Five Minutes With
Five Minutes With HIV/AIDS Activist Paula Akugizibwe
Paula Akugizibwe is currently the advocacy coordinator at the AIDS and Rights Alliance for Southern Africa (ARASA), an organization focused on ensuring universal access to quality HIV, tuberculosis, and health services as a human right. Akugizibwe has worked with the Clinton HIV/AIDS Initiative, the Southern African Development Community, and the World Health Organization on issues related to infectious diseases throughout Africa.In July, she headlined the opening ceremony of the 2010 International AIDS Conference in Vienna, Austria. Her candor, charisma and tireless advocacy have made Ms. Akugizibwe a force to be reckoned with in the international aid community.
Campus Progress caught up with her after the Global Fund Replenishment conference in New York City last week. The conference was chaired by U.N. Secretary-General Ban Ki-moon and aimed to draw donations to secure long-term funding for the fight against AIDS, tuberculosis, and malaria. With a budget of over $19 billion, the Global Fund accounts for over half of the international financing of HIV/AIDS programs in the world’s poorest countries.
Unfortunately, the representatives of 40 countries meeting in New York last week failed to raise the $13 billion deemed necessary to maintain services at current levels over the next three years. The United States was a notable exception at the conference by increasing its previous contribution by 40 percent, bringing the total to $4 billion.
Campus Progress spoke to Akugizibwe just hours before the final results of the donations were released.
Campus Progress: What are the biggest issues in battle against HIV/AIDS in Africa today?
I think HIV is such a multifaceted epidemic that you need to break it down a little bit to get to the heart of what the issues are.
A lot of challenges at the political will level, both reflected in the cutbacks in global funding and national government commitments to HIV. We have seen low levels of investment in HIV treatment from many governments in African region and we have seen corruption in the use of HIV funds. I think both of those have contributed to this global backtracking of commitment.
A lot of the challenges are outside the health systems. To a large extent, some of the socio-economic challenges that we see in the African region pose the greatest threats to overcoming HIV—gender violence, unemployment which leads people into unsafe sexual practices as a means of survival, and so on.
Also, in regards to infrastructure, HIV has traditionally been approached in a centralized fashion. People go to clinics and hospitals to get tested, care and treatment. There is an urgent need to look beyond the traditional paradigm of delivering services and really find a way we can decentralize HIV care throughout countries, because a lot of barriers to people accessing services are distance to faculties.
How big of a role do cultural issues play addressing the epidemic?
I think a lot of these cultural barriers come up when we don’t see countries and communities deciding for themselves what the best way to set up programs and deliver services is. These problems are not insurmountable.
We recently started a program in Swaziland—one thing we were told quite emphatically is that if you are going to be working in Swaziland, you have to work with traditional healers. Traditional healers had historically been one of the most vocal opponents of HIV treatment, warning people against the toxicity of treatment … [and in Swaziland], a lot of people listen more to traditional healers than their doctors.
In our approach, we had traditional healers fully involved in the delivery of programs. We did quite a lot of follow up to persuade the leader of the traditional healers’ organization to come to our first training. After a great deal of resistance, he eventually came. It allowed us to build a relationship that has resulted in traditional healers becoming some of our strongest allies. This kind of relationship building is something that aid organizations often miss out on.
It’s [usually] quite didactic, it’s like, ‘This is what you need to do,’ and countries respond, ‘Well, actually, this is not what we need to do. What do you know? You’re sitting in Washington D.C.’
For example, for years and years huge amounts of U.S. funding were earmarked for abstinence only messaging. Abstinence was their solution to AIDS. I mean, in an ideal world of monasteries and convents, perhaps. But in the real world, it just was not a realistic approach. Thankfully, with the new administration, that restriction has been lifted.
You testified in front of Congress recently on HIV and AIDS in Africa. How were you received?
Congress was OK. People said the things that needed to be said … but ultimately the true test of political will comes down to commitment of resources. In a few hours time we will know better.
The one thing I started to realize increasingly is that this is ultimately a political struggle. What really lies at the heart of declining investment in HIV is the lack of recognition that health is a right, and not just a human right, but the basis of social and economic development. We all know that governments have conflicting priorities that often do nothing to advance human development, but somehow they find millions of dollars for that.
Are you optimistic about reaching the funding goals of the Global Fund?
I’m very pessimistic about reaching the goals set out for the global fund—I’m hoping for a miraculous surprise. The Global Fund has saved five million lives. It funds up to 80 percent of regional HIV treatment budget in some counties. It is hard to find a person in southern Africa that does not have a friend or loved one that has been personally affected by the Fund. In New York or D.C., it is all abstract numbers—but in the communities we come from, it is life or death.
Kayvan Farchadi is a staff writer for Campus Progress.