Mozambique Makes Gains in Fight against AIDS, Needs More Prevention

01/09/2011 - The top UNAIDS official visited Mozambique recently, calling for the country's leadership to back greater prevention efforts to fight AIDS. Mozambique has had many recent successes, but still faces several challenges.

Michel Sidibé, Executive Director of the Joint United Nations Programme on HIV/AIDS (UNAIDS), has called on Mozambique to strengthen its commitment to HIV prevention. While on a four-day tour, the chief of the UN agency also congratulated the country on its effort to fight the devastating virus.

Among Mozambique's many efforts has been an alignment of their national strategies with those of the UN Political Declaration on HIV/AIDS. What is now needed is to ensure long-term financing for these national strategies. Mr. Sidibé has called on the country's leaders to help make this a reality.

Raising domestic funds to finance HIV and AIDS programmes is an important aspect of the sustainability. For, when it comes to initiatives aimed at combating the disease, 97 per cent of Mozambique's AIDS budget is derived from external donors.

Possibilities for new financing methods include national contributions, private sector constitutions, and social health insurance development. Mr. Sidibé, who met with the Mozambican Prime Minister, Aires Aly Bonifácio, spoke also of considering AIDS in the context of other health and social development activities.

While Mozambique is behind other sub-Saharan African countries when it comes to the absolute number of HIV infections as well as the overall prevalence rates, it has the second-highest rate of new adult infections (incidence rate) in the world.

As such, "there is a need to accelerate prevention programmes," advised Mr. Sidibé.

At the end of last year, there were 200,000 HIV-positive people undergoing treatment in Mozambique. It is among only five countries that still have high levels of new paediatric HIV infections. Of the 500 new daily infections, 90 occur among children via mother-to-child-transmission, according to data from the UN Children’s Fund (UNICEF).

Already, Mozambique has expanded its prevention programme, opening 909 new sites to provide 67 per cent of pregnant women with treatment coverage over the course of last year. Women, who face significant power inequities in the sphere of social relations, are especially vulnerable to contracting HIV. Prevalence rates among girls aged 15-24 are three times higher than that of boys their age.

The first case of HIV in Mozambique was recorded in 1986. In 2004, adult prevalence reached 16.2 per cent and the government declared the disease a "national emergency." Prevalence has declined to 11.5 per cent, as of 2009.

Today, AIDS is a key determinant of child and adults mortality. Life expectancy declined from 41 years old in 1999 to 38 in 2004. While it has now climbed to 48 years old, AIDS is a critical contributing factor to the country's "orphan crisis."

Of the 2.1 million orphaned Mozambican children, 670,000 are estimated to have lost their mother or fathers – or both – to AIDS. Usually, orphaned children find homes with their extended families. Unfortunately, AIDS has disrupted these traditional patterns of alternative care, straining social safety nets at both the community and familial levels.

In 2004, a minority of households caring for orphaned and vulnerable children, half of which were female-headed and a fifth of which were headed by an elderly person, received any kind assistance.

Orphans in Mozambique are also less likely to attend school their non-orphan counterparts. The eldest children are often forced to drop out to care for their siblings once their parents have died.