Special focus on HIV/AIDS AIDS 2010 holds in Vienna The voiceless victims of HIV New advances spur vaccine research

MDG Summit assesses progress Modern energy for all by 2030 OPEC exhibition marks golden jubilee OFID Quarterly is published four times a year by the OPEC Fund for International Development (OFID).

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EDITOR-IN-CHIEF Mauro Hoyer Romero EDITORIAL COORDINATOR Audrey Haylins

CONTRIBUTORS Mariela Hoyer Guerrero, Anna Ilaria-Mayrhofer, Syahrul Luddin, Silvia Mateyka Violet Onyemenam, Verena Ringler, Mojgan Sanandaji, Fatimah Zwanikken

PHOTOGRAPHS Rana Wintersteiner (unless otherwise credited) PRODUCTION Susanne Dillinger

DESIGN etage.cc/krystian.bieniek PRINTED IN AUSTRIA Stiepan & Partner Druck GmbH COMMENT

OCTOBER 2010 HIV/AIDS: getting priorities right 2

SPECIAL FEATURE

Containing the HIV/AIDS pandemic 4 4 AIDS 2010 comes to Vienna 9 OFID at AIDS 2010 12 OFID sponsors participants at AIDS 2010 14 At risk of being forgotten The voiceless victims of HIV 16 Overcoming stigma and discrimination The other battle against HIV/AIDS 19 New advances spur AIDS vaccine research 22 Text H for health Are mobile phones the key to fighting AIDS? 25 46 Tuberculosis and HIV: a lethal combination 28 Washington calling: looking ahead to AIDS 2012 31

OUTREACH

Building a new future for Haiti’s children 34 Boosting cancer care in Zambia 36 OFID Diary 40 Meetings attended by OFID 41 Loan and Grant signature photo gallery 42 132nd Governing Board photo gallery 44

DEVELOPMENT COOPERATION

Millennium Development Goals still within reach New York Summit inspires fresh hope 46 Modern energy for all by 2030 New drive to launch soon 48 54 Four decades of Arab AID: a proud tradition 50

COVER PHOTO: JOCICALEK/SHUTTERSTOCK MEMBER STATES FOCUS Gabon and Nigeria celebrate 50 years of independence 52

Maps are for illustration purposes only and are not to be taken as accurate representations of OPEC borders. For reasons of scale, countries/territories with small areas are not shown. OPEC Anniversary Exhibition showcases Member Countries 54 COMMENT

HIV/AIDS: getting priorities right

en years ago it was rare to pick up a news- one-half of the 8.8 million people in developing paper or turn on the television without countries who need treatment for HIV. The rea- T being confronted with headlines about son? A lack of funding and political will, for the AIDS – the “killer pandemic” sweeping the globe. most part. Back then, AIDS was big news, sending shock Indeed, access to treatment is still one of the waves around the world. Today, the pandemic biggest stumbling blocks in the fight to contain causes barely a ripple – at least in the mass media. the spread of AIDS. Stigma and discrimination is To all intents and purposes, HIV/AIDS has another. As long as HIV and AIDS remain “dirty” dropped off the public radar. words, people at risk will be reluctant to come How ironic, considering that in 2008 alone forward for testing or treatment for fear of losing two million people lost their lives to this disease. their jobs or being ostracized within their com- Fewer, maybe, than the record 2.2 million in munities. 2004, but an awful lot of bereaved families Then there is the problem of mother-to- nonetheless. The vast majority of these deaths, child transmission, something that can easily be however, were in poor African countries. And prevented with antiretrovirals – if they are avail- there lies the rub. Thanks to the advent of highly able, that is. And in the poorer countries, they active antiretroviral treatment (HAART), the not always are. In 2008, for example, 430,000 pandemic is no longer the threat it once was – at babies in the developing world were infected least in the developed world, where HAART is with HIV while in utero, during delivery or readily available. Hence, apparently, the lack of through breast feeding. urgency in containing it elsewhere. Another major concern is the soaring num- This July, at the XVIII International AIDS ber of infections caused by injecting drug use, Conference in Vienna, the G8 nations were which in some regions accounts for as much as roundly chastised for this ambivalence, when 80 percent of all new cases. Dr. Julio Montaner, President of the Interna- Shocking as they are, these facts do not tell tional AIDS Society, condemned their failure to the whole story about the AIDS pandemic, live up to the “universal access” pledge they which has long evolved from being a simple pub- made in 2005. The pledge, part of the Millen- lic health issue. AIDS strikes at the very heart of nium Development Goals, had promised that society, at its productive backbone, at working HIV/AIDS prevention, treatment and care men and women, mothers and fathers. It is a would be universally available by 2010. So far, viciously destructive disease that is no respecter though, HAART has been rolled out to barely of class, creed or culture.

2 OFID QUARTERLY OCTOBER 2010 COMMENT

As early as the mid-1990s, OFID Universal access at least US$20 billion in new was expressing its concern about money to the Global Fund to Fight the enormous economic and so- to treatment AIDS, Tuberculosis and Malaria. cial repercussions of AIDS. It The Global Fund’s replenish- started contributing to the global cannot be reached ment committee met on October 5 dialogue and offering financial without stronger in New York, where donors support to conferences and other pledged a total of US$11.7 billion forums. In 2001, OFID took steps political will towards the campaign for the pe- to consolidate its involvement by riod 2011-2013. While this is defi- creating a special grant account and a massive nitely a step in the right direction, with its own dedicated resources. injection of it falls well short of the amount Regular replenishments have fol- needed. Donors may have dug lowed, as the funds have been funding. deep, but not deep enough. quickly used up. Today, OFID is Such reluctance certainly proud to count itself a partner in wasn’t the case when it came to the broad coalition of stakeholders who are finding bailout cash at the height of the finan- working to stop the spread of the disease and cial crisis – a fact Julio Montaner pointed out win back some of the development gains lost during his opening address in Vienna. “Why over the past decade. are the coffers always empty when it comes to It is to the credit of those at the sharp end global health?” he asked, noting the €110 bil- of the fight against the pandemic that any lion that had “appeared from nowhere” to res- progress has been made in slowing its path. cue the Greek economy earlier this year. And we should not forget that there has indeed OFID shares Dr. Montaner’s frustration, been progress, albeit measured. The number of especially since his statement applies not just to people dying from AIDS has fallen steadily health, but to the wider issue of poverty in since 2006. The number of new infections has general. Strong, healthy populations are a pre- also stabilized, suggesting some degree of con- requisite of economic and social progress. What trol over its transmission. And HAART has better investment can there be in our common proved to be highly effective in eliminating ver- future? What mindset puts personal, institu- tical transmission of HIV. These achievements, tional or national wealth-building ahead of the however, are no reason for complacency. Uni- physical wellbeing of mankind? As Montaner versal access to prevention, treatment and care boldly put it: “It is a matter of priorities, and is still the goal. As is, ultimately, reversing the priorities have to change.” spread of HIV and paving the way for a new OFID could not agree more, which is why AIDS-free generation. we will continue to work with our partners to It is clear that none of these objectives can promote HIV prevention and testing and to be reached without stronger political will and a provide care, counseling, treatment and sup- massive injection of funding. Which is why, at port for those affected. This we shall do for as AIDS 2010, scientists, practitioners and activists long as it takes. Anything less is simply not issued a clarion call to world leaders to commit good enough.

OFID QUARTERLY OCTOBER 2010 3 SPECIAL FEATURE

Containing the HIV/AIDS pandemic

It is a disease that has infected some 33.4 million people worldwide and claimed 22 million lives. Around 7,400 new cases are reported every day, many of them in newborns. In its wake, it has left millions of children without parents and whole communities without an effective workforce. Here, the Quarterly tracks the impact of the HIV/AIDS pandemic and global efforts to contain it. by Fatimah Zwanikken PHOTO: PHOTOTAKE INC./ALAMY

4 SPECIAL FEATURE

5 SPECIAL FEATURE

IV/AIDS affects more people than bases are eroded due to prolonged AIDS- In addition to causing great human suf- H it infects, posing formidable health, related absenteeism and shrinking labor fering, the HIV/AIDS pandemic is defer- economic and social policy concerns. The supply, together with the impact of ring many developing countries’ hopes human toll of the pandemic is not easily healthcare, pension and death-related for advancement by slowly unravelling quantifiable, as it includes not only those benefits. decades of progress in raising life ex- who are infected or have died of the dis- By slowing output growth in all eco- pectancy, improving public health sys- ease, but also their families and commu- nomic sectors and reducing income and tems and developing human resources. nities. Since most HIV-positive people are wealth, the epidemic has created a vicious Schools are losing teachers and students, in the (re-)productive age group (15-45), cycle of poverty and macroeconomic reversing hard-won gains from invest- in the prime of their working and parent- degradation. It makes families poor as ment in human capital; losses that will, in ing lives, the pandemic has deprived they try to meet the escalating costs of turn, impoverish the next generation. countries of manpower and left behind a healthcare and pay for the funerals of By slowly strangulating economies, the generation of orphans. In countries worst family members. They become poorer HIV/AIDS pandemic is jeopardizing affected, where the workforce is either too still as they try to cope with the loss of in- efforts to reach the first Millennium weak or dying in large numbers, produc- come following the death of a breadwin- Development Goal (MDG) of reducing by tivity and the quality of services in all sec- ner. Less money forces them to cut spend- half the number of people living in tors have declined. The disease puts mas- ing on food and health, leaving them absolute poverty by 2015. sive pressure on already stretched public more vulnerable to infection and facili- health budgets, systems and services. tating the spread of HIV/AIDS and other HIV/AIDS also cripples the private sector, diseases. Regional breakdown as expenditures increase and revenue In recent years, the HIV/AIDS pandemic seems to have stabilized, with the number of newly-infected people globally drop- ping from a high of 3.5 million in 1996 to 2.7 million in 2008. The number of AIDS- Number of people living with HIV, number of people newly related deaths declined from a record infected with HIV and number of AIDS deaths worldwide, 2.2 million a year in 2004 to 2 million a 1990-2008 (millions) year in 2008. Despite the declines in new HIV infections, however, the pandemic is far Living with HIV Newly infected with HIV Deaths due to HIV from over. The total number of people 4.0 People newly infected People living with 40 living with HIV worldwide continued to with HIV and deaths HIV (millions) grow in 2008 to an estimated 33.4 mil- 3.5 due to AIDS 35 lion people, reflecting the continued (millions) high rates of new infections and the 3.0 30 increased availability of anti-retroviral 2.5 25 therapy, which is helping people to live longer. Prevalence continues to rise in 2.0 20 Eastern Europe, Central Asia and other 1.5 15 parts of Asia due to the high rate of new HIV infections. 1.0 10 Although the HIV/AIDS pandemic 0.5 5 does not respect borders or class, the poorest countries which have fewer 0 0 resources at their disposal suffer dispro- 1990 1992 1994 1996 1998 2000 2002 2004 2006 2008 portionately from the harmful conse- quences. Sub-Saharan Africa – home of Source: MDG Report 2010

6 OFID QUARTERLY OCTOBER 2010 PHOTO: NEPAL RED CROSS SOCIETY/IFRC

Women at an AIDS prevention class in Nepal. Education and awareness are key tools for limiting the spread of the disease.

Challenges and opportunities the majority of the world’s poorest coun- households into poverty by 2015 unless Conscious of the tremendous threat tries – has been, by far, the hardest hit by global, regional and national responses posed by the pandemic to sustainable de- the pandemic. Out of the 2.7 million are significantly strengthened. velopment, the international commu- new infections worldwide in 2008, The disease also poses a growing nity, meeting for the UN Millennium Sum- 1.9 million people or 71 percent were in threat to the Latin America and Caribbean mit, New York, September 2000, adopted sub-Saharan Africa. The number of peo- regions, with two million and 240,000 as part of the MDGs the target of halting ple living with HIV in the sub-region people, respectively, testing HIV-posi- and beginning to reverse the spread of rose slightly to 22.4 million in 2008, due tive in 2008. In North Africa and the Mid- HIV/AIDS by 2015. The following gains in part to improved access to treatment dle East, 310,000 people were infected in have since been made in preventing new prolonging life. HIV/AIDS is the leading the same period. HIV infections, saving lives and raising cause of death in the sub-region, claim- In Eastern Europe and Central Asia, life expectancy: ing 1.4 million lives in 2008. HIV prevalence continues to increase • Advocacy, public awareness and capacity With about 4.7 million HIV-positive rapidly, with the number of persons liv- building. Much can be done to halt and people, the Asia region comes second to ing with HIV/AIDS rising to 1.5 million reverse the spread of HIV/AIDS through sub-Saharan Africa in terms of the num- in 2008. One of the major causes of in- effective policy response, advocacy, care ber of people living with HIV, with India creased prevalence in the region is the and prevention. Knowledge on how to alone accounting for roughly half of rapid growth in injecting drug use, avoid exposure to the virus plus the Asia’s HIV prevalence. Since Asia ac- which accounts for around 10 percent of availability of priority health sector in- counts for 60 percent of the world’s pop- all new HIV infections worldwide. In terventions for HIV/AIDS prevention, ulation, the region will likely come to Eastern Europe and Central Asia, intra- treatment and care have continued to dominate the HIV/AIDS picture in terms venous drug use is the main route of HIV expand at the global, regional, national of the total number of people infected. transmission – accounting for over 80 and local levels during the last three This will force millions of people and percent of all HIV/AIDS cases. decades, yielding positive results.

