Aleem Siddique (Deputy Chief, UNMIL Public Information Office)
We are joined by Dr. Gameli Seadzi who is the UNMIL’s Chief of HIV/AIDS office here in Monrovia; we are also joined by the Executive Director of Liberia National AIDS Commission, Dr. Ivan Camanor, and we are also joined by Isacc Ahemesah, Program Officer for UNAIDS here in Monrovia. We have a very special guest here, Ms. Cole who is joining us from a Liberian Organization presenting people who have been affected by HIV/AIDS. A very warm welcome to all of our guest speakers.
Dr. Gameli Kofi Seadzi (UNMIL Chief HIV/AIDS)
Thank you and welcome to our listeners. As Aleem has already said, World Aids Day is celebration every year on 1 December and it is a global day. The importance of which is to raised awareness about the HIV/AIDS problem, put all of our attention to it and remind us that HIV/AIDS problem has not gone away.
Every year there is a global theme for the commemoration of the World Aids Day. And this year’s theme is “Getting to Zero”. Zero in infections, zero discrimination and zero irrelated deaths. The call is to all of us to ensure that we prevent ourselves from becoming infected with HIV; not to stigmatize of discriminate against anyone living with or who may be affected by HIV that we may know, and also with present availability of treatment, there should be no AIDS related death.
For this year commemoration, Liberia has chosen the of “Eliminating HIV transmission from Mother to child in Liberia Yes we Can”. Despite the recent progress in reducing HIV/AIDS, globally, there are still a lot to be done.
The latest UNAIDS report we received just last week indicated that there about 2.5 million people who became infected with HIV in the year 2011 alone. Though there are many countries that show some reduction in new infection. Amongst these countries that show reduction in new infections; there are about twenty –five that show more the fifty percent reduction in new infections. Again we are have been informed that the reduction in new infections were due to the prevention of new infection in the new born. A new born can only be infected by transfusion from the mother to the child. So with reduction in the new born infection from mother to Children, that has been reduced by more than half in about twenty-five countries.
I have a few more figures to show you that in 2011 that globally there was 43% reduction in new born infections in women as compare to what happened in 2003. These figures are showing us that it is possible to achieve reduction in infection in new born babies as has happen in the past few years. We are looking in at eliminating completely by 2015.
You would realize that when you get IHV, it is a life time event. You may be on treatment for life, probably may kill you. Which means, that if your bring forth a child today who is HIV positive, it means that child must be on treatment for the rest of its life. If it is preventable, why can’t we take action to stop that. It is possible that is why we have Ms. Cole here to tell us that she has gone through it and came out with HIV negative baby.
Therefore the theme that Liberia chose to eliminate HIV transmission from mother to child by 2015 is in line with the global trend. The theme is realistic, it is subjective and achievable. What is needed all of us to lend our support in various ways to spread the good message about the program that is in existence, the program that prevent mothers from transmitting HIV to their children and we also as program officers will also do our best to make the program available to the people who need it in the country.
Dr. Ivan Camanor (Executive Director National AIDS Commission, Liberia)
Thank you very much for the clear introductory comments about the HIV.
What we note from your discussion is that the world is making progress in controlling the spread of HIV I think the statistics repeated at International Conferences in the UNAIDS report that clearly the epidemic is declining; that the number of new infections are decreasing in many countries; twenty-five countries globally, but in West Africa the West African Health Organization (WAHO) reported that about six to seven countries also are reporting decrease in new infections. And I think even in our country Liberia; looking at the data we have from the Health Facilities, the Ministry of Health and some of the Surveys that are ongoing, it is strongly suggested that Liberia too is seeing the decrease in new infections.
This progress has been made largely by the tremendous efforts that the International Community and countries have made. We have given the control and prevention of HIV high priority. This is basically based on the experience that many countries; especially in Easter and Southern Africa where the epidemic case havoc to the population. So there was increase determination in the international community and the countries to tackle HIV as a serious challenge.
We are happy that in our country, we have seen progress, progress specifically in many areas that are contributing to reduction of new infections. This is not to be complacent but to be encouraged that the inventions that are been promoted and supported by Government are making progress. We have really intensified and increase awareness. Four to five years ago, there was not much discussion, printing, radio broadcast about HIV. I came back to the country in 2008 and there was basically total silence. But as you all are aware now, there has been increase communication, awareness, and targeting of the vulnerable population; the women and child, youth. I think this is one of the thing that we know that people need to know more about HIV, need to know how HIV is transmitted and how we can prevent ourselves from the infection. That is an era where we are making progress.
