Speech for PACT Workshop for Potential Grant Applicants

Swaziland, 3 June 2005

Colleagues, Ladies and Gentlemen,

I wish to thank the USAID/RHAP program and PACT for convening this workshop in support of implementation of the President’s Emergency Plan in Swaziland. I am happy to share this event with a number of NGO, FBO and CBO leaders who are so instrumental in waging an effective fight against HIV/AIDS in Swaziland.

The past few years have seen a sea change in the global response to AIDS. Spending on AIDS in low and middle income countries has more than doubled since the beginning of 2000 to its current level of over $5 billion. It has been widely accepted that at least $10 billion annually is needed - and with the initiation of the Presidents Emergency Program for AIDS Relief (PEPFAR) and the establishment of the Global Fund and other significant donor contributions to the effort, we are getting there.

But despite the sea change in funding, attitudes and the norms for the response to AIDS, we are still a long way from the scale of implementation that is needed to start reversing the epidemic and that is especially true in Swaziland.

This PACT project represents the best and biggest attempt to date by the US in Swaziland to enlist NGOs, CBO and FBOs more fully in the fight against HIV/AIDS. You have the dedication, experience and grassroots connections to the people of Swaziland and you understand better than anyone the almost overwhelming nature of the pandemic. You also understand the need for the kinds of programs that you are striving to provide and wish to enhance through the USAID PACT project.

This workshop will hopefully better equip you with the tools and means to prepare a winning proposal and move to the stage of implementation for the betterment of the thousands of people in Swaziland affected by HIV/AIDS. I thank you in advance for your efforts and for being here.

One of the other most important ingredients in the struggle against HIV/AIDS is leadership. Leadership in the form of increased advocacy and leading by example from the top of and the rest of government is essential to the equation: national leaders command national policy and resources and are influential as role models to the Swazi people. No NGO, CBO or FBO or business can replace this role, as important as you are. The countries where HIV incidence is falling are those where governments and their leaders have stepped up to the line – Uganda, Thailand, Cambodia, Uganda, Brazil, Senegal. The list is getting longer.

What are key problem areas where leadership can make a difference?

1. The first has to do with stigma. Swazi people need to feel comfortable seeking and accessing HIV/AIDS tests.  Stigma associated with HIV/AIDS causes people to avoid testing. Yet knowing one’s status is essential to allow people access to appropriate prevention, care, and treatment services.

2.  The second has to do with access to services. In the event they are HIV-positive or children of HIV+ persons, Swazis need access to expanded services including ARV-based treatment and care services (including services for orphans).

3.  The third has to do with sexual practice and behavior. Sexual practices that include multiple partners in unmarried relationships has brought Swaziland the world’s highest HIV rate.

Leadership is required to reduce stigma. Leadership also is essential in the promotion of HIV/AIDS testing and in convincing people of the importance of knowing one’s status.

Some actions of leadership could include the following:

·  Public officials, chiefs, leaders and so forth could routinely undergo voluntary counseling and testing publicly.

·  High-profile HIV positive leaders could be encouraged to make their status known to help destigmatize HIV, and to demonstrate that HIV+ leaders can lead productive, non-stigmatized lives.

·  Leadership should also advocate a strong message about the need for fundamental change in sexual behavior.  A strong message on abstinence (and delay of sexual debut) for youth, partner reduction, and condoms use among adults can serve to help transform the sexual behavior.  Top level leaders, chiefs, community leaders, government at all levels, church leaders, traditional healer leaders should promote this message.

·  Local level leaders, faith-based leaders, traditional healers, and communities should be empowered to come up with local solutions for prevention, care and treatment.  This includes supporting and addressing needs of orphans in communities.  These local level leaders can work with NGOs, their communities, and churches to organize community-based responses.

·  Leaders should demand that the govt. develop and implement workplace programs, especially across all ministries, to help workers with access to HIV/AIDS testing, prevention, care, and treatment services.

 *Leadership should also advocate for policy change and ensure its implementation to make certain that the health system respond more effectively and rapidly to the HIV/AIDS crisis.

But governments operating without the support of other sectors, including the FBO, NGO and CBO communities, are doomed to fail on AIDS. AIDS is a crisis and it needs a crisis response. The AIDS epidemic is on a scale that demands this type of response - it needs us all to rewrite the boundaries of enlightened self interest, and indeed the boundaries of where social responsibility starts and stops.

In Swaziland, the US Government is providing bilateral assistance to the GOKS via 6 USG agencies:

1& 2. CDC/USAID---Community-based HIV/AIDS care including PMTCT, VCT,  NGO/FBO grants, social marketing, assistance to orphans, human capacity building, behavior change, policy reform, media, etc.

3. Dept of Defense—equipment and awareness/testing for the Swazi Defense Force

4. Peace Corps—50 volunteers in rural AIDS-effected communities

5. Africa Development Foundation—agriculture and food security assistance to AIDS-effected communities..

6. Dept of Labor—workplace HIV/AIDS program via the ILO
and the US contribution to the Global Fund for Swaziland—at over $20 million, places the approximate US-financed total for HIV/AIDS assistance to Swaziland at some $30 million.

The fact is that today in Swaziland in many parts of the fight against HIV/AIDS, availability of funds is less of a problem than the need for action on the ground. That’s where the organizations represented in this room come into the equation. You have the power to make a difference.

Thank you for your attention.