OFID QUARTERLY OCTOBER 2010 7 SPECIAL FEATURE

of blood before use. In the developing AIDS-related deaths with and without antiretroviral therapy, global countries, 5 – 10 percent of HIV infec- tions result from contaminated blood. There remains a real need to improve 3.0 Number (millions) No antiretroviral therapy comprehensive blood screening and ac- 2.5 cess to safe blood transfusion services in 2.0 developing countries, particularly in 1.5 At current levels of sub-Saharan Africa. antiretroviral prophylaxis 1.0 • Intravenous drug use. The practice among injecting drug users of sharing 0.5 contaminated needles is a major route 0 of HIV transmission in many regions, 1996 1999 2002 2005 2008 including Eastern Europe, Central, South and Southeast Asia and some Source: AIDS epidemic update 2009 countries in Latin America. Structural • Access to highly active antiretroviral jor stumbling block for prevention and and social drivers include the global- therapy (HAART). HIV/AIDS is treat- treatment, fuelling the spread of the ization of drug markets and lifestyles, able. Several developing countries pandemic by encouraging low levels of poverty and gender inequality. A com- have made universal free access to voluntary testing and by excluding prehensive approach to HIV preven- HAART a priority. Over four million high-risk groups from prevention serv- tion must include not only HIV educa- people in developing countries were ices. The problem is compounded by tion and prevention services, but also receiving HAART by 2007, a 47 percent inadequate legal frameworks and the more opportunities and greater equal- increase over 2006. In 2008, of the 1.4 disempowerment of women, com- ity in education and employment for million HIV-positive pregnant women, bined with little negotiating power and women, young people and marginal- more than 628,000 received HAART to knowledge about the disease. Legal ized populations. prevent the transmission of HIV to reform, together with improvements in • Developing a vaccine. Funding for re- their children. According to the World HIV/AIDS-related workplace policies search and development of an AIDS Health Organization, this represents and programs, are important measures vaccine has been limited, despite the coverage of 45 percent – an increase of for overcoming the stigma associated efforts of not-for-profit organizations 10 percent compared with 2007. with HIV/AIDS. such as the International AIDS Vaccine (see separate story, page 22) • CAPRISA microbicide gel. This medical • Weak government capacity and resources. Initiative . breakthrough, developed in South National governments with limited Although scientific progress is being Africa and announced at the AIDS 2010 resources and capacity cannot win the made, financial resources are urgently needed to accelerate activity in this conference in Vienna, is a vaginal gel battle against the HIV/AIDS pandemic area. which allows women to protect them- without help. Timely and adequate selves from being infected with HIV. Its assistance from the international donor primary benefit is that it can be used in- community is needed to mobilize Conclusion dependent of collaboration with male resources, strengthen existing health The HIV/AIDS pandemic is a long-term partners and regardless of a woman’s systems and education sectors, im- threat to the human race. Since it has a ability to negotiate mutual monogamy prove advocacy, prevention efforts and long incubation period, its impact is grad- or the use of condoms. Women who diagnosis, enhance access to adequate ual, and its full effects may not be felt for used this gel in a trial reduced their risk care and treatment, and expand basic decades to come. Unless adequate inter- of infection by up to 40 percent. infrastructure and transport facilities. ventions are made, backed by robust lead- Key to the financing issue will be ership and sustained financing, the virus However, several issues continue to replenishment of the Global Fund to will continue its relentless spread. hamper progress in tackling HIV/AIDS. Fight AIDS, Malaria and Tuberculosis. Stronger and concerted efforts are needed These include: • Comprehensive blood screening. HIV from governments, development agen- • Denial, stigmatization and discrimination transmission through the transfusion cies, the private sector, the media, research of HIV/AIDS patients. The stigma and of infected blood has been reduced to institutions and civil society organizations discrimination experienced by people virtually zero in the industrialized coun- to turn the epidemic around and ensure living with HIV/AIDS constitutes a ma- tries owing to the universal screening that the next generation is AIDS-free.

8 OFID QUARTERLY OCTOBER 2010 SPECIAL FEATURE

AIDS 2010 comes to Vienna Human rights take center stage

The 18th International AIDS Conference (AIDS 2010) took place in Vienna, July 18 – 23, focusing global attention on the race to meet the sixth Millennium Development Goal of providing universal access to HIV prevention, treatment, care and support. Here, OFID Operations Officer, Syahrul Luddin, summarizes the highlights of the gathering.

ttended by some 19,300 delegates progress. Universal access, the confer- In his opening remarks, Dr. Montaner A from around 200 countries, AIDS ence concluded, requires universal un- noted with satisfaction the achievements 2010 was one of the largest international derstanding and support. in rolling out Highly Active Antiretrovi- conferences held in Vienna in recent The conference was opened by Aus- ral Therapy (HAART) over the past five times. With the theme “Rights Here, trian President Dr. Heinz Fischer, who years. “We went from almost no-one on Right Now”, the conference emphasized was joined by other political leaders and HAART in 2005 to nearly five million to- the importance of framing the fight HIV/AIDS activists including Kgalema day,” he said, adding: “This unprece- against HIV/AIDS within a broader hu- Motlanthe, Deputy President of South dented success proved many skeptics man rights context. At the same time, it Africa; Dr. Julio Montaner, President of wrong.” He went on, however, to express provided a platform for assessing progress the International AIDS Society (IAS); Mr. his “profound disappointment and deep towards the goal of universal access. Michel Sidibé, Executive Director of UN- frustration” at the failure of G8 leaders While delegates learned of major AIDS, and Dr. Alois Stoeger, Austrian to live up to their commitments. “These breakthroughs in pushing back the pan- Minister of Health. Among the promi- same leaders had absolutely no problem demic, the overwhelming mood was one nent speakers at the plenary sessions over the past year finding the money on of frustration and despair that stigma were former US President Bill Clinton a moment’s notice to bail out their cor- and discrimination continue to hinder and Bill Gates. porate friends … yet when it comes to

OFID QUARTERLY OCTOBER 2010 9 PHOTO: UNAIDS/H.AGA Dr. Julio Montaner, President of the Interna- global health the purse is always The human rights theme was echoed in tional AIDS Society, empty,” he stated. “It is a matter of prior- an organized march through the streets ities …. Therefore, our number one ob- of Vienna on the evening of July 20. was highly critical of jective here today is to ensure that AIDS Attended by thousands of conference del- the world’s wealthiest remains at the top of their [the G8’s] egates and local residents, the march agenda.” called for human rights to be included as nations for turning their a fundamental component of efforts to backs on the pledge Human rights-based approach prevent new infections and secure treat- made five years ago to AIDS 2010 emphasized the importance of ment for all people living with HIV/AIDS. a human rights-based approach to miti- The march ended with a rousing concert make treatment for gating the extent and effects of the performance by AIDS activist Annie HIV/AIDS universally HIV/AIDS pandemic and promoting uni- Lennox. The march and rally were held versal access. Although there has been successfully and peacefully and the AIDS available by 2010. considerable progress in many areas, 2010 organizers thanked the City of punitive laws, policies and practices, to- Vienna and the Austrian government for gether with stigma and discrimination respecting the delegates’ rights to protest. continue to block the achievement of universal access targets. In many parts of Treatment breakthroughs the world, stigma and discrimination On the more positive side, hopes were have made the fight against AIDS impos- raised during the conference with the sible, particularly among men who have announcement of some major break- sex with men. throughs in treatment protocols. The The struggle for universal access is biggest headline related to the results of considered as a broader struggle for social the CAPRISA 004 study in South Africa, justice by giving a voice to those who are where scientists have developed a micro- voiceless, such as prisoners and sex work- bicide vaginal gel. Clinical trials of the gel ers. Universal access implies that every- show a 39 percent reduction of HIV risk one has the right to receive treatment for in women over a period of two years, a HIV/AIDS without fear of violence, rejec- success that offers millions of women tion or exclusion. around the world a means of protecting

10 OFID QUARTERLY OCTOBER 2010 SPECIAL FEATURE

themselves from HIV/AIDS infection. At- prevention and treatment of these three “HIV epidemics fuelled by the criminal- tention will now focus on how the registra- diseases. The conference called for gov- ization of people who use illicit drugs.” tion and release of the gel can be acceler- ernments and other stakeholders to re- The Declaration urges drug policy reform, ated and made available in the near future. plenish the Global Fund with US$20 bil- based on scientific evidence, to help re- AIDS 2010 also highlighted in- lion over the next three years to enable it move barriers to effective HIV prevention, creased expectations for the role of pre- to scale up programming and move closer treatment and care. The document seeks vention technologies in reaching univer- to achieving universal access. Many con- (on-line) endorsement from scientists, sal access. It has been proven that HAART ference speakers urged that the platforms health practitioners and the public in or- is not only effective at preventing HIV- of the G8 and G20 be used for advocating der to bring the issue to the attention of related morbidity and mortality, but also more resources, arguing that investment international governments and interna- decreases HIV transmission from all in HIV/AIDS should not be a casualty of tional agencies. routes. HAART has now been adopted as the financial crisis. AIDS 2010 was closed by incoming the recommended strategy for eliminat- IAS President, Ugandan Dr. Elly Katabira, ing vertical transmission of HIV/AIDS. The Vienna Declaration who stated that the conference had One of the most significant outcomes of demonstrated that there was considerable Funding AIDS 2010 is the Vienna Declaration, a know-how available to guide the With regard to financing, AIDS 2010 em- document issued in response to calls by HIV/AIDS response. However, the stated phasized that the Global Fund to Fight the international scientific community goal of universal access could only be AIDS, Tuberculosis and Malaria will be crit- for an acknowledgement of the “limits achieved with increased political will and ical in achieving universal access. Created and harms of drug prohibition,” among financial resources, he concluded. in 2002, the Global Fund is a unique pub- which it identifies “punitive laws and lic/private partnership charged with mo- policies” that drive drug users away from The 19th International AIDS conference will bilizing and disbursing resources for the HIV prevention and care services, and be held in Washington DC in July 2012. PHOTO: IAS/STEVE FORREST/WORKERS' PHOTOS

Julio Montaner, IAS President, and Michel Sidibé, Executive Director of UNAIDS, joined thousands of activists in a march through the streets of Vienna to highlight the human rights’ aspects of dealing with HIV/AIDS.

OFID QUARTERLY OCTOBER 2010 11 OFID at AIDS 2010

As well as attending the conference itself, OFID was among the 150 exhibitors at the concurrent AIDS 2010 exhibition. Participants ranged from pharmaceutical companies and research institutes to NGOs, advocacy groups and funding agencies. OFID’s stand attracted hundreds of visitors every day and was a focal point for the dissemination and exchange of information.

Conference delegates queued patiently for an opportunity to learn more about OFID and take away some informa- tion materials. Even OFID Director-General, Suleiman J. Al-Herbish (left), took his turn at manning the stand and talking to visitors.

12 OFID QUARTERLY OCTOBER 2010 The holding of AIDS 2010 in Vienna, OFID’s host city, was a unique oppor- tunity for the institution to broaden its involvement in the biennial event, which it has sponsored since 2004. One of the highlights of the week was an evening reception, held at OFID headquarters and attended by guests from the global and local HIV/AIDS community. Gerry Keszler, founder of the Vienna Life Ball, with OFID Director-General, Suleiman J. Al-Herbish.

Irina Bokova, Director-General of UNESCO.

Seth Berkley, President and CEO of the International AIDS Vaccine Initiative (left), talks with Michel Sidibé, Executive Director of UNAIDS.

OFID QUARTERLY OCTOBER 2010 13 SPECIAL FEATURE

Sridhar Rangayan, OFID sponsors is a gay filmmaker and activist whose films on HIV/AIDS have played at numerous interna- participants tional festivals and won several awards. at AIDS 2010 How are you involved in HIV/AIDS? For the past 16 years, I have been developing training and advocacy Among the 19,300 delegates materials about attending AIDS 2010 were some HIV/AIDS and sexuality. My film 68 Pages about an HIV/AIDS counsellor and five of her counselees from high risk groups is part 850 people whose participation of the counsellor training program toolkit in India. was funded through the confer- What did the opportunity to attend AIDS 2010 mean to you? It was my first ever AIDS conference, and I had the opportunity ence’s scholarship program. Here, to screen three of my films, make two oral and poster presenta- tions and represent my organization at several meetings and col- three of the 100-plus scholarship laborative talks. Each day presented a new challenge and varied winners sponsored by OFID share interaction with a new set of people. It was a fantastic opportu- nity for knowledge and resource sharing. their impressions of the gathering. What did you take away from the conference in terms of knowledge, experiences, etc? All these years, I have been focused on the men who have sex with men and transgender populations. But attending the con- ference made me aware of other high-risk communities and, more importantly, families of HIV-positive persons. I saw a video of an African child dying of AIDS-related complications because there was no financial or medical help available nearby. This touched me deeply and made me realise that it is not only Asia that is affected.

How do you plan to use this new-found knowledge in your work back home? I would like to take forward the initiative of building alliances and networks with other communities and groups working on similar issues, as a means to creating awareness and propagate understanding. One idea would be to organize a film festival on HIV/AIDS for World AIDS Day on December 1. I would also like to develop educational/awareness materials targeted specifically at the wives and children of HIV-positive men.

What will remain your most abiding impression of AIDS 2010? There are several imprints – the empowering, colorful march by sex workers shouting “Sex work IS work”; the strident and soul- ful Annie Lennox concert: she not only made me cry but also raised a great surge of hope; and the great big AIDS rally along the glorious streets of Vienna.

14 OFID QUARTERLY OCTOBER 2010 SPECIAL FEATURE

Ejimole Fidelia Onwuekwe, lives in Imo State, Nigeria. She is a retired nurse and founder of the World Youth Peace Organization, an NGO established to help empower youth.