We are also making progress in the expanding services. Again in 2008, there were only four to five health facilities that were treating people who were infected. Now we have over thirty or more and we have quite a number of health facilities that are counsel and testing people; HIV Counseling and Testing Centers. There are about three hundred and sixty now in the country. That means in every county and districts, there are facilities that people can go and get counseled and tested, and if you are found positive can be referred to a treatment center.
That is the change and the progress that has been made. And I have to say that we are seeing people, young people, and women accepting the services more freely. There are people going to be tested. We want to encourage that because that is how people are going to know their status and get person education, counsel how you can prevent yourself from being infected. And if you are infected, you can have information on how you can look after yourself and get treatment.
We are also advocating strongly for the rights of people living with HIV because this is one of the areas that hamper the progress we make. People are afraid because we do not know about HIV and has made it a dreadful disease; indeed it is a disease that we should pay attention to. We have made it worse than it really should be. Because we have labeled it as a disease as the result of immorality, it is a disease as a result of promiscuity and this not entirely true because HIV is now known to be like any other disease more or less. It can affect anybody. Anybody that is involve in reproductive act, that does not know how protect oneself is liable to be infected. When look at children who are born to mothers who are infected what immorality act have they committed? So you have children born with HIV and they all are given discriminated. We have people who infected through accidental exposure or even through violence and so for the. So it has to be seen now that we cannot lay blame on people who are living with HIV, we have to consider as people who are sick like any other chronic diseases like Tuberculosis, leprosy, high blood pressure, diabetes; they are all sick people. From my orientation it is out of culture to really laugh at or discriminate or point out anybody who has an illness. I think our culture is to provide care and support. This is why we are advocating.
We are also strengthening partnership because HIV is no longer a health issue alone. We have come a long way with that. At the beginning it was the Ministry of Health that led the activities for HIV because it was seen as a disease. But we have seen in and as experienced in many countries that HIV affects other sectors equally. When teachers die, it affects the educational system. When lawyers, architectures and engineers die it affects all those sectors. When the farmers die, then it affects food production. It cannot be an issue that only the Ministry of Health should be concerned with. So we are mobilizing partnership. We are working with seven key ministries that we are advocating and supporting to take leadership role in their sectors: they Ministry of Education, Ministry of Youth and Sport, Ministry of Agriculture, Ministry of Labour, Ministry of Gender and Development, and Ministry of Justice. We are working with all the other sectors.
The whole idea of the partnership is that everyone becomes concern because HIV is everybody’s concern. If all of us play an active role then we are able to come and talk of the epidemic. I think the theme this year is basically one that is a worldwide goal. The world is so happy and enthusiastic about the progress that has been made that we are now thinking that it is possible to have no new infections, basically to get rid of HIV virus. We are really into progress be made in the production of new drugs, work be done on the production of vaccine. The technology that we have now, the strategies that we have in place now; if we effectively implement them, it is possible to reach to zero infection.
Treatment now is seen as a preventive measure. Those who are infected when treated live better life. The rate of infection from infected on treatment to the public is low. So we have a lot of technology that has been developed we are very hopeful.
We are challenging the public to know more about HIV. Know it can be treated and how one can get infected and how one can protect oneself from getting infection. I would also charge families and communities to look after those who are unfortunately affected. When we look after them then they have a better environment to live and better access services and lives better lives.
Mr. Isaac Offei Ahemesah: Programme Officer UNAIDS
Today is a very important day as we prepare ourselves to do the big celebration on Saturday. This year’s World AIDS day is a special one, special in the sense that, for the first time, we have seen significant progress globally in our effort to address the HIV/AIDS in many countries.
We have seen significant progress in the reduction in the number of new infections that we are having. Twenty-five countries have recorded over fifty percent reduction in new cases. It means for instance if they a prevalent rate of forty percent, each year they were getting twenty thousand people infected with every year. It has significantly reduced to ten percent. This is significant in the sense that now we are going to eventually head toward getting to the goal of achieving zero new transmission in those countries. The first step has begun and I do believe together, we can work in achieving that.
