High Level Dialogue on ending AIDS by 2030 Strengthening the assessment of AIDS and Health in the APRM mechanism by Joseph TSANG MANG KIN Member, APR Panel of Eminent Persons 25 November 2014, UNECA, Addis Ababa 1

2 Outline of presentation Introduction APRM Assessment Framework for Health and HIV/AIDS APRM Normative Framework for AIDS and Health Assessment of AIDS and Health across APRM themes Case study: South Africa Case Study: Uganda Conclusion

3 Introduction The African Peer Review Mechanism (APRM) is a mutually agreed instrument voluntarily acceded to by the member states of the African Union (AU) as a self-monitoring mechanism. Founded in 2003, its mandate is to encourage conformity with political, economic and corporate governance values, codes and standards, among African countries so as to accelerate socio- economic development. To date 34 AU Member States have acceded to the APRM and 17 have been peer reviewed by the APR Forum.

4 APRM Assessment Framework for Health and HIV/AIDS APRM countries are assessed on Four Thematic areas: i) Democracy and Political Governance, ii) Economic Governance and management, iii) Corporate Governance and iv) Socio-Economic Development. APRM deals with the problem of Health and HIV/AIDS both directly and indirectly in the APRM Questionnaire by: Assessing the normative framework (signing, ratification, & domestication of international and African Codes & Standards) Assessing the implementation of the commitments (outcomes-based) Monitoring of Progress Reports on implementation of National Plan of Action (NPOA) submitted yearly.

APRM Normative Framework for AIDS and Health APRM Standards and Codes, directly dealing with Health and HIV/AIDS, include the:  African Charter on Human and peoples’ Rights (1981);  African Charter on the Rights and Welfare of the Child (1990);  World Summit on Social Development Plan of Action (1995);  Convention on the elimination of all forms of discrimination against women (1979)  UN MDG (2000)  African Youth Charter (2006)  Protocol to the African Charter on Human and People’s Rights on the Rights of Women in Africa (2003) Other health instruments used during assessment not specifically listed in the APRM Questionnaire: African Health Strategy ; and Abuja Call for Accelerated Action Towards Universal Access to HIV and AIDS, Tuberculosis and Malaria Services in Africa by

Assessment of AIDS and Health across APRM themes Democracy and Political Governance: under Rights of Women, Rights of the Children, and Rights of vulnerable groups. The assessment examines legislation, policies, and institutional framework in place to promote right to health and combat AIDS among these groups. Corporate Governance: organizational compliance with human rights and labour laws; corporate social responsibility in the area of health and combatting HIV/AIDS. Socio-economic Development: more emphasis on social issues, notably health and HIV/AIDS. Strengthening policies, delivery mechanisms and outcomes in key social areas including HIV/AIDS  Measures taken by government Legal, policy, institutional steps Volume, criteria for resource allocation Participation of all stakeholders  Outcomes on social indicators HIV prevalence disaggregated by sex, age, region 6

Case study: South Africa SA fourth APRM Member State to be peer reviewed in July 2007 by APR Forum. Country Review Report (CRR) identified HIV/AIDS pandemic as major cross-cutting issue. Estimated 5.3 millions living with HIV/AIDS by end of 2005 making SA second in the world with highest number of people living with HIV By March 2006, only 130,000 patients were on state funded ARVs program CRR identified critical areas needing government attention: treatment (increased public access to ARVs), protection of women and children from rape; providing strong and clear leadership by addressing “Aids denialism”; stop violence against women; promote preventive measures (know your status, condom, behavioral change). It worked: Government implemented a multipronged strategy (combining prevention and treatment). The 3 rd Progress Report on implementation of APRM NPOA presented January 2014 reveals:  Over 2 million people were on antiretroviral (ARV) treatment by mid-2012, leading to increased life expectancy of people living with HIV  Increased of ARVs sites (3000 sites in 2012)  Medical male circumcision government drive to limit the spread of HIV  Reduction of HIV transmission from mother to child from 8% in 2008 to 3.5 in  Introduction of single dose pill reducing the risk of patients defaulting 7

Case Study: Uganda The seventh APRM country to be peer reviewed in June 2008 and hard hit by HIV pandemic with adult prevalence rate of 18 % in the early 90s. CRR identified Government response to HIV/AIDS as best practice:  Strong political leadership by President Museveni in the campaign against HIV/AIDS  Open and multi-sectoral policy approach pursued by the government  Massive campaigns on prevention based on ABC- Abstinence, Be faithful and Condom use  Improved access to treatment with free ARVs  First voluntary counseling & testing clinic (VCT) in Africa  Training of health workers in the villages to provide needed health services including VCT, preventing mother to child transmission (PMTCT) and ART programs  Successful public private partnerships implementing HIV/AIDS projects involving key government ministries, CSOs, CBOs and private sector companies.  Acquisition of an ultra modern pharmaceutical facility for producing some of the drugs, including ARVs. This has helped to bring down the costs and increase access to more people.  Result was a dramatic reduction of HIV prevalence from 18.5 % beginning 90s to 6.5% in 2006 though increased to 7.2% in

Conclusion APRM offers platform to strengthen assessment of AIDS and Health in Africa APRM not only assesses and monitors the extent to which commitments are implemented, it also provides the opportunity for policy makers and ordinary citizens/stakeholders to hold each other accountable. Hence the need to strengthen the Mechanism as a monitoring and accountability mechanism. In line with its mandate, the Common Africa Position on post 2015 Development agenda, and AU Agenda 2063, APRM will continue to review and urge member states to sign and ratify UN and regional instruments, including those on HIV/AIDs and ensure implementation and compliance. Together and with a strong political commitment, the call for ending epidemics of HIV/AIDS, TB and Malaria by 2030, can be a reality. 9