Ivars Kokars, from Riga, Latvia, is the Board Chairman of How are you involved in HIV/AIDS? AGIHAS, a support group for people living with HIV/AIDS. I have cared for a number of people in my village who were stricken with HIV/AIDS. I am also engaged in various awareness How are you involved in HIV/AIDS? activities to inform youth about the disease and means of I’ve volunteered and been involved in various projects for the lo- prevention. cal NGO AGIHAS for 15 years. My responsibilities include treat- What did the opportunity to attend AIDS 2010 mean to you? ment advocacy; counseling and giving psychological support to It meant more to me than you can imagine. I was overwhelmed HIV positive people, their friends and families; and, educating in- to receive the opportunity to participate in such an event and dividuals on HIV issues. I also carry out these services in prisons, to be able to share the knowledge with my people back home for both inmates and staff. in Nigeria. What did the opportunity to attend AIDS 2010 mean to you? Thanks to the scholarship program, this was the first opportunity What did you take away from the conference in terms of I had to attend a World AIDS Conference. I was very excited to be knowledge, experiences, etc? in Vienna and witness the enormity of the event in person. I gathered an abundance of useful information materials, which will go far in helping to teach my people. I look forward What did you take away from the conference in terms of to informing my people of new developments in prevention knowledge, experiences, etc? and treatment as well as issues relating to stigmatization. I also AIDS 2010 offered a wide array of opportunities for so many – used the opportunity to network with some of the donor organ- doctors and researchers, journalists and policy makers, as well as izations. We NGOs – particularly those based in Africa – face a for NGOs and activists. New knowledge could be garnered from significant obstacle in securing enough funds to continue our the numerous sessions and workshops that were available. I was work. able to obtain a host of fresh information relating to the latest de- velopments in research and achievements made in treating How do you plan to use this new-found knowledge in HIV/AIDS, among many other topics. your work back home? How do you plan to use this new-found knowledge in The major problem with HIV/AIDS services in Nigeria is that your work back home? they are concentrated in urban areas. I learned a lot at the con- The new knowledge will assist me with my advocacy work in ference that will assist us in reaching youth in rural areas of Imo boosting the accessibility of HIV/AIDS treatment in my country. State. We have to educate young people, as they are our future I’ll also incorporate my experiences and learning in my counsel- leaders. ing and education work. What will remain your most abiding impression of AIDS 2010? What will remain your most abiding impression of AIDS 2010? It is difficult to quantify, as the experience was so overwhelm- I was deeply impressed by the wide diversity of races, cultures and ing. It was very exciting to make new friends and be able to approaches to addressing HIV issues. This sense of solidarity, de- collect new ideas. And, to be able to talk to so many different voted to the one common goal of winning the fight against people who, like me, are trying to help their countries deal HIV/AIDS, was truly memorable. with HIV.

OFID QUARTERLY OCTOBER 2010 15 SPECIAL FEATURE

At risk of being forgotten The voiceless victims of HIV

HIV/AIDS has a greater incidence among sex workers, men who have sex with men, drug users, prisoners and migrants. Nevertheless, in many countries these minorities are criminalized and have no access to treatment.

by Mariela Hoyer Guerrero

hey don’t want to be ignored, but have sex with men, transgender people, worldwide, laws do not allow drug users T they feel that they are. And they drug users, prisoners and migrants. to receive treatment for HIV/AIDS. alerted the world to their plight with ban- Yves Souteyrand, coordinator of the Migrants also suffer from lack of ac- ners showing the phrase “We are dying Strategic Information Unit in the HIV/AIDS cess to treatment. The story of Isaac, a cit- less, but we are dying faster.” Under red Department of WHO, explained that the izen of Botswana with a Zimbabwean girl- umbrellas, a group of protesting sex work- only way to respond effectively and glob- friend is typical of many tragedies of this ers interrupted the opening ceremony of ally to the pandemic is by considering the kind. The couple lived in his country, but the XVIII International AIDS Conference human rights violations among vulnera- because of her nationality she was not el- (AIDS 2010), demanding help and atten- ble populations. He pointed out, as an ex- igible to receive the drugs that would pre- tion. ample, that men who have sex with men vent mother-to-child transmission of the Sex workers may be a minority af- have 19.3 times greater risk of being in- virus. She gave birth to Otsile in 2007, an fected by HIV/AIDS, but they are one of fected with the disease than does the gen- HIV-positive baby boy, who was unable the most vulnerable groups in a pandemic eral population. But, as homosexuality is to access antiretroviral therapy as he did that claimed the lives of 5,000 people criminalized in more than 80 countries not inherit his father’s citizenship. The daily in 2008, as reported by the World worldwide, prevention efforts in this result: Otsile died in 2008. Paula Akugiz- Health Organization (WHO) at the Vienna group have not been initiated globally. ibwe, executive director of the AIDS and event. Nevertheless, this group is discrim- Today, nearly 10 percent of all HIV Rights Alliance for Southern Africa, re- inated against in many countries and infections are a direct result of unsafe in- vealed his story at the Conference as an only receives one percent of the global jecting drug use, according to UNAIDS. example of discriminatory policies. resources dedicated to fighting the virus. Excluding sub-Saharan Africa, up to 30 Prisoners are another forgotten “Rights Here, Right Now” was the percent of global HIV infections are due group in society. Jails all over the world theme of the conference, which gathered to this reason. Around three million of an share the problems of lack of condoms, close to 20,000 participants in the Aus- estimated 15.9 million people who inject overcrowding and no access to water. Sex- trian capital. From the opening day, the drugs in 148 countries are infected with ual violence also complicates the situa- speakers defended sex workers, men who HIV. However, in 40 percent of countries tion. In the United States, for example,

16 OFID QUARTERLY OCTOBER 2010 SPECIAL FEATURE PHOTO: DES WILLIE/ALAMY

Although at high risk of being exposed to HIV, vulnerable minorities are frequently ignored when it comes to testing, treat- ment and counseling.

17 SPECIAL FEATURE

Among the harm reduction measures recommended by UNAIDS are access to sterile injecting equipment, opium substi- tution therapies, community-based out- reach and the prevention of sexual trans- mission of HIV among drug users. Michel Sidibé, Executive Director of

PHOTO: UNAIDS/A. RAUSCHENBERGER UNAIDS, mentioned cases of countries that have substituted punishment for drug use with access to HIV treatment. These countries include China, Indonesia and Malaysia. Decriminalization, he in- sisted, supports the AIDS response. Manfred Nowak, UN special rappor- teur on torture, disclosed that the preva- lence of HIV/AIDS in prisons is 10 times higher than in the rest of the population. He considers prisoners’ health as a public health issue because, each year, 30 mil- lion people pass through jails and, if they At AIDS 2010, minority groups made clear their anger and get infected there, they can transmit the virus to the rest of the population once frustration at not being heard. they are free. Some of the solutions he proposes are information and education, HIV testing and counseling in jails, con- dom distribution, avoiding sex violence 27 percent of prisoners suffer sexual and making treatment available to pris- violence. The absence of human rights in oners. However, only 10 countries have prisons creates conditions that allow needle and syringe programs in jails. HIV/AIDS to spread, explained Akugiz- Nowak knows that change is possi- ibwe. ble. In Spain, for example, AIDS in prisons There is still hope decreased from 32 percent in 1989 to One of the main reasons for holding the 7 percent in 2009. For him, it is a matter of 2010 Aids Conference in Vienna was its political will. position as a gateway to Eastern Europe From Vienna, experts and affected and Central Asia, the only region of the people reminded world leaders that world where HIV prevalence is growing, high-risk populations, such as drug although paradoxically prevention pro- users, migrants and prisoners, have to be grams are decreasing. Since 2001, preva- taken into consideration if the goal of lence in Eastern Europe has suffered a 66 universal access to treatment is to be percent rise, bringing the number of peo- realized. The Executive Director of UN- ple living with HIV to 1.5 million in 2008. AIDS stated: “The vision of reaching zero In this region, only 23 percent of infected new infections, zero discrimination and adults were receiving treatment that year, zero AIDS-related deaths cannot be compared with the average of 42 percent reached until we can restore dignity to in low and middle-income countries, says people and ensure that their rights to UNAIDS. health are respected.”

18 OFID QUARTERLY OCTOBER 2010 SPECIAL FEATURE PHOTO: PICTURE CONTACT BV/ALAMY

Overcoming stigma and discrimination The other battle against HIV/AIDS

ith its theme “Rights Here, Right W Now,” AIDS 2010 emphasized the In the 28 years that have passed since the fundamental connection between human rights and HIV. In his opening statement first clinical evidence of AIDS was reported, to the conference, Dr. Julio Montaner, President of the International AIDS Soci- great strides have been made in the treat- ety (IAS), stated that stigma, discrimina- ment and control of the disease. Outside the tion and human rights violations – whether directed at people living with or scientific community, however, the virus associated with HIV – “pose huge barriers to HIV testing, care and support and dra- continues to be surrounded by stigma and matically increase risk of transmission.” Whether it is education, employ- discrimination. For people living with HIV, ment, insurance or medical services, no such prejudice has become a fact of life. area in the lives of those infected with HIV remains untouched by stigma and By Silvia Mateyka discrimination. Since its very early days, the pandemic has been characterized by social responses of fear and denial. Many people assume that the virus is highly

OFID QUARTERLY OCTOBER 2010 19 SPECIALOvercoming FEATURE ignorance. Young volunteers in India, wearing Red Ribbon T-shirts and caps, commit to helping spread correct information and knowledge about HIV/AIDS.

PHOTO: 2005 ANIL GULATI/COURTESY OF PHOTOSHARE

contagious and can be transmitted dur- but also the fear of discrimination and loss All these reasons deter people from being ing non-sexual, casual contact. Moreover, of rights if they disclose their health status. tested or from making an open admission many perceive it – erroneously – as a death Discrimination is common in insti- of their HIV-positive status. According to sentence. The fear provoked by this belief tutional settings – in particular, in the the latest data from UNAIDS, more than frequently manifests itself as discrimina- workplace, healthcare services and edu- 60 percent of people living with HIV are tion of anything and anybody associated cational institutions. Examples are the unaware of their status and are not receiv- with HIV/AIDS. In short, fear and igno- denial of employment based on HIV sta- ing life-prolonging antiretroviral therapy. rance reinforce and legitimize the prejudi- tus, compulsory HIV testing, exclusion of They are thus unwitting carriers of the cial treatment of HIV-positive people. HIV-positive individuals from pension disease, a situation that interferes greatly The stigma attached to HIV is fuelled schemes and medical benefits, denial of ac- with effective prevention efforts. by presumptions about the moral in- cess to medical care and treatment and, last Responding to HIV and AIDS with tegrity and values of those infected, who but not least, negative attitudes and de- blame, stigma and discrimination, sim- are almost always associated with im- grading practices by healthcare workers. ply forces the epidemic underground, cre- moral, bad and risky behaviors, in par- A significant number of countries ating the ideal conditions for the virus to ticular with sexual promiscuity and in- have even legalized discriminatory prac- continue to spread. travenous drug use. Moreover, many tice. Such legislation includes the com- Against this background, the people with HIV already belong to so- pulsory screening and testing of certain United Nations Educational, Scientific cially marginalized groups such as sex groups and individuals, the prohibition and Cultural Organization (UNESCO) workers, homosexuals and the poor. of HIV-positive people from certain types has placed education at the heart of its These vulnerable populations thus often of employment, and limitations on in- strategy to tackle prejudice, fear and ig- face a double stigma. ternational travel, including mandatory norance. Education, it believes, is an ef- The consequences of HIV stigma are HIV testing for those who seek work per- fective instrument through which more great. People living with the virus suffer mits and the deportation of HIV-positive tolerance, respect and understanding not only the burden of the disease itself foreigners. about HIV can be communicated to a

20 OFID QUARTERLY OCTOBER 2010 SPECIAL FEATURE

wide range of young people and adoles- comprehensive, scaled-up education pro- cents. Ms. Irina Bokova, Director-General grams on HIV and AIDS through both for- Defining stigma of UNESCO, states: “Everybody has the mal and non-formal channels. Its objec- and discrimination right to education, information and serv- tives are promoted through collaboration ices that will enable them to protect among UNAIDS co-sponsors and key According to UNAIDS, HIV/AIDS related themselves from HIV infection; and for stakeholders, including national authori- stigma is described as a “process of deval- those living with HIV, to have the best ties, ministries, bilateral agencies and civil uation” of people either living with or as- possible quality of life, free from stigma society groups. sociated with HIV/AIDS. This stigma and discrimination.” She adds that “a More, however, needs to be done central aspect in the discussion about with respect to the legal protection of peo- often stems from the underlying stigmati- HIV/AIDS stigma is the importance of cre- ple living with HIV/AIDS. Discriminatory zation of sex and intravenous drug use – ating more awareness, especially among laws, rules and policies regarding HIV-pos- two of the primary routes of HIV infection. young people and the youth.” itive individuals and high-risk groups Discrimination follows stigma and is the In recognition of the important role have a detrimental impact on these peo- unfair und unjust treatment of an individ- education plays in the battle against the ple’s lives. In many countries, there is an ual based on his or her real or perceived AIDS pandemic, UNESCO’s Executive urgent need to establish a legal framework Board has included EDUCAIDS, the UN- that is based on acceptance and respect HIV status. ESCO-led Global Initiative on Education for HIV infected persons. The absolute pri- and HIV and AIDS, as one of the three ority of governments should be to recog- core priority initiatives for support to the nize that HIV/AIDS is a public health crisis achievement of its “Education for All” rather than an opportunity to punish and goals. Through EDUCAIDS, UNESCO and marginalize. An effective response to its partners are currently supporting 53 HIV/AIDS is only effective if it is grounded countries in their implementation of on respect for human rights.