Nearly twelve countries in sub-Saharan Africa and some countries in Asia have recorded this significant progress. We have also seen that over the past two years a lot of countries have increase the number of people who are on treatment. Treatment used to be a major concern for many countries because they could not have access to the drugs, access to testing but now we see that a lot of countries are approaching the zero AIDS related death by making access to treatment available to the greater part of the population.
We do know that between 2005 and 2011, there have been twenty-four percent declines in AIDS related death globally. This is important because if people know that they can live with HIV as a normal chronic disease then the tendency for people to hide themselves in their closet when they are infected would reduce.
What we need to emphasized for people to realize is that HIV now is becoming a chronic disease like diabetes, high blood pressure. You take your drugs regularly and you can live very long with it. In our current situation, the number of people who are dying as a result of HIV infections is significantly reducing; and it is a progress that has been achieved over the last few years that calls for celebration in this World AIDS Day.
Partnership becomes very important and we have seen across many countries there has been significant increase in domestic financing in national AIDS responses. In the past you have a situation where most countries depended on donors to support their national responses but today over fifty percent of our countries some significant contribution from their Government in the national response, which is very positive. We are focusing on the three zeros. Zero transmission of HIV infection, zero HIV related death and zero HIV stigma and discrimination across the globe. These three goals is something that most countries have signed on to. And that the high level meeting that took place in New York in 2011, over 170 countries sign on to ensure that by 2015 we would push the bandwidth to ensure that we have a zero transmission of HIV infection, zero transmission of HIV related death and zero stigma and discrimination. This is the first to achieving the MDGs target that has been set and we are going to be evaluated on in 2015.
Distinguished listeners, as you know we have less than a thousand days towards reaching the MDGs target. And this work is a reminder for all of us to begin to take action to address the HIV situation in Liberia and across the globe.
I think for the UN side, there has been a lot of contribution that the UN has made in support of the National response. As most of you are aware, each agency has its own mandate and based on their mandate the support the national response. UNDP for instance is responsible for good governance, all the efforts they have made is to support the Government to improve capacity, the rule of law issues as it relates to HIV infections. We have UNICEF which is the lead agency for children in the county. And as most of you are aware, UNICEF has made significant contribution to mother, in terms to intervention from mother to child transmission in the country. They also have supported the young people in terms of providing adolescent service for young people which is also something that UNFPA is also supporting.
Together as the UN, we have provided a lot of support to the national commission and I believe as we celebrate the World Aids Day on Saturday we will come together as a country to look at specific things that we can do to contribute and reducing mother to child transmission. Unlike the other interventions for HIV prevention, mother to child transmission is one single intervention we know it works. It does not depend on people behavior and attitude. The technology is there, the drugs are there, all that people need to do is for pregnant women to get tested and they would be put on HIV treatment and once they are on treatment, they reduce the possibility of transmitting the virus from the mothers to the babies or infant. All that we need to do is to provide support to pregnant women, provide the encouragement so that they can get tested.
And I call on all of our listeners to begin to think about this. If there is a pregnant woman in your house hold, please encourage the person to go for HIV testing. This is the very first step in she knowing that she is HIV positive and then protecting her child from getting affected. There are drugs available for women who are positive, and can be put on drugs to prolong their lives.
A single challenge for all of us is the problem of stigma and discrimination. People are not going for services because they fear that if I am tested and I am HIV positive people in my community will stigmatize me. The HIV law makes it very clear that we cannot discriminate people living with HIV in Liberia. And yet people living with HIV are stigmatized every day. We are happy that the level of stigma is coming down due to the efforts that has already being made people are much more aware about HIV. We need to ensure that people living with HIV are protected at all times.
Ms. Workie Cole (Representative from a Liberia Organization representative people affected by HIV/AIDS)
I am happy that I am to be part of this conference today. As a woman who has gone through the PMTT (prevention of mother to child transmission), I was infected and when to the process, I access all that was due to me; that is respecting my appointment. This is very important. Whenever the Doctor tells you that you due to the clinic a particular time always respect it. Once you are about to give birth, do not give birth at home because there are certain injections they will give you that will help the mother and child.
With all the process, I was able to give birth to a baby boy. He is a year plus and is even in school. If it can happen for me, it can also happen for those mothers out there who are also positive and do not want to access the treatment. If you do not access the treatment, you are denying the unborn child to have treatment. What you are suffering, do not let that unborn child suffer. HIV is a life sickness or disease. I can say that HIV is not my problem because HIV lives with me. I will control it, it will not control me. This is why I take my medication; I do not joke with it. If it can happen for me, it can happen for you out there.
