Towards universal access: West and Central Africa
07 November 2006
"Towards Universal Access to Prevention, Treatment, Care and Support in the West and Central African Region”
The renewed commitment to universal access to prevention, treatment, care and support undertaken by countries across the world, has paved the way in West and Central Africa to more inclusive dialogue among partners, galvanizing consensus around the core challenges currently obstructing the national response, and strengthening joint determination to scale up national programmes.
The process of scaling up towards universal access in West and Central Africa has demonstrated the positive impact that broad and collaborative partnerships can provide, bringing together actors from government, civil society, (including people living with HIV, faith-based organizations, women’s groups, networks of health NGOs, youth associations, community based organizations), the media, the private sector, and bilateral and multilateral partners. This broad partnership set the backdrop for informed and open discussion on central themes of the national consultations, for example, raising issues around the importance of prevention as a means to ensure the sustainability of treatment provision.
The UNAIDS Regional Support Team in Dakar has extensively supported the meaningful involvement of civil society which has been of varying but increasing frequency/intensity, In several countries such as Burkina Faso, Mali, Nigeria and Senegal, civil society has been actively involved in both the target setting and review processes of national strategic planning, ensuring the critical input of West African civil society into regional and global fora. This participation was ensured at the Brazzaville regional consultation and the Abuja Heads of State Summit, but more significantly, enabled African civil society to contribute to “ Africa’s Common Position to the UN General Assembly Special Session on HIV/AIDS” June 2006.
Significant momentum has built up on target setting and its follow up, facilitated by technical and financial support provided by the UNAIDS country and regional offices, the UN Country Team and UN Theme Group . Seventeen of the twenty countries who have held national consultations to date have set targets towards scaling up, with countries raising the bar of aspiration by setting far more ambitious goals for 2010, in line with the 2001 Abuja Declaration and the UN High Level Meeting of June 2006.
Progress made in West and Central Africa testifies to the central importance and utility of a strong strategic plan as the vehicle for reaching ambitious targets. Thirteen countries in all have developed nationally agreed roadmaps for scale-up over the next five years (2006-2010). Evidence suggests that those countries able to harmonize target setting with the strategic planning cycle, encountered far less difficulties in establishing targets than those who undertook a separate process. A harmonized strategic planning approach ensures that partners operate in accordance with national priorities, supporting the principles enshrined in the Three Ones and Global Task Team recommendations. In addition, it has been widely recognised that countries will only succeed in scaling up towards universal access if the critical obstacles identified during the country consultations are addressed through the national HIV strategic plans, and are complemented by regional and global level policy action.
Countries in the region have nevertheless encountered several challenges in the target setting and planning processes. In some cases, target setting has been hindered by a lack of available and reliable data, and further support is needed to establish one national M&E system, including a common database accepted and accessible by all partners. In addition, countries have struggled to cost their revised annual workplans, a process completed by six countries to date. Particular attention is needed to scale up technical capacity in this area to elaborate detailed costed annual work plans. Continued and sustained technical and financial support will be needed, for national governments and country-based civil society, to accelerate the national response .
The Regional Support Team in Dakar and the Country and Regional Support Department of UNAIDS Geneva will continue to provide technical and financial support to countries towards scaling up including the finalization of target setting and planning processes. In addition, the RST will also continue to work with the regional civil society networks in West and Central Africa to empower their respective member organization networks to play their role in the national AIDS response and to help them identify more effective means of communication and representation at key regional and global fora and institutions.