OFID/IDLO Joint Program

The International Development Law Organiza- tion (IDLO) has wholly dedicated its work to promoting the rule of law and good governance in developing countries around the world. In 2009, IDLO launched a three-year HIV and Health Law Program, supported by OFID. The program is addressing some of the most signif- icant legal challenges relating to HIV in five regions around the world. Its overall objective is to strengthen the legal framework and institutional capacity to fight HIV/AIDS by providing advice and assistance on the legal, regulatory and practical aspects of HIV/AIDS, as core determinants of poverty alleviation, enhanced human rights and sustainable development.

OFID QUARTERLY OCTOBER 2010 21 SPECIAL FEATURE

New advances spur AIDS vaccine research

With AIDS expected to remain one of the leading causes of death globally

PHOTO: ROBERT MAASS, COURTESY OF IAVI for the foreseeable future, the develop- ment of a vaccine is the Holy Grail of AIDS scientists and researchers. Spear- heading the quest is the not-for-profit International AIDS Vaccine Initiative, headed by Dr. Seth Berkley. Dr. Seth Berkley, President and CEO of IAVI.

n the absence of a cure, antiretrovi- OQ: Why was IAVI set up and how does it ered, for example. So it’s important to I ral therapy is the chief weapon in go about its work? have local input into those issues. As a re- the treatment of HIV and AIDS. However, sult, we cultivate in our programs the sup- SB: IAVI’s mission is to accelerate the de- while these drugs help improve and pro- port of communities in which trials are velopment of a safe and effective vaccine long life, they are expensive and have a conducted and work to engage local and number of undesirable side-effects. The to prevent HIV infection and to ensure national leaders in the mission of devel- discovery of a vaccine, therefore, would that when it has been developed it is oping a vaccine. Over the past decade we be one of the biggest medical break- made available to all who need it. Since have invested deeply in building sustain- throughs of the 21st century. the need is greatest in developing coun- able capacity for clinical research in sev- IAVI, the International AIDS Vaccine tries, where the burden of AIDS is the eral developing countries, building and Initiative, was launched in 1996 and most severe, it was clear from the outset revamping laboratories and clinics, train- has evolved into one of the leaders in that we would need to work closely with ing researchers, doctors, counsellors and vaccine research. Its groundbreaking the researchers, governments and com- nurses, and educating communities work is showing encouraging, if moder- munities of these countries to pursue our about HIV and its prevention, and about ate, results, with recent trials identifying mission. the pandemic and the need for HIV vac- two antibodies that have the potential There are a number of reasons for cines. We hope that this capacity will, in to neutralize, or deactivate, HIV (referred this. To ensure that a future AIDS vaccine the long run, contribute not only to the to as broadly neutralizing antibodies). Dr. is effective where it is needed most, it public health of these countries but, Seth Berkley, President and CEO of IAVI, must be tested in those places. Also, it through the cultivation of science and spoke to the Quarterly about the latest must be appropriate to local needs, in technology capacity, to their economic research advances. terms of how it is priced, stored and deliv- development as well.

22 OFID QUARTERLY OCTOBER 2010 OQ: What does the recent discovery of because HIV vaccine candidates have not uninfected by HIV despite frequent expo- the two broadly-neutralizing antibodies historically provoked very much anti- sure to the virus. mean in terms of vaccine development? body production. In partnership with IAVI, KAVI has so far conducted five HIV vaccine trials as SB: These antibodies may provide impor- OQ: What is IAVI’s relationship with the well as a number of clinical and epidemi- tant clues to the design of effective AIDS Kenya AIDS Vaccine Initiative (KAVI)? ological studies related to AIDS vaccine vaccines. Importantly, they attach them- What are some of the highlights of KAVI’s research and development. The KAVI- selves to a new and relatively exposed site research? on the surface of the virus that could pres- run laboratory was among the first in ent a new target for a candidate vaccine. SB: In its engagement with developing Africa to win accreditation under the With the knowledge of how these anti- countries, IAVI partners with local re- stringent Good Clinical Laboratory Prac- bodies deactivate HIV, researchers can try search institutions and supports them in tice scheme, and its researchers have to make candidate vaccines that work in expanding their capacity and skills re- been trained in Good Clinical Practice as the same way. While there is still a long quired for the conduct of AIDS vaccine well to ensure that vaccine trials are con- way to go before we will have such vaccine research. KAVI is one such partner. The re- ducted at the highest ethical and profes- candidates in our hands, the isolation and search unit is based at the University of sional standards. The partnership has also analysis of the newly discovered antibod- Nairobi and was established in 1999 by invested significantly in community edu- ies is a critical first step to that end. local researchers with support from the cation and in the improvement of volun- This pair of antibodies recently iso- IAVI and the Medical Research Council tary counselling and testing for HIV. lated are unique in a number of ways. Human Immunology Unit at Oxford Uni- OQ: How does IAVI go about getting local They neutralize a very broad range of HIV versity, England. communities on board when it comes to subtypes, including many of the HIV vari- Researchers at Oxford were already implementing clinical trials? ants that circulate in sub-Saharan Africa, engaged in an AIDS vaccine research and the region most devastated by AIDS epi- development project when IAVI initiated SB: IAVI and partners engage with local demics. They also neutralize HIV very po- its partnership with the University of communities through seminars and by tently – which suggests that they will not Nairobi. That project stemmed from the tapping peer networks to increase aware- need to be elicited in very large quantities observation that a small number of ness and knowledge about HIV preven- to block HIV infection. This is important women in a local community remained tion and AIDS vaccine research. They

In a critical first step towards the development of a vaccine, IAVI scientists have identified two antibodies that have the potential to deactivate HIV.

PHOTO: COURTESY OF IAVI

OFID QUARTERLY OCTOBER 2010 23 SPECIAL FEATURE

the Indian Institute of Science in Banga- lore, the International Institute for Ge- netic Engineering and Biotechnology in India, and a new laboratory for AIDS vac- cine design that we expect will soon be

PHOTO: COURTESY OF IAVI established in that country. These are crucial elements of IAVI’s program to address each of its research priorities and will most likely have a sig- nificant impact on the momentum and direction of IAVI’s vaccine design and development efforts. It will also con- tribute to sustaining the necessary infra- structure and human resources of col- laborating clinical research centers in Africa and India. OQ: What does the immediate future hold for IAVI?

SB: Based on the recent progress in ap- plied research, most notably the antibod- ies we have isolated, we anticipate a very exciting period ahead of us in AIDS vac- cine design and development. We plan to accelerate our activities to try and As part of the research and development process, IAVI has so far conducted five clinical trials design an entirely new generation of vac- in association with the Kenya AIDS Vaccine Initiative. cine candidates in the next few years and move them into clinical trials in our net- work laboratories. The field is currently also ensure that community voices are developed the first manual ever written energized by the recent discoveries, and heard and cultural issues are taken into to train people to be aware of the gender many researchers are growing optimistic account in the planning and conduct of issues relevant to AIDS vaccine research about the prospects for developing a clinical research through the recruit- and overseen its application to AIDS vac- broadly effective AIDS vaccine. These re- ment and active training of community cine trials in India. sults have, ironically enough, come just as advisory boards. These boards advise the AIDS vaccine field has begun to feel OQ: OFID is supporting IAVI’s work with researchers on protocols and provide the impact of the global economic reces- grant funding. How are these resources being channels of communication with the sion on its financing: investment in HIV used? community. We have also developed vaccine R&D (basic, applied and clinical) training tools on AIDS vaccine research SB: The partnership with OFID has al- in 2008 declined by 10 percent – the first that are written in language accessible lowed IAVI to move forward in key areas decline in funding in a decade. to lay audiences and bundled these of research that we expect will support Our challenge is to continue to build materials in a vaccine literacy toolkit and accelerate the development of an ef- on recent scientific progress by making that is freely available to healthcare staff fective AIDS vaccine. These areas include: prudent choices about the course of our and community outreach workers. In Increasing capacity for AIDS vaccine research programs and prioritizing the many cases, these workers have been clinical trials, epidemiological and im- most promising activities. We will focus trained with IAVI support to convey the munological research in Kenya, Uganda, on three priorities: first, designing candi- information clearly to audiences of all Rwanda, Zambia, South Africa and India date vaccines that can elicit broadly educational backgrounds. Our partners in collaboration with local partners; and neutralizing anti-HIV antibodies; second, also devise communications tools and Progress in solving some of the key chal- preparing novel vaccine concepts for organize events to inform key commu- lenges of AIDS vaccine design, not least evaluation in the clinic; and third, mov- nity stakeholders about progress in vac- the neutralizing antibody problem, ing our best AIDS vaccine candidates cine-related research. IAVI has, further, through work done in partnership with towards more advanced testing.

24 OFID QUARTERLY OCTOBER 2010 SPECIAL FEATURE

Text H for health Are mobile phones the key to fighting AIDS?

It may be a tiny device, but the seemingly innocent mobile phone is turning into a powerful tool in the uphill battle against HIV/AIDS. Five billion cell phone subscriptions exist globally – a blessing for sub-Saharan Africa and the newly developing global sector of mHealth. By Verena Ringler

t doesn’t seem so long ago that cell I phones were considered toys for yuppies. Today, cell phones are used by mothers and fathers in villages without electricity. People who live on a shoe- string are very likely to possess a SIM card

and airtime. PHOTO: JACOB SILBERBERG/PANOS Some five billion mobile phone sub- scriptions exist worldwide, of which close to two-thirds are in developing economies. “Lack of access to mobile connectivity is now the exception rather than the norm in most countries,” says Joshua Goldstein, a technology expert at UNICEF. “The so-called digital divide is less about access, but rather about the recognition that mobiles can be a tool in the fight against HIV/AIDS. In Kenya for instance, over 90 percent of people can easily access cell phones, via shared phones for example.” The cell phone is a blessing. It over- comes a host of obstacles in the develop- ing world: the shortage of healthcare workers; remoteness from health facili- ties; poor transportation; the cost of med- ical services; language barriers; and,

OFID QUARTERLY OCTOBER 2010 25 SPECIAL FEATURE

most importantly, social distance. The HIV/AIDS is key to changing male atti- tion and treatment issues and to help latter is key because “stigma and discrim- tudes and sexual behavior to reduce the mothers navigate the health system. ination play a significant role in keeping spread of HIV/AIDS. Imbizo uses SMS “Once the mothers have given birth, people from seeking services,” according messaging to remind men of HIV testing M2M get the kids tested for HIV/AIDS. to Laura Guay, Vice President of Research opportunities and of outreach events. SMSs allow for a continuum of care and of at the Elizabeth Glaser Foundation. Al- Abigail Dreyer, a researcher, found that adherence,” says Jimmy Kolker, chief of lowing for better and private communica- besides advantages such as advice and UNICEF’s HIV/AIDS global program. Like tion, the new field of mHealth has thus anonymity, Imbizo strikes a chord with in many mHealth programs, M2M clients been developing. men’s desire for the kind of social respect can use a call-back system rather than mHealth connects public health, linked to cell phone activities. “When my having to pay for airtime. good governance and grassroots activism phone goes beep, beep and I say, oh, it’s Cell-Life is a social enterprise in with private sector telecommunications Imbizo, it’s like they are contacting me South Africa trailblazing cell phone activ- technology. Dozens of projects have been because I am so important,” said one par- ities in the fight against HIV/AIDS, espe- piloted, especially in sub-Saharan Africa. ticipant in a poll. cially with adolescents and young moth- In the field of HIV/AIDS, three main aims Mothers to Mothers (M2M), operat- ers, but also on the research side. One of stand out. The first is public information. ing in South Africa and Kenya, is an its projects is called “Cellphones 4 HIV,” SMS (Short Messaging Service) messages award-winning HIV/AIDS initiative for where mass information is offered for pre- are delivered from health authorities or women. M2M uses SMS messaging to fol- vention and positive living, and where organizations to people. Such messages low up with pregnant women on preven- patients and clinics are linked. might include, for instance, famous peo- ple talking against stigma or reminding phone subscribers that HIV is preventable and AIDS treatable. The second aim is the interactive field of counseling, adherence, dialogue and networking via a two-way communications channel. Remarkable results can be achieved within the stan- dard communication space of 160 charac- ters or less on a display, when nobody is watching or listening in and when the conversation is free, because the counsel- ing agency calls you back. The third aim is the education of health workers, actual treatment and early infant diagnosis in remote areas, where parents can have their children tested for HIV without making the long journey to a clinic – all cell phone-based. The global frontline of mhealth in- novation is sub-Saharan Africa, where South Africa is the country spearheading the use of mobile phone technology to combat HIV/AIDS. Four leading mHealth initiatives are the Imbizo Men’s Health Program, Moth- ers to Mothers, Cell-Life, and Text to Change. The Imbizo Men’s Health Program in South Africa is run for men by male counselors and has seen more than 10,000 men participate since its incep- tion in 2005. The education of men on

