Amakuru yawe
Your Excellency President Kagame,
Your Excellency President Filipe Nyusi
Your Excellency Jeannette Kagame, First Lady of the Republic of Rwanda,
Your Excellencies First ladies
Prof. John Idoko, ICASA president
Honourable ministers, ambassadors, distinguished guests, dear colleagues and friends,
First of all, I would like to say that I am delighted to be home at this very important event.
The theme of this year’s conference is an AIDS-free Africa.
This is a theme that once, we would not have even dreamed of.
We would have thought it was too ambitious, too presumptuous.
But the fact that we now have a conference with a theme like this shows how far we have come.
Rwanda is a perfect example.
More than 90% of people living with HIV in this country know their status, and almost all of them – 98% – are on life-saving treatment.
Of those, 90% have achieved viral suppression.
That makes Rwanda one of the few countries to achieve the 90-90-90 targets prior to 2020.
New HIV infections and AIDS-related deaths have dropped by more than half over the last decade.
The progress here in Rwanda is nothing short of incredible. But it’s not alone.
Globally, of the 37.9 million people living with HIV at the end of last year, more than 80% now know their status, more than 60% receive treatment and more than half have achieved viral suppression.
The number echoes overall progress in Africa, where 75% of all people with HIV live.
Millions of people are on treatment. Even better, millions of people are NOT on treatment because they have the tools to protect themselves.
We’ve accelerated research and development. We’ve pushed back the boundaries of science and are now in hot pursuit of a cure.
We’ve championed the rights of the most marginalized and vulnerable.
All of this has enabled us to dream of an AIDS-free world.
It’s a theme that reflects the ambition of the Sustainable Development Goals, to end the AIDS epidemic by 2030.
This is an ambition to which WHO is firmly committed.
But we must be realistic. Numerous challenges stand between us and the realization of that dream.
The gains we have made are under threat, with signs of wavering political commitment and declining funding.
In 2018, 770 000 people died from HIV and 1.7 million people were newly infected and the vast majority of these cases and deaths occurred here in Africa.
We know who these people are; over half of people newly infected with HIV belong to key populations groups and their partners, such as men who have sex with men, people who use drugs, sex workers, transgender people and prisoners.
In this region, young people are the most vulnerable, especially adolescent girls, who account for three in four new infections.
We have the tools to prevent these new infections, like PrEP, condoms and voluntary medical male circumcision.
But more effort is needed to improve access and uptake of these tools, alongside anti-retroviral therapy.
Testing and treatment efforts neglect the needs of our children.
Half of the children living with HIV lack access to testing and treatment with coverage levels lower than among adults.
Of children receiving treatment, 2 in 3 are on suboptimal medicine.
What do we need to do to overcome these challenges?
The theme of this conference doesn’t only give us the vision of an AIDS free Africa. It also tells us how to get there: innovation, community and political leadership.
Allow me to finish with three challenges for all of us in each of these three areas.
First, innovation.
Innovation has brought us this far in the fight against HIV, and innovation is essential for overcoming the obstacles we still face.
We need better treatments, better diagnostics, and we still need an HIV vaccine.
But we also need innovative ways of delivering services to reach key populations and marginalized communities, to retain people in prevention and treatment services, and for those with HIV to promote life-time adherence to treatment.
WHO guidelines now recommend the simplest, most innovative ways to deliver person-centred HIV testing, treatment, care and support, integrated with other health services.
Second, community.
Since the early days of HIV, communities of affected people have been the driving force of the response.
And they must continue to be. New tools can only be effective if they are developed with and embraced by the people who need them.
I’ve seen many of these communities in action, from mentor mothers in Lesotho to community pharmacists in Nigeria and adolescent treatment supporters in Zimbabwe.
Our job as leaders is to listen to what these communities are telling us they need, rather than telling them what we think they should have.
That is the meaning of people-centred care.
But we also need to address the full range of health needs.
We must give children pediatric ARVs alongside vaccinations for measles and hepatitis B.
We must give women testing services for HIV and syphilis, but also for breast cancer.
We must offer men who have sex with men PrEP, but also services for mental health.
We must give communities condoms, but also smoking cessation services.
And we must do it all as part of an overarching commitment to universal health coverage.
Which brings me to the third challenge: political leadership.
I know from my own experience that support from the highest levels of government is essential for making real progress.
That is what enabled us to make progress in Ethiopia.
And that is one of the key lessons here in Rwanda.
The results you have achieved would not have been possible without Your Excellency’s, President Kagame’s, vision and leadership, not only for HIV, but for universal health coverage. Your Excellency President Kagame, please accept my respect and appreciation.
This is the kind of leadership we need in every nation.
And it’s the kind of leadership that is now building here in Africa, and around the world.
At the African Union Summit earlier this year, countries committed to increasing domestic investment in health, and to being accountable for that commitment, which was led by President Kagame.
At the United Nations General Assembly in September, all 193 UN Member States approved the political declaration on universal health coverage.
The AU Call to Action and UN political declaration complement each other.
Three weeks later, at the Inter-Parliamentary Union Assembly in Belgrade, legislators from 140 countries adopted a global resolution to translate that political commitment into reality.
Of course, commitments, declarations and resolutions are only pieces of paper unless they are implemented.
But without them, we cannot make the progress we need at the pace we need it.
Excellencies,
My brothers and sister,
The SDGs give us the mandate to work together for an AIDS-free world.
With innovation, community engagement and strong political leadership, we can make that vision a reality.
I thank you. Murakoze cyane.