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Report on the Presidential
Mission on Children
Orphaned by AIDS in Sub-Saharan Africa: Findings and Plan of Action
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Forces for LIFE Leadership
and Investment in Fighting
Global AIDS Initiative
the US Government investment in the global battle against AIDS to begin to reflect
the magnitude of this rapidly escalating pandemic.
Making a difference in
Africa and in other highly impacted areas requires broader political commitment,
enhanced community mobilization, and, most urgently, increased resources.In 1998, spending on AIDS in Africa totaled only $165 million.Compared to the ever-escalating need and other
health programs, this amount is woefully inadequate.For example, in 1998, over $500 million was
spent for basic childhood immunization programs in Africa.Based on our experience in those countries
that are starting to demonstrate success, such as Uganda and Senegal, UNAIDS
and donors now agree that a minimum of $600 million is needed in sub-Saharan
Africa per year for HIV prevention alone ($2 per adult per year).
we acknowledge the leadership role that the US plays globally and the urgent
need to act, clearly an effort to combat AIDS must be driven by many actors
including host countries, multi-lateral organizations, and bi-lateral donors,
to be successful.In FY1999, the US
Government spent $74 million in USAID prevention and care in Africa and $38
million in HHS research and surveillance/prevention.But more remains to be done in sub-Saharan
Africa and in other seriously affected parts of the world.
The Administration proposes to commit an additional $100 million in FY2000
to the global battle against AIDS.This
initiative will enable us to move forward on four critically important and interconnected
the AIDS Pandemic ($48 million) Implement a variety of prevention and
stigma reduction strategies, especially for women and youth, including: HIV
education, engagement of political, religious, and other leaders; voluntary
counseling and testing; interventions to reduce mother-to-child transmission
(MTCT); and enhance training and technical assistance efforts, including Department
of Defense efforts with African militaries.
Home and Community-Based Care ($23 million) Deliver counseling, support,
palliative and basic medical care including treatment for sexually transmitted
diseases, opportunistic infections (OIs), and tuberculosis (TB) through community-based
clinics and home-based care workers.Enhance training and technical assistance efforts.
for Children Orphaned by AIDS ($10 million) Assist families, extended
families, and communities in caring for their children through nutritional
assistance,education, training, health,
and counseling support, in coordination with micro-finance programs.
Prevention and Treatment by Augmenting Planning, Infrastructure, and Capacity
Development ($19 million) Strengthen host country ability to plan and
implement effective interventions.Strengthen
the capacity for effective partnerships and the ability of community based
organizations to deliver essential services. Strengthen surveillance systems
to track the epidemic and target HIV/AIDS programs.
US Government assistance would be provided through AID ($55 million), HHS ($35
million), and DoD ($10 million).The focus of this funding is HIV prevention,
and AIDS care and treatment.In those
areas, this initiative represents nearly a doubling of funding in Africa from
current levels ($81 million in FY99, which excludes research).The Administration recognizes the fight against
AIDS must be sustained to keep pace with this burgeoning epidemic, and is committed
to a multi-year effort in this critical area.
II.Building partnerships with other key stakeholders to maximize our impact
on the rapidly expanding pandemic.
US investment in the global battle against AIDS is critical, but is not sufficient
to achieve the outcomes needed. The commitment of in-country political leaders
and of various segments of civil society are key to success.Moreover, resources provided by the US Government need to help leverage,
and to be coordinated with, those of other donors, the private sector, and national
governments to ensure synergy and to maximize impact.Building partnerships with key stakeholders in support of effective action
at the community level is our greatest hope for progress.
This initiative will pursue a variety of strategic opportunities for challenging
other partners to join in an enhanced effort, including:
Meeting On September 7, 1999, First Lady Hillary Rodham Clinton will convene
a meeting of key US officials, The World Bank, UNAIDS, as well as heads of
foundations, corporate CEOs, and others to discuss how best to enhance AIDS
prevention and treatment efforts in Africa and around the world.The meeting will focus not only on leveraging
additional resources, but also on establishing priorities, identifying effective
public/private partnerships, and identifying targets for action to combat
the crisis of HIV/AIDS.
Leaders SummitWe propose hosting
a high-level meeting with Africa government and community leaders within the
next ten months.This meeting will
highlight the critical role of leadership in arresting the epidemic and will
work to encourage increased leadership efforts. Topics will include the economic
impact of HIV/AIDS, examination of models of success in reducing the transmission
of HIV, and addressing the need for increased investment in health programs.
Additional topics will include AIDS care and treatment and support for children
orphaned by AIDS.
UN Conference on Children Orphaned by AIDS
On December 1, 1999 (World AIDS Day), the United Nations in conjunction with
the National Black Leadership Commission on AIDS, The White House Office of
National AIDS Policy, The Magic Johnson Foundation and a variety of NGOs,
will organize a conference to focus attention on the growing number of children
orphaned by AIDS worldwide.Special
emphasis will be placed on assessing the needs of orphaned children in sub-Saharan
Africa and the Americas.Participants
will include noted experts on the priority issues identified by UNAIDS, UNICEF,
and other UN agencies.
Business The Department of Commerce will
facilitate a meeting of business leaders active in Africa to encourage them
to increase their efforts to rise to the AIDS challenge. Given the impact
that AIDS is having on businesses as well as the overall economic-impact on
African countries, such a meeting will seek enhanced business commitment and
involvement in AIDS programs.
The Commerce Department
will work with American Chambers of Commerce abroad and other business organizations
to publicize the successful AIDS efforts of US firms in Africa and to support
others taking similar action.In addition,
the Department will direct work to promote closer coordination in Africa between
Commercial Service Offices, other USG agencies, the business community, and
African NGOs in a united effort to promote corporate partnership in AIDS programs.
Labor The Secretary of Labor will facilitate a meeting of US and
African labor leaders, and will be co-chaired by the AFL-CIO.The success of the AFL-CIO and its Solidarity
Center in South Africa (supported by USAID) in working with the South African
Trade Union Federations to include AIDS as a key labor outreach and policy
issue provides a model for similar action elsewhere.Outcomes include assisting labor organizations
in educating their members and securing commitments to develop workplace-based
AIDS education and prevention programs, including outreach to youth.
Leaders SummitThe US government
will facilitate a meeting of African, American, and other religious leaders
to discuss the important role of communities of faith in the fight against
AIDS. In Uganda and Senegal, the involvement of religious communities and
leaders had a dramatic impact on the ability of these two countries to reduce
HIV incidence and to maintain it at low levels over time. The outcome of such
a meeting would be to increase attention to the need for involving religious
communities, to mobilize these organizations and leaders in the fight against
AIDS, and to identify ways to support their efforts.
Diplomatic Initiatives The Department
of State, NSC, and ONAP will work with US and African ambassadors to increase
attention to AIDS within the diplomatic community.The NSC, the Department of State, and USAID will work with G-8 and
other donors, and challenge them to match the increased investment put forward
in this initiative.