26 OFID QUARTERLY OCTOBER 2010 SPECIAL FEATURE

Text to Change, an initiative originally The first positive trends in mHealth make founded in 2006 in Uganda but which is strategy developers cautiously optimistic Further Reading: now operating in Kenya and Madagascar about the potential of cell phone tech- as well, uses cell phone technology to nology in the fight against HIV/AIDS. The emerging sector of mhealth or mobile raise awareness and send SMS reminders Jimmy Kolker suggests that digital tech- health – a sub-segment of “e-Health” on to adhere to medication. A large quiz in nology has made a world of a difference the one hand and of M4D – “Mobiles for Mbarara region of Uganda in 2008, for in public health. He tells the Quarterly development” – on the other hand, is reg- instance, reached 15,000 cell phone that, “Previously, attention to AIDS ularly explored and driven further at spe- users, and saw a 40 percent increase in has often been driven bottom-up and cialist summits, e.g. the mHealth Summit the number of HIV tests in the weeks fol- only by activists. Now, thanks to tech- every fall in Washington, D.C., or, the In- lowing the campaign. “If you reach one nology, peers are found, networks are ternational Conference on Information and person with a cell phone in a very poor created, knowledge is multiplied, issues Communication Technologies and Devel- community, and you provide that per- are pushed. Stakeholders communicate opment and the IPID annual “ICT4D Con- son with HIV/AIDS information, they without having to meet.” ference” in London. share it with other people. Eventually, And yet, technology on its own is Helpful guides to mHealth are Patricia you reach the poorest of the poor,” says not enough to spread mHealth, as three Mechael’s and Daniela Sloninsky’s “To- Bas Hoefman, co-founder of Text to experts caution. Katrin Verclas, the wards the Development of an mHealth Change. founder of Mobile Active, an open- Strategy: A Literature Review”, published source platform, believes that questions by the Earth Institute at Columbia Univer- still remain over impact. “We are only sity in 2007 and updated in 2008; “mHealth in year three or four of this develop- for Development – The Opportunity for ment, and there is still a lot of experi- Healthcare in the Developing World” by mentation. Of course, what we want to Vital Wave Consulting, 2009; and “The In- know is: Do these SMS services or dia- novative Use of Mobile Applications in East logues influence how somebody behaves Africa” by the Swedish International Devel- in intimacy? Do people have safer sex, or opment Cooperation Agency (SIDA), 2010. later debuts, because of mhealth? Are PHOTO: KEN BANKS/KIWANJA.NET Popular online platforms are: transmission rates lower?” She also be- lieves that “the best projects are collabo- www.mobileactive.org rative ones, where health ministries, www.open-mobile.org multilateral groups and the private sec- www.comminit.com tor join forces.” Laura Guay from the www.texting4health.org Glaser Foundation warns, “Mobile tech- nology would be one component in the toolbox of activities. We cannot let it be the final answer.” And Patricia Mechael, mHealth advisor on the Millennium Villages project at Columbia University’s Earth Institute, says the key to success now lies in open-source software solutions for spreading and improving mhealth applications. Another crucial reminder for mHealth initiators comes from Joshua Goldstein, UNICEF’s technology expert. Focusing on local ownership and participation, he says, “Get low cost, low barrier learning tools into community leaders’ hands. From the general theme (HIV prevention, condom use), allow community leaders Verena Ringler is a winner of the 2010 to determine as much as possible what European Young Journalist Award. message goes out to the people.”

OFID QUARTERLY OCTOBER 2010 27 SPECIAL FEATURE

Tuberculosis and HIV: a lethal combination

“We cannot win the battle against AIDS if we do not also fight TB. TB is too often a death sentence for people with AIDS.” Nelson Mandela

by Mojgan Sanandaji and Audrey Haylins

uberculosis (TB), a disease largely T believed eliminated in the devel- oped world 30 years ago, today kills al- PHOTO: AERAS most two million people globally. Around one-quarter of these deaths are AIDS-related, making TB the leading cause of death among people living with HIV/AIDS worldwide. The World Health Organization warns that HIV and TB form “a lethal combination,” each speeding the other’s progress. In many cases, especially in de- veloping countries, people are living with HIV, but dying from TB. A joint, co- ordinated approach is therefore essen- tial in finding ways to fight both dis- eases. Around one-third of the world’s population is thought to be infected with TB, a contagious disease that spreads through the air. Most cases, however, lie dormant, with just one in 10 developing into active TB. The latent disease is activated when immune sys- tems are weak. An HIV-positive person, for example, is 50 times more likely to develop active TB than someone who is HIV-negative. Around 80 percent of those co-infected with TB and HIV live in Africa. Untreated, TB can kill an HIV-positive individual in a matter of weeks. Unlike HIV/AIDS, however, TB is completely curable in the vast majority of cases, The majority of TB infections remain dormant, but an HIV-positive person is 50 times more likely with drugs to treat a standard case cost- to develop active TB than someone who is HIV-negative. ing as little as US$20 for a full course.

28 OFID QUARTERLY OCTOBER 2010 SPECIAL FEATURE

The biggest stumbling block is the dura- the presence of HIV significantly reduces (Bacillus Calmette-Guérin) vaccine in- tion of the treatment, which requires the the chances of an accurate sputum vented 90 years ago. This has become patient to adhere to a strict regimen of smear, which is the standard form of less effective over time due to the emer- antibiotics for up to 24 months. Such testing for TB. gence of drug resistant strains of TB and treatment can be difficult to implement According to Peg Willingham, Sen- is not recommended for babies born to and control in poorer countries, where ior Director, External Affairs, Aeras mothers infected with HIV. health services are already stretched and Global TB Vaccine Foundation, new tools “New TB vaccines need to be safe where side effects, such as increased are urgently needed to accurately and and effective for all ages, including those appetite, tempt people to stop taking the effectively diagnose and treat TB-HIV living with HIV,” Mrs. Willingham told medication as soon as they start feeling co-infection. These requirements include the Quarterly. “They should also work better. new drugs, scaled-up laboratory capacity against infection by drug-resistant TB, Another problem is that the stan- in developing countries to help detec- which is on the increase, especially in dard therapy for TB relies on drugs that tion, and infection control measures to Eastern Europe and the former Soviet are over 40 years old and that, in some prevent HIV patients from becoming Union.” cases, cannot be taken with the anti- infected with TB in clinical settings. Mrs. Willingham reported that retroviral therapy recommended for Most important of all is the search Aeras scientists were at a “pivotal stage” HIV. Diagnosis is also compromised, as for a new vaccine to replace the BCG in the development of a new vaccine,

Estimated HIV prevalence in new TB cases, 2008

HIV prevalence in new TB cases, all ages (%) 0-4 5-19 20-49 ≥ 50 No estimate

Source: Global Tuberculosis Control – A short update to the 2009 report

OFID QUARTERLY OCTOBER 2010 29 OUTREACH

PHOTO: AERAS Testing for TB in western Kenya as part of clinical with four vaccines currently undergo- critical issue for Aeras and others like it. ing clinical trials at partner sites in Africa Mrs. Willingham pointed out that more trials to develop a new and a fifth poised to begin trials this year. needed to be done in raising awareness vaccine that is safe and The Aeras Foundation – which is about TB and mustering support for based in Washington, DC, and has an- vaccine development. “People tend to be effective for everyone, other office in Cape Town, South Africa – shocked when they hear that more people including people who are is just one of several research groups pur- died last year of tuberculosis than at any HIV-positive. suing an improved TB vaccine. time in human history, because they Mrs. Willingham further revealed assume that it is a disease that affected that the new, recombinant vaccine being our grandparents’ generation. This is a developed by Aeras had the potential to misconception that must be overcome,” prime the immune system better than the she said. existing vaccine and would be followed In arguing the case for more fund- up with a booster vaccine. “Our re- ing, Mrs. Willingham highlighted the searchers believe that this ‘prime-boost’ heavy burden that the treatment of TB strategy will not only enhance protection, placed on patients, their families and but also extend it over a longer period of health systems. An effective vaccine time,” she explained, adding that a would not only save lives, but also pre- booster vaccine could be made very serve the enormous investment that cheaply and delivered orally or by aerosol donors had already made to treat spray. “This would avoid the problem of HIV/AIDS, she stressed, adding: “Until a needle contamination and cold storage, vaccine is found, people whose lives have which are a particular challenge in devel- been preserved by antiretroviral drugs will oping countries,” she said. continue to be swept away by undiag- As is often typical when it comes nosed and untreated TB.” to research, the question of funding is a

30 OFID QUARTERLY OCTOBER 2010 SPECIAL FEATURE

Washington calling: looking ahead to AIDS 2012

In the two years from now until the next Interna- tional AIDS Conference, global efforts will focus on four main pillars: scaled-up prevention, new approaches to treatment, gender equality and an end to discrimination. Leading the charge is UNAIDS Executive Director, Michel Sidibé, who spoke exclusively to the Quarterly while in Vienna

for AIDS 2010. By Audrey Haylins Michel Sidibé, UNAIDS Executive Director.

ichel Sidibé is a bundle of energy. “We cannot settle for a world where some their health and welfare. It is this same M He sweeps into OFID’s headquar- people get treatment while others do tenacity that he has brought to his role as ters like a tornado, his entourage scurry- not,” he declared. “Where some enjoy leader of the global fight against HIV and ing in his wake. An otherwise unassuming access to prevention, while others are AIDS. figure, he carries an unmistakable air of criminalized for who they are and who My thoughts are interrupted by the charisma. I don’t know whether to feel they love. Where some are offered hope, sound of movement behind the doors of intimidated or enthralled. Mr. Sidibé, UN- while the hope of others is crushed.” the DG’s inner sanctum. As Sidibé AIDS chief since January 2009, has prom- The title of Sidibé’s speech was “We emerges, I jump to my feet, determined ised me 10 minutes of his time in between cannot turn back.” By the time he’d fin- not to waste a second of my precious 10 a courtesy meeting with our Director- ished, the very notion of giving up minutes. He greets me warmly with a General and attending the event being seemed utterly absurd. His passion made firm handshake and a genuine smile. prepared in our atrium – a cocktail recep- anything and everything seem possible. “Let’s do this!” he says. tion on the occasion of the XVIII Interna- And Michel Sidibé is a passionate We settle side by side at the vast, tional AIDS Conference. man. By his own admission, he is an out- polished table in the OFID conference Waiting in the ante-room of the spoken advocate for those ill-equipped, room. My first question relates to what DG’s office, I flick through the impas- for whatever reason, to speak for them- has changed in the two years since the last sioned speech Mr. Sidibé had delivered selves. He is no stranger to battles. As a AIDS conference in Mexico. The words two days previously at the opening ses- young man in his native Mali, he took are scarcely out of my mouth before sion of AIDS 2010. He had inspired every- up the cause of the nomadic Tuareg peo- Sidibé launches into his response. He one present with his words: ple, campaigning tirelessly to improve delivers it with the assuredness of a

OFID QUARTERLY OCTOBER 2010 31 SPECIAL FEATURE

man who knows exactly what he’s talk- revolution.” He goes on to explain the im- By this time, I’ve given up trying to take ing about. portance of what he calls “a better tar- notes or formulate more questions. Sidibé “What has changed fundamentally geted approach.” This would have at its is on a roll and is best left to state his is that we are moving from a period of center the elimination of mother-to- piece. I decide to sit back and let my digi- abundance to a period of scarcity in terms child-transmission, a goal Sidibé believes tal voice recorder do its job. of funding,” he states. Rather than this to be entirely feasible – and more than Sidibé has moved on to the issue of being an obstacle, however, Sidibé sees it that: “sacrosanct.” He is unshakeable in treatment. To be more precise: treatment as an “opportunity for innovation.” By his conviction that “an AIDS-free genera- 2.0 – the next generation, where treat- this, he means the development of tion is within reach and should not be al- ment itself is a prevention tool. “Treat- cheaper drugs and the identification of lowed to slip from our grasp.” ment 2.0 calls for a new, radical ap- new sources of funding, such as a “Robin Sidibé’s zeal is contagious, and I find proach that simplifies drugs, making Hood tax” on global financial transac- myself nodding vigorously with every them easier to access, easier to use and tions, among other “creative” solutions. point he makes. He becomes especially less toxic,” he says, clearly undaunted He drives home his point: “We are mak- animated when talking about what he by the fact that this will require “bold ing progress. Now is not the time for flat- sees as a “major paradigm shift” in the at- new partnerships” with the pharmaceu- lining or scaling down.” titude of youth towards prevention ef- tical industry. Once again, Sidibé’s de- I am starting to realize that Michel forts. “Thanks to young people choosing termination leaves me in no doubt that Sidibé is not used to take no for an an- to lead prevention programs rather than he will get exactly what he wants, re- swer. He is clearly a man on a mission. So, being passive beneficiaries, they have be- gardless of the might of the drugs manu- what is the way forward? I ask. come agents of change,” he explains. He facturers. With barely a pause to gather his backs up this statement by quoting recent He is prepared to take on anyone it thoughts – or even his breath – he sets off data which shows that HIV prevalence seems, including the 80 countries that again: “Prevention, prevention, preven- has dropped by 25 percent among youth have homophobic laws. “No one should tion,” he says, rapping on the table for in 15 of the most affected and infected endure discrimination,” he declares. “Not emphasis. “What we need is a prevention countries. men who have sex with men, not sex

Percentage of pregnant women living with HIV and infants born to them who received antiretrovirals for preventing mother-to-child transmission, 2004-2008

50 Percent 45 Pregnant women living with HIV 40 Infants born to pregnant women living with HIV 34

30 24 32

20 15 20 10 18 10 12 6 0 2004 2005 2006 2007 2008

Source: Towards universal access: scaling up priority HIV/AIDS interventions in the health sector. Progress report 2009 (WHO, UNICEF, UNAIDS).

32 OFID QUARTERLY OCTOBER 2010 SPECIAL FEATURE

PHOTO: GIACOMO PIROZZI/PANOS Dummytext Layout Text Dummy Layout Dummy- text Layout Text Dummy Layout Dummytext Layout Text Dummy Layout

Thanks to young people

workers, not people who inject drugs, not “We are making more progress than in becoming “agents of change”, prisoners, and especially not people living most other MDGs,” he replies. The key HIV prevalence has dropped by with HIV.” Sidibé’s feeling of injustice is moving forward would lie in “integration.” one-quarter among the youth palpable. There clearly is no place for By this, he means, linking MDG 6 closely stigma in Michel Sidibé’s world. On this with those relating to maternal health and of 15 most affected countries. he brooks no argument. child health. The evidence to do so is com- He is equally uncompromising on pelling: in some African countries, more the issue of gender equality, which he than 50 percent of maternal deaths are due says “must become part of our DNA.” to HIV. Sidibé stresses that the AIDS re- Women and girls must have the rights, sponse should be a bridge joining the other the skills and the power to protect them- movements. “It is not a competition. By selves from violence and negotiate their taking an integrated approach, we can re- own sexuality. Poverty, he points out, duce duplication and transaction costs and robs women of choice and allows little bring energy to the world to deliver.” control over how they lead their lives. With those final words, the inter- Sidibé is still in full flow when I be- view is over. After thanking me charm- come aware that our protocol officer is ingly, Sidibé is ushered away, entourage starting to twitch uncomfortably. My 10 once more scurrying in his wake. His minutes must be almost up. However, departure leaves a growing void, as the there is one more question I have to ask: energy in the room slowly dissipates. Are we on track to achieving the sixth I realize I’ve just met one of life’s true Millennium Development Goal of halt- gladiators. With Michel Sidibé to lead the ing and starting to reverse the spread of charge, the battle against HIV/AIDS will HIV/AIDS by 2015? surely be won.

