prime Minister Moulaye Ould Mohamed Laghdaf and Minister of Health Ahmedou Ould Hademine Ould Jelvoune. He also visited an outpatient treatment centre in Nouakchott that provides integrated services including prevention, treatment and social support services for HIV and TB.

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