I say thank you to my guests for allowing me to be a part of this conference.
Questions and Answers
Q: Adolphus Marwolo (New Liberia Newspaper)
I want to know from Mr. Camanor what the current prevalence rate of HIV in Liberia is?
Q: William Selmah (West Africa Democracy Radio)
Dr. Camanor, what is the level of coordination between your Institution and other agencies fighting against AIDS? We have seen conflicting accounts over the years of the prevalence rate of AIDS in Liberia?
A: Dr. Ivan Camanor (Executive Director National AIDS Commission, Liberia)
The official estimate of the prevalence rate is 1.5% in the reproduction age population. This estimate is official. It was released by Liberia Institute of statistics, the official organization and authority of information. Basically this is what we have now. We other secondary data the we used to estimate. For instance we do survey in pregnant women. We have done that since 2006 to 2011 and we see that rate declining. That is not the official estimate but a monitoring tool. LIGIS be will doing a survey in January and we will have a new estimate in terms of the prevalence
I do not think there is any confusion in the statistics because the statistics is only released by the Commission. Other partners may release the own date, but the official data is released by the commission and everybody recognizes that.
There are a number of coordinating mechanism put in place. We have the Broad of Directors that is chaired by the President in which all the key partners participate and they are briefed, discuss and give directions. The Board of Directors meets twice a year and it is composed of about thirty key partners in the country; most of the key Ministries and the UN are there. It is at this Board of Directors meeting that the policies are made, programs are approved. That sets the environment in which there is national coordination. The President chairs this committee. Then you have the committee itself that consists of five professionals that have various units of coordination. For instance we the Government Ministries focal persons group; they meet regularly, discuss and also coordinate their work. We have a Monitoring and Evaluation Coordination; that means all the research that is done in the county, the data being released is coordinated by this group.
So there are a number of mechanisms that are run or conducted by the commission to make sure all the key partners are working together. The result of this is we now have one National Coordinating committee which is the commission; The National AIDS commission is the body empowered by the Government of coordinates the national response. We have one national plan that was led by the commission but by all the partners. All the activities in this country had to be based on that plan. We have one monitoring and evaluation plan as well.
Q: Bill Diggs (Insight Newspaper)
My question goes to Mr. Ahemesah. You talk about some law on stigmatization and mentioned that stigmatization is still a problem in Liberia. What other measures do you think will be necessary to curtail stigmatization against people living with HIV?
A: Mr. Isaac Offei Ahemesah (Programme Officer UNAIDS)
The law is there to protect all of us. The law on HIV was passed by the Legislature sign by the President last year and it is in place. What it means is that if somebody is being ejected from his house because he is HIV positive, we can fall on that law to give that person protection. If somebody is being sent out of school because he is HIV positive, the law protects the person from being sent out of school or out of work.
The important that we have done and will continue to do is continuously increase people knowledge on HIV because if people know that if I drink from the same cup with a person living with HIV I will not be infected. I think it is important that we continue to educate ourselves. HIV is not contagious as people believe. The important thing is we are all in this, we are supposed to protect each other from getting infected. Stigmatizing people will not help us do a good job. And we call on all of us to try and minimize stigma. If need information on HIV, it is readily available. I think the media is doing quite a good job and we will encourage you to do this.
Dr. Ivan Camanor (Executive Director National AIDS Commission, Liberia)
I think we have seen a big reduction in stigma because some of you who are old enough in the mid eights when someone said John had HIV, they will more or less want to stone you. We now know our relatives and friends who are HIV positive and also we have made progress; we have treatment. The reason HIV was big a dreaded disease because it was classified as a death sentence. But it is no longer a death sentence so people do not have to be afraid of it as much as we used to be. Moreover, we know a lot more now on how HIV is transmitted and we also know how it is prevented.
This press briefing took place on Wednesday November, 20, 2012
The panelists were as follows:
Dr. Gameli Kofi Seadzi, UNMIL Chief HIV/AIDS Office, Dr Ivan Camanor, Executive Director National AIDS Commission, Liberia, Mr Isaac Offei Ahemesah: Programme Officer UNAIDS