OFID QUARTERLY OCTOBER 2010 33 OUTREACH PHOTO: JEFF GREENBERG/ALAMY

Building a new future for Haiti’s children

Nine months after the devastating earthquake that claimed a quarter of a million lives, the Caribbean island of Haiti is finally starting to rebuild. Among a host of priorities is the need to get the country’s education system back on its feet. Spearheading these efforts is UNESCO – with a helping hand from OFID.

34 OFID QUARTERLY OCTOBER 2010 OUTREACH

he January 2010 quake was the T strongest to hit Haiti, the poorest UNESCO’s priorities in Haiti country in the western hemisphere, in 200 years. In addition to the massive death toll, it left a staggering 1.5 mil- lion people homeless. Estimates have placed the total cost of reconstruction at US$11 billion. Just days after the catastrophe, Haiti’s Education Minister, Joel Jean- PHOTO: MEHDI BENCHELAH/UNESCO Pierre, reported that one-half of the country’s primary and secondary schools had been destroyed or badly damaged. The three main universities were also in ruins, as was the building housing the Ministry of Education. Six months later, the news from Mr. Getachew Engida, Deputy Director General of UNESCO, was that very little had changed. UNESCO’s efforts in Haiti have focused on emergency measures to restart education UNESCO believes that education is activities and on helping the authorities to build a stronger education system at all levels. at the core of Haiti’s recovery and the key UNESCO is actively supporting Haiti’s National Ministry of Education in carrying out a post- to the country’s development. The chal- lenges, however, are great. Indeed, a re- disaster needs assessment, as well as in its back-to-school initiatives, curricula and exams. cent report from the Global Campaign for As part of the UN earthquake response, UNESCO has sent experienced emergency Education lists Haiti as one of the worst staff to the country, including Michaelle Jean, the UNESCO Special Envoy for Haiti, places in the world to be a school child. appointed by the Director-General. UNESCO is also taking part in international efforts to Even before the earthquake, the deliver long-term relief to Haiti. Haitian education system faced severe ob- stacles with regard to access and quality. For example, only about one-half of the country’s school children were enrolled, Achieving these goals will require a com- The UNESCO/OFID project is expected to largely because the cost of schooling was bination of efforts, from repairing dam- directly benefit approximately 110,000 beyond the reach of most families. aged infrastructure and providing tem- secondary, TVET and higher education Working together, UNESCO and porary facilities to supplying education students, including 50,000 female stu- OFID are co-financing a reconstruction materials. The project will also offer dents as well as 500 key staff from the project that will go some way towards re- teacher training programs and conduct Ministry of Education and Vocational establishing education services in Haiti. capacity building within the education Training. The main objectives are to support in- authorities. According to Ms. Irina Bokova, depth damage assessment and response But the recovery and development Director-General of UNESCO, it is planning; to provide emergency support of the Haitian education system will also UNESCO’s goal not only to help Haiti to secondary and tertiary education as depend on an effective response to the to return to the previous status quo, well technical and vocational education psychological impact of the earthquake. but actually to move forward. “When and training (TVET); to support educa- The project will therefore train teachers there is investment in education, devel- tional planners and managers; and to an- and other education personnel in oping countries make huge break- alyze opportunities for restructuring and trauma management in order to help throughs,” she said recently. strengthening the Haitian education sys- lay the foundations of a more resilient tem in the long term. education system.

OFID QUARTERLY OCTOBER 2010 35 OUTREACH

Boosting cancer care in Zambia

When Lusaka’s very first Cancer Diseases Hospital (CDH) opened its doors in early 2006, it was a significant milestone. Just a few years later, this state-of-the-art facility is already embarking on a new expansion phase. In the following interview, Dr. Kennedy Lishimpi, CDH’s Executive Director. Dr. Kennedy Lishimpi, CDH’s Executive Director and Clinical and Radiation Oncologist, talks about the success of CDH, its plans for expansion and the challenges cancer still poses for Zambia.

by Anna Ilaria-Mayrhofer

p until five years ago, cancer suffer- Although the cost of their treatment was top five cancers are HIV-related. As a U ers in Zambia faced slim survival covered, patients going abroad still had to result, Zambia’s cancer patients are much prospects, as no specialist treatment was pay for transport and accommodation. younger than those in developed coun- available within the country, which has Hence, families who were already trying to tries, the majority being aged between 25 some of the highest incidences of cancer cope with the diagnosis of cancer had the and 45, compared with an average age of in Africa. Pre-2006, mortality rates from additional stress of worrying about find- 50 years and older in Europe. “Before the the disease were inordinately high. ing the funds to travel. “With the founding advent of retroviral treatment for “Before CDH was built, the only op- of CDH – and its proximity to the pathol- HIV/AIDS, patients would die before tion available to cancer patients was to ogy, nuclear medicine and radiology facil- manifesting cancer-related diseases. Now, travel to Zimbabwe or South Africa for ities at Lusaka’s University Teaching Hospi- they are living longer, and thus higher treatment,” says Lishimpi. “This was tal (UTH) – such concerns have been all cancer rates are being reported,” explains arranged at huge cost to the government but eliminated,” declares Lishimpi. Lishimpi. – around US$10,000 per individual – and Zambia’s cancer indicators are nega- Another contributing factor to by 2004 we had 5,000 patients waiting tively impacted by the high prevalence of Zambia’s cancer profile is urbanization – for treatment.” HIV/AIDS in a country where three of the the more heavily-populated an area,

36 OFID QUARTERLY OCTOBER 2010 OUTREACH

Although modest in terms of size, Lusaka’s Cancer Diseases Hospital boasts pioneering screening services, state-of-the-art diagnostic and treatment equipment and a corps of highly-qualified medical personnel.

PHOTOS: DANA SACCHETTI, ANGELA LEUKER/IAEA, SYAHRUL LUDDIN/OFID, CDH

OFID QUARTERLY OCTOBER 2010 37 OUTREACH

“Zambians have put a lot of faith in Number of people served by one radiotherapy unit the facility and I am confident that CDH has delivered what it set out to do,”

Tunisia Lishimpi says. “Patients coming in with early-stage presentations of cancer have a Morocco good chance of being cured, and we can at least provide palliative treatments to late- Algeria Libyan Arab Western Jamahiriya Egypt stage cancer sufferers. To witness the relief Sahara they express when their pain is taken away is a very rewarding experience.” Cape Verde Mauritania Mali Niger Eritrea CDH is also carrying out concerted Senegal Chad Gambia Burkina prevention activities. According to Faso Sudan Djibouti Guinea Bissau Benin Lishimpi, one of the biggest hurdles in Guinea Nigeria Côte Central African Ethiopia this regard is the shortage of cytologists Sierra Leone D’ivoire Ghana Republic Liberia Togo Cameroon Somalia – the specially-trained individuals who Sao Tome Equatorial Uganda can read slides of cell samples. This defi- & Principe Guinea Republic Kenya Gabon of Congo Democratic ciency poses a significant constraint to Republic Rwanda of Congo Burundi Seychelles detecting cervical cancer, the major Availability United Republic of treatment Tanzania cause of mortality and morbidity in the Angola Comoros country, as the Papanicolaou (Pap) smear Malawi below 500 000 Zambia is a very effective means for detecting 500 000−1 million Mauritius Zimbabwe pre-cancerous and cancerous cells. Since 1−2 million Namibia Botswana Madagascar this requires the skills of a cytologist, 2−5 million Mozambique such technology is seldom available in over 5 million Zambia. Lesotho Swaziland no unit To circumvent this problem, CDH South Africa no data has been pioneering a very successful, low-cost alternative to the Pap smear. The procedure involves staining the cervix Source: IAEA-DIRAC database 10/2010 with weak acetic acid (similar to house- hold vinegar), which highlights any can- “Zambians have put the higher the rate of sexually-trans- cerous lesions by turning them white. a lot of faith in the facility mitted diseases (STDs). Some STDs, such Thus, a visual inspection of the cervix will as the human papilloma virus (HPV), quickly highlight any abnormality. and I am confident that have been implicated in causing cancer. Thanks to this screening program, CDH has delivered what According to Lishimpi: “We see a lot of 80 percent of the malignancies found at patients with HPV-driven cancers of the CDH are in the early stages. This success it set out to do.” cervix, vagina and other areas. Most of has prompted the government to start them – around 60 percent – are also in- scaling up similar cervical cancer screen- fected with HIV.” ing programs in almost every district Given the complexity and gravity across the country. of Zambia’s cancer problems, the open- Lishimpi reports that CDH is imple- ing of the CDH in 2006, with OFID fund- menting breast cancer awareness cam- ing, could not have been timelier. paigns and training health personnel in Although initially operating at partial conducting clinical breast screenings. capacity, it was not long before the cen- Outreach programs are also being carried ter started receiving referrals from other out during trade fairs, public service days hospitals, and the numbers of patients and other events, where information ma- soon soared – from 36 in 2006 to 719 the terials are distributed to encourage peo- following year. More than 1,200 new ple to come to the hospital for testing as cases were treated in 2008 and 2009, and soon as they feel that something isn’t a similar number is expected this year. quite right with their health.

38 OFID QUARTERLY OCTOBER 2010 OUTREACH

“We are moving towards setting up a national cancer control program … OFID’s support will help us do just that.”

With all of these activities taking place, was decided that CDH should provide low ing center that will attract foreign stu- and patient numbers steadily climbing or no-cost patient hostels for the poor,” dents. Hopes are that the successes of each year, it isn’t surprising that resources says Lishimpi, “while also offering higher- CDH will create the impetus for more can- at CDH are becoming overstretched. end facilities for foreign patients and cer centers to be built in Zambia, which While the facility could, in theory, handle Zambians who can afford to pay. We will also boost the need for training. “We up to 2,500 new cases annually, a major would then be able to channel any profits are examining all of these possibilities as constraint is the shortage of qualified per- back into the hospital’s operating budget a means to raise more funds for the hospi- sonnel. “Until we can boost the number to help subsidize the costs for patients tal, particularly as our primary goal is to of oncologists, oncology nurses and ra- who are unable to pay for their treatment insure that the very poor have full access diotherapists, we simply can’t accommo- and accommodation.” to modern cancer treatment facilities,” date the additional numbers,” states In addition to constructing patient Lishimpi adds. Lishimpi. “waiting hostels,” the project is building Human resources will be bolstered The additional caseloads are also well-equipped staff accommodation in through the provision of training for 40 causing the surgical wards at UTH to be- the form of two or three-bedroom apart- medical specialists, including clinical ra- come overcrowded. Moreover, patients ments as well as stand-alone houses. diation oncologists, radiation therapists who don’t require an in-patient stay, but Lishimpi is confident that by being able and oncology nurses. Additional radio- nonetheless must remain in close prox- to offer such facilities, CDH will stand a therapy equipment will also be pur- imity to the CDH to receive a six to seven better chance of retaining its staff. chased to meet the anticipated larger week-long daily course of chemo- and/or Meanwhile, the congestion being ex- caseloads. radiotherapy, are in need of accommoda- perienced on UTH’s wards will be allevi- “Fortunately, our government has tion. The CDH is also facing a problem ated through the construction of six in- been very supportive in including cancer that is being encountered by healthcare patient wards, each with a 40-bed capac- care in its basic healthcare package,” says facilities across Zambia; namely, person- ity, which will be dedicated solely to CDH Lishimpi. “We are moving towards set- nel leaving to pursue higher-paying posts patients. ting up a national cancer control pro- elsewhere. This problem could be re- The expansion will also construct gram that covers the five main pillars: duced, believes Lishimpi, if staff housing staff offices and a training center. The lat- screening, early detection, treatment, were made available. ter will not only enable CDH to become palliative care and research. And the sec- It is these key issues that the OFID- more self-sustaining, explains Lishimpi, ond phase of OFID’s project will help us sponsored CDH expansion will target. “It but also, in time, become a regional train- do just that.”

OFID QUARTERLY OCTOBER 2010 39 July – September 2010

JULY 6 pre-export financing for the ed on July 23, with the atten- Egyptian General Petroleum dance of some 100 participants AUGUST 24 Corporation “PEL IV,” one of sponsored by OFID. Public sector loan the most visible structured trade See story page 12. Emergency assistance agreements signed transactions in the region this grant approved year. OFID has committed AUGUST 5 Ethiopia. US$20 million. Jijiga – US$50 million, alongside 26 Burkina Faso. US$200,000. This Degehabur Power Transmission. other banks and financial grant helped support emergency operations to aid victims of severe Lesotho. US$8.4 million. institutions participating in Public sector loan the syndicate. agreement signed flooding. An estimated 85,000 Tikoe Industrial Park. people were directly affected by Emergency assistance Grant agreements signed Nepal. US$15 million. Lumbini the disaster, and 26,000 lost not only their homes but also their grant approved United Nations Children’s Connectivity and Infrastructure livestock. Proceeds from the grant, Fund (UNICEF). US$3 million. Improvement. Niger. US$200,000. This grant, which was channeled through the OFID/UNICEF Joint Project on which was channeled through IFRC, were used to provide tempo- Scaling up Assistance to Children the International Federation of AUGUST 6 rary shelter, food and non-food Affected by HIV/AIDS in Africa. Red Cross and Red Crescent Soci- relief items and primary health- eties (IFRC), assisted communi- United Nations Educational, Emergency assistance care, among other needs. ties experiencing food insecurity Scientific and Cultural Organi- grant approved as a result of prolonged drought. zation (UNESCO). US$750,000. SEPTEMBER 1-3 In addition to providing food aid Reconstruction of Emergency Pakistan. US$500,000. This to some 60 villages in the vicini- Schools in Haiti. grant, which was channeled ty of Zinder town, the IFRC will through the IFRC, was extended BANDES delegation holds Foundation for the Social help develop sustainable agricul- to help the estimated 2.5 million working sessions at OFID Promotion of Culture (FPSC). people caught up in the humani- tural practices to reduce the risk OFID’s sister organization, US$400,000. Support to Rural tarian crisis caused by severe of food crises in the future. BANDES, the Social and Economic Communities in La Reina, rainfall and flooding. OFID’s Nicaragua. Development Bank of Venezuela, JULY 9 grant went towards relief and visited the institution’s headquar- emergency operations undertak- ters to discuss issues of mutual JULY 15 en by the Pakistan Red Crescent interest and explore avenues of Cuban Vice-Minister Society. future cooperation. of Culture visits OFID’s Public sector loan in-house exhibition agreement signed Grant approved under SEPTEMBER 9 the Special Grant Account HE Fernando Rojas, Vice Minister Azerbaijan. €20 million. for Palestine of Culture of Cuba, visited OFID’s Janub Power Plant. Participation in-house exhibition showcasing United Nations Relief and agreement signed Member Country Venezuela. Works Agency for Palestine Mr. Rojas was accompanied by JULY 20 OFID signed its first participation Refugees in the Near East HE Norma Goicoechea, Ambassa- under the Global Trade Liquidity (UNRWA). US$500,000. This dor of Cuba to Austria and Program (GTLP), an initiative of Public sector loan grant will support an UNRWA HE Alí de Jesús Uzcátegui Duque, the International Finance Group agreement signed initiative that aims at mitigating Ambassador of Venezuela to (IFC) designed to pool funds to the effects of the blockade Austria. Côte d’Ivoire. US$7 million. commercial banks in the wake of endured by Gaza’s Palestinian North East Abidjan Drinking the recent financial crisis. The refugees. Proceeds are to be Water Supply. investment consists of a three-year JULY 12 directed towards priority inter- credit line to Banco Galicia, ventions in the form of cash Argentina, for up to US$20 million OFID enters into JULY 18 - 23 and food assistance for families that the IFC will disburse as trustee Facility Agreement living in abject poverty; job for funds provided by OFID. The OFID active at AIDS 2010 creation schemes; provision of whole facility amounts to $40 mil- OFID entered into a Facility prosthetic devices for children lion and will boost agriculture Agreement in the amount of The XVIII International AIDS with disabilities; and school lending to farmers and small and US$2 billion in a syndicated Conference (AIDS) 2010 conclud- feeding programs. medium-size businesses.

40 OFID QUARTERLY OCTOBER 2010 OFID DIARY

SEPTEMBER 21 Technical assistance will showcase Arab achievements SightSavers International (SSI). grants approved across the world to celebrate the US$150,000. This grant will help 10th anniversary of the ATF. finance a project that aims at nd International University of eliminating preventable blind- 132 Session of Caritas-Spes. US$100,000. This Africa. US$350,000. The Univer- ness in the Dohod, Jhabua and grant will support rehabilitation the Governing Board sity, which is situated in Khar- Banswada districts of Central of a children’s camp in Yablin- toum, the Sudan, aims to provide Western India by 2020. Some ista, Ukraine, which offers disad- Project loans approved more educational opportunities 60,000 people will be screened vantaged and disabled children for women through the construc- by SSI physicians, of which Cambodia. US$12 million. the chance to participate in recre- tion of a fully-furnished and around 12,000 will receive Water Resource Management ational activities and receive equipped hostel for female stu- cataract surgeries. School screen- Sector Development. therapeutic care. A low-cost heat- dents. The new facilities will ing programs will also take place ing system will be installed to China. US$18 million. have the capacity to accommo- for approximately 10,000 chil- Bayin River Management. date 256 individuals. This is enable year-round opening of the dren. expected to encourage more facility. Some 900 orphaned and Egypt. US$40 million. Zenab for Women in Develop- women to enroll at the institu- homeless children are expected Banha Power Plant. ment. US$60,000. This grant will tion, particularly those from to benefit from the scheme. support a project that aims at Guatemala. US$15 million. impoverished rural areas. Islamic Academy of Sciences empowering women farmers in Sustainable Rural Development (IAS). US$30,000. This grant will Hilfswerk International Austria. 20 villages in the Elgedarif Project for the Quiche Region. support the 18th IAS conference US$300,000. This grant will sup- region, the Sudan. This will be which will convene in Shah Sierra Leone. US$19 million. port a scheme devised by the achieved by providing benefici- Alam, Selangor, Malaysia, Three Towns Water Supply Austrian NGO Hilfswerk Interna- aries with agricultural inputs, December 8-9. Bearing the theme and Sanitation. tional that aims at strengthening on-farm training classes and Towards the Knowledge Society in the capacities of disadvantaged instruction on modern cultiva- Tanzania. US$10 million. the Islamic World: Knowledge Pro- groups in the rural areas of the tion techniques. These activities Geita District Rural duction, Application and Dissemi- Khatlon region of Tajikistan. This will help improve yields, raise Electrification. nation, the event will be held will include development of an household incomes and boost jointly with the International educational food processing food security. Islamic Academy of the Sciences Grant approved under the enterprise to enhance the pro- and Biotechnology and the Uni- duction of high value-added HIV/AIDS Special Account versity of Selangor. crops, together with an agribusi- United Nations Office on ness intermediary that will offer Drugs and Crime. (UNODC). specialized extension services for US$2 million. This grant will co- fruit and vegetable farmers. finance an OFID/UNODC initia- tive aimed at bolstering the Research grants approved Meetings attended by OFID response to social and livelihood Arab-European Young Leaders needs for HIV/AIDS prevention Forum. US$50,000. This grant JUNE 27 – JULY 4 SEPTEMBER 11 – 14 among drug users in East Africa. will support an Arab-European Activities will cover the develop- Young Leaders Forum that will ABU DHABI, VIENNA, AUSTRIA/ ment of local capacity to provide hold November 24-27 in Vienna, UNITED ARAB EMIRATES BRATISLAVA, SLOVAKIA emergency social assistance; Austria, bringing together some th supplementing of low threshold 60-70 young professionals from 67 Coordination International Press Institute healthcare services; harm- Europe, Turkey and the Arab Group Meeting World Congress and 60th reduction interventions; anti- world. One of the key aims of the Anniversary Celebration retroviral therapy; and drug- event is to foster mutual under- JULY 18 – 23 dependence treatment programs. standing and enhance cross- cultural and regional coopera- VIENNA, AUSTRIA SEPTEMBER 20 Grant approved under tion. The forum is being spon- 18th International AIDS VIENNA, AUSTRIA sored by the Austrian Federal the Special Grant Account th Ministry for European and Conference (AIDS 2010) 54 General Conference for Palestine International Affairs of the IAEA Assistance to Civil Society Arab Thought Foundation JULY 19 – 29 Organizations in Palestine – (ATF). US$100,000. This grant OXFORD, UK SEPTEMBER 20 – 22 Phase II. US$2.7 million. This will support the FIKR 9 confer- nd grant will support 30 Palestinian ence sponsored by the ATF enti- 32 Oxford Energy Seminar NEW YORK, USA NGOs that are providing vital tled Shaping the Future: Arab’s UN High-Level Plenary assistance in the areas of educa- Role. The event will hold Decem- AUGUST 27 – 31 Meeting on the Millennium tion, health, agriculture and ber 8-9 in Beirut, Lebanon, and Development Goals community development. The provide a platform for the BLED, SLOVENIA funds will help insure that these exchange of ideas and creative Bled Strategic Forum 2010: organizations can continue deliv- thinking among business leaders “The Global Outlook for the ering services that would other- and representatives of academia wise be unavailable to the Pales- and civil society from the Arab Next Decade” www.ofid.org tinian population. region. This year’s conference

OFID QUARTERLY OCTOBER 2010 41 OFID DIARY

LOAN and GRANT SIGNATURE

July 6 HE Dr. Makase Nyaphisi, Ambassador of Lesotho to Austria, and OFID Director-General, Mr. Al-Herbish initial the loan agreement. The country has taken US$8.4 million to help build a new industrial park.

July 12 Ms. Afshan Khan, Director, Public Sector Alliances and Resource Mobilization Office, UNICEF, signs the US$3 million grant agreement for the OFID/UNICEF Joint Program on Scaling-up Assistance to Children affected by HIV/AIDS in Africa. July 12 Ms. Pilar Lara, President of the Foundation for the Social Promotion of Cul- ture. The NGO received a US$400,000 grant for an initiative to improve rural living stan- dards in the La Reina region of Nicaragua

42 OFID QUARTERLY OCTOBER 2010 OFID DIARY

July 6 Ms. Lulit Z. Gebremariam, Chargé d'Affaires a.i. at the Embassy of Ethiopia in Vienna, and Mr. Al-Herbish at the signature ceremony. The US$20 million OFID loan will help increase elec- tricity access by expanding the national grid.

July 20 HE Y. Bamba, Ambassador of Côte d’Ivoire to Austria, shakes hands with Director-General Al-Herbish, after signing the loan agreement. The US$7 million credit will be used for a drinking water supply project.

July 20 HE Samir Sharifov, Minister of Finance of Azerbaijan, concluded a €20 million agreement for a priority energy project. The loan will go towards the construction of a new gas-fired power plant in the city of Janub.

The full list of loan signatures can be found on pages 40-41.

OFID QUARTERLY OCTOBER 2010 43 132nd Session of the Governing Board

Meeting in its 132nd Session in Vienna on September 21, OFID’s Governing Board approved close to US$120 million in fresh funding for development. Of the total, US$114 million was earmarked for loan-financed operations in six countries, the bulk going to energy and water supply projects. The remaining funds were drawn from the institution’s various grant accounts, including the two dedicated to HIV/AIDS and Palestine. Commenting on the approvals, OFID Director-General, Suleiman J. Al-Herbish said that OFID would continue to channel vital resources to low-income countries to help them recover from the global financial crisis. “Such support is essential if national development programs are to remain on track,” he emphasized.

William Cañas Delgado, Venezuelan Alternate Governor Ad-Hoc (right), with Carlos Lopez Herrera, Office of the Executive Director (International Cooperation & Financing), BANDES.

44 OFID QUARTERLY OCTOBER 2010 OFID DIARY

HE Mr. Ismail Omar Al-Daffa, Alternate Governor of Qatar to OFID.

HE Jamal Nasser Lootah, Chairman of the Governing Board.

HE Dr. Anny Ratnawati, Governor of Indonesia to OFID (right), and Mr. Mudjo Suwarno, Alternate Governor.

Iranian Governor, HE Dr. Behrouz Alishiri (left), with Alternate Governor, Saman Ghasemi.

OFID QUARTERLY OCTOBER 2010 45 DEVELOPMENT COOPERATION

Millennium Development Goals still within reach New York Summit inspires fresh hope

With the creation of a new plan of action to spur progress towards the Millennium Development Goals, September’s MDG Summit in New York has injected fresh impetus into global efforts to halve poverty and hunger by 2015.

rganized under the theme We Can ference of the Parties of the UN Convention that, despite setbacks due to the eco- O End Poverty by 2015, the MDG Sum- on Biodiversity, which was held in Nagoya, nomic, financial and food crises, remark- mit brought together 140 heads of state Japan, this October. able progress has been made in many and government, along with bilateral, re- In parallel, six round-table sessions countries, and the goals remain achiev- gional and multilateral organizations, debated the following key issues: (i) ad- able. civil society, academia, the private sector dressing the challenge of poverty, hunger Progress, however, has been mixed and the media. The main objectives of the and gender equality; (ii) meeting the and uneven and falls short of what is three-day gathering were to take stock of goals of health and education; (iii) pro- needed. Although a number of countries implementation to date, identify gaps moting sustainable development; (iv) ad- have achieved major successes, others and accelerate progress towards the eight dressing emerging issues and evolving threaten to be left behind. Without addi- ambitious goals that were set exactly 10 approaches; (v) addressing the special tional efforts, several goals are likely to be years ago. needs of the most vulnerable; and (vi) missed in many countries. The challenges At the plenary sessions, the major widening and strengthening partner- are most severe in least developed coun- themes discussed included: mainstream- ships. Dozens of high-profile side- and tries, land-locked developing countries, ing the MDGs into national and interna- partnership events, focusing on specific small island developing states, and fragile tional policy; the interconnectedness of initiatives, also took place. states in, or emerging from, conflict. all MDGs; the need for improved ac- The Summit concluded with the Cognizant of the work that remains countability and delivery on commit- adoption by world leaders of an outcome to be done, the outcome document in- ments; the critical importance of women document entitled Keeping the promise: cludes an action plan for worldwide in achieving the MDGs; and the impor- United to achieve the Millennium Develop- achievement of the goals and targets. tance of ensuring success at the 10th Con- ment Goals. The 32-page document notes Based on examples of success and lessons

46 OFID QUARTERLY OCTOBER 2010 PHOTO: UN PHOTO MARTINE PERRET / LOGO: UNITED NATIONS

School meal programs are an effective way of improving childhood nutrition and fostering progress towards the hunger- and health-related targets of the MDGs.

learned over the last 10 years, the plan spells out specific steps to be taken by all The Millennium Development Goals stakeholders to accelerate progress on all eight goals. The MDGs were conceived at the September 2000 UN Millennium Summit, The conclusion of the Summit also saw several new initiatives being an- when heads of state and government unanimously adopted the UN Millen- nounced, among them a Global Strategy on nium Declaration and collectively committed to combating poverty, hunger Women’s and Children’s Health, which was and disease through eight time-bound and measurable goals. The target date launched with pledges of US$40 billion for achievement of the goals is 2015. over the next five years from a wide variety of sources. These include developed and Goal 1. Eradicate extreme poverty and hunger developing country governments, the Goal 2. Achieve universal primary education private sector, foundations, international Goal 3. Promote gender equality and empower women organizations, civil society and research Goal 4. Reduce child mortality organizations. A number of other signifi- Goal 5. Improve maternal health cant commitments to accelerate progress Goal 6. Combat HIV/AIDS, malaria and other diseases on each of the eight goals were made by representatives of national governments, Goal 7. Ensure environmental sustainability international organizations, civil society Goal 8. Develop a global partnership for development and the private sector.

OFID QUARTERLY OCTOBER 2010 47 DEVELOPMENT COOPERATION

Modern energy for all by 2030 New drive to launch soon

Global leaders may not have embraced universal energy access as the ninth Millennium Development Goal, but the fight to push the cause up the global agenda is far from over.

ew would dispute the importance of According to UNIDO Director-General, Quarterly on the sidelines of a Vienna En- F modern energy to human progress Kandeh Yumkella, this reluctance is less ergy Club (VEC) meeting in early Octo- and economic development – and by def- to do with a head-in-the-sand mentality ber. “What we need is a new approach to inition to the eight Millennium Develop- than with the political decision made to energy poverty – an ‘energy revolution’ ment Goals (MDGs). It is a subject, how- “ring-fence” the eight goals in such a way that would address the twin challenges of ever, that continues to be sidelined from that nothing new could be added. “While energy poverty and energy efficiency,” he the political mainstream, as was evident at we understand the link between energy added. the recent MDG Summit in New York, access and the MDGs, it has not been easy In his keynote address to the VEC – where despite lobbying efforts the matter politically to negotiate and transact hav- an informal group of energy stakeholders received only modest attention. ing it as an MDG,” Yumkella told the based in the Austrian capital – Yumkella revealed that plans were already under- way for a global campaign to help “kick start” this energy revolution. Spear- headed jointly by the UN Secretary- General’s Advisory Group on Energy and Climate Change, UN Energy and UNIDO, the campaign would launch in 2011. “The long-term goals would be to achieve uni- versal energy access and increase energy efficiency by 30 – 40 percent by 2030,” Yumkella said. He further disclosed that a request had gone to the UN General As- sembly to declare 2012 as the Year for Uni- versal Energy Access. Such a move would go a long way towards raising awareness among all stakeholders – from govern- ments, the private sector and other donors to NGOs and civil society. Yumkella’s announcement came fol- lowing the release of an International En- ergy Agency (IEA) report entitled: “Energy Kandeh Yumkella, UNIDO Director-General (center), exchanges views with OFID Director- Poverty: How to make modern energy General, Suleiman J. Al-Herbish (left) and OPEC Secretary General, Abdalla Salem El-Badri (right), at a meeting of the Vienna Energy Club. access universal.” The report, which was

48 OFID QUARTERLY OCTOBER 2010 DEVELOPMENT COOPERATION

Yumkella, who chairs both the UN Secre- Premature annual deaths from household air pollution tary-General’s Advisory Group and UN and other diseases Energy, expressed confidence that the proposed “Energy Access for All” cam- paign could have the same success as sim- 2.5 Million 2008 2030 ilar campaigns for HIV/AIDS and malaria. Above all, he stressed the importance of 2.0 combining the access and efficiency as- pects. “Even though most countries agree 1.5 that energy efficiency is the low-hanging fruit as far as solving climate change is 1.0 concerned, there have been several barri- ers preventing it from being picked,” he 0.5 said. The campaign would seek to dis- mantle these barriers. 0 Yumkella conceded that, with atten- Malaria Tuberculosis Smoke from biomass HIV/AIDS tion focused on mobilizing resources to meet the MDGs, generating additional, Source: World Energy Outlook 2010, OECD/IEA separate funding for energy programs produced in conjunction with UNIDO victims a year – more than 4,000 people a would be challenging. It would be crucial, and UNDP, estimates that US$36 billion a day – by 2030. The report also draws atten- he said, to ensure that some of the financ- year would be needed to ensure that tion to the health implications of biomass ing allocated to climate change mitiga- “every citizen in the world benefits from collection, which it describes as a “time- tion be directed towards funding energy access to electricity and clean cooking fa- consuming and exhausting task” that of- related projects in developing countries. cilities by 2030.” It concludes that this ten causes “serious, long-term physical Also key would be public/private partner- could be achieved without a significant damage.” Said Yumkella: “Eradicating en- ships. These, he indicated, would look at worsening of the climate change problem. ergy poverty is as much about women’s combining grant funding for capacity Addressing the Club, Yumkella in- welfare and empowerment as promoting building with private sector financing for sisted that climate change concerns were energy access.” technology transfer. no grounds for side-stepping the equally important problem of energy access. “Why should those who have con- tributed the least to climate change pay Annual electricity consumption in New York and Sub-Saharan Africa the highest price?” he asked, quoting fig- ures in the IEA report which show that the 19.5 million inhabitants of New York SUB-SAHARAN AFRICA City consume in a year roughly the same Population 791 million quantity of electricity as the 791 million people in sub-Saharan Africa. There were also compelling health NEW YORK reasons for eradicating energy poverty, Population 19.5 million said Yumkella, citing World Health Or- ganization estimates that around 1.45 mil- 2,050 lion people – most of them women and kWh per capita children – die prematurely each year from 52 household air pollution caused by cook- ing with biomass. According to the IEA re- kWh per capita port, this number is higher than the cur- rent number of deaths from malaria or tu- berculosis. Moreover, unless there is tar- geted action to deal with the problem, bio- mass pollution would claim 1.5 million Source: World Energy Outlook 2010, OECD/IEA

OFID QUARTERLY OCTOBER 2010 49 DEVELOPMENT COOPERATION

Four decades of Arab AID: a proud tradition

According to Arab Development Assistance: Four Decades of Cooperation, a recent publica- tion by the World Bank, Official Development Assistance (ODA) provided by Arabic-speaking countries and their development finance institutions (“Arab Aid”) is an increasingly important factor in global development financing.

evelopment cooperation by Ara- the Development Assistance Commit- opment Organizations, and the Arab D bic speaking donors has been tee (DAC) of the Organization for Eco- Monetary Fund1. These Sister Institu- among the most generous in the world, nomic Cooperation and Development tions have grown to become major with ODA totalling US$272 billion over (OECD) – the world’s richest industrial- providers of external financial assis- the period 1973-2008. The bulk of this ized nations. tance. Total Arab aid provided by the assistance has been provided by OFID In addition to bilateral (govern- three national funds (the Saudi Fund, Member Countries the Kingdom of ment-to-government) development co- the Kuwait Fund and the Abu Dhabi Saudi Arabia, Kuwait and the United operation, Arab donors established sev- Fund) and the five major multilateral Arab Emirates. eral multilateral development financing funds and banks has quadrupled since Arab donor countries dedicated institutions (DFI’s) in the 1960s, 1970s the 1970s, reaching over US$90 billion 1.5 percent of their combined Gross and early 1980s. Besides OFID, this group (in commitments) as of the end of 2008. National Income (GNI) to ODA in 1973- includes the Arab Fund for Economic 2008 – more than twice the United Na- and Social Development, the Arab Bank 1 Other OFID Sister Institutions include the Arab Authority for Agricultural Development and tions target of 0.7 percent of GNI, and for Economic Development in Africa, Investment (AAAID), the Arab Monetary Fund five times the average of 0.3 percent of the Islamic Development Bank, the Arab (AMF), and the Arab Trade Financing Program GNI provided by member countries of Gulf Program for United Nations Devel- (ATFP).

50 OFID QUARTERLY OCTOBER 2010 DEVELOPMENT COOPERATION PHOTO: BCEOM

nical advice. They have participated in debt relief, offered balance of payments and budget support, provided trade fi- nancing, established facilities to encour- age private sector operations, and estab- lished financing instruments consistent with the tenets of Islamic law. The Arab DFIs usually co-finance their projects and programs and stand out for their high degree of policy coor- dination and procedural harmonization as part of the Arab Coordination Group. Common procedures have enabled Arab agencies to reduce transaction costs, fos- ter greater transparency in project man- agement and improve project safeguards and accountability. In addition, mem- bers of the Arab Coordination Group participate in ongoing global initiatives to foster aid effectiveness through better harmonization and alignment. More recently, the Arab Coordina- tion Group has started to coordinate policies and projects with members of the OECD/DAC, as evidenced by the Joint Technical Meeting convened by OFID at its Headquarters in April 2010. Representatives from the International Fund for Agricultural Development and the Inter-American Development Bank (IDB) also attended the meeting – the first of its kind – which focused on means to strengthen world food and Djibouti Port was co-financed by OFID and four other Arab aid institutions, namely the Abu Dhabi energy security, as well as capacity Fund, the Arab Fund, the Kuwait Fund and the Saudi Fund, together with the Government of Djibouti. enhancement for improved reporting. The World Bank report concludes In the past four decades, Arab donors focus. Assistance through these institu- that Arab development financing is have expanded their reach to provide tions increased substantially by over likely to grow and serve as an increas- development assistance to an increasing 4 percent per year in real terms over the ingly important source of global devel- number of developing countries across past 20 year. opment financing in the decades to the world, with a focus on poor and low- South-South cooperation is one of come. Despite the severity of the global middle-income countries, especially in the hallmarks of Arab aid, with commer- financial crisis, Arab donors have in- sub-Saharan Africa. As countries have cial self-interest playing a significant creased their aid volumes since 2002 – subscribed to the Millennium Develop- role in its allocation. Development fi- both in volume and as a share of GNI. It ment Goals (MDGs), greater emphasis nancing provided by Arabic-speaking is noted that Arab ODA is delivered has been placed on agricultural develop- donors generally takes the form of ODA through reasonably well-capitalized ment, social sectors, debt relief, emer- grants and concessional loans for spe- and conservatively managed funds and gency relief, capacity building, targeted cific projects and programs. While in- banks. These growing and maturing poverty reduction programs and private vestment operations are their mainstay, institutions are well-placed to tap into sector development. The Report singles Arab financial institutions have also capital markets to increase the scope out OFID, the Kuwait Fund and the provided grant financing for capacity of their operations over the medium Saudi Fund for being the most global in building, project preparation and tech- to long run.

OFID QUARTERLY OCTOBER 2010 51 MEMBER STATES FOCUS

Gabon and Nigeria celebrate 50 years of independence

The year 2010 has seen many of Africa’s former colonies marking milestone anniversaries of their independence – including two OFID Member Countries Gabon and Nigeria, who celebrate their golden jubilees.

Gabon The West African nation of Gabon marked the 50th anniversary of its inde- pendence on August 17. The highlight of the celebrations was a grand military pa-

rade on the seafront of the capital Libre- PHOTO: WILFRIED MBINAH/AFP ville, attended by President Ali Bongo and a host of heads of state from neigh- boring countries. Later that night an “inter-genera- tional” concert featuring more than 50 artists was held in the city’s Omar Bongo stadium with tens of thousands of peo- ple in attendance. Until its independence in 1960, Gabon was part of French Equatorial Africa, which also included the present- day nations of Cameroon, Chad, the Democratic Republic of Congo and the Central African Republic. Gabon’s President Ali Bongo Ondimba and his wife Sylvia greet the crowd at the end of a parade Since becoming a sovereign state, marking the country’s 50th anniversary of independence. Gabon has prospered, thanks largely to its plentiful mineral resources. It is sub- Saharan Africa and the country enjoys the thousand remain today. The country is Saharan Africa’s third-largest crude oil pro- highest ranking of all African countries in home to over 40 ethnic groups with sep- ducer as well as exporter and is the world’s the Human Development Index of the arate languages and cultures. The offi- largest producer of okoume, a soft wood United Nations Development Program. cial French language, however, has been used to make plywood. Per capita income The original inhabitants of Gabon a unifying force. Gabon is one of the in Gabon is four times the average for sub- were the Pygmies, of whom only a few least populated countries in Africa.

52 OFID QUARTERLY OCTOBER 2010 MEMBER STATES FOCUS

Gabon is famous for its magnificent ecosystem, which consists of millions of hectares of tropical rainforest, arable land and some 800 km of coastline. It also has three karst areas where there are hundreds of caves located in the dolomite and lime- PHOTO: WOLE EMMANUEL/AFP stone rocks. Gabon is also noted for efforts to preserve the natural environment and is becoming a popular ecotourism destina- tion. The country boasts a total of 13 national parks, with a large variety of migratory birds, elephants, gorillas and magnificent forest waterfalls. As part of the Congo basin, Gabon has fauna and flora that are among the most diversified in the world. Animal species are ex- tremely varied and around 400 different trees have been counted. Gabon has played an important leadership role in the stability of Central Africa through involvement in mediation efforts in Chad, the Central African Nigerian President Goodluck Jonathan (left) inspects the guard of honor during a presidential fleet Republic, Angola, the Republic of the review to mark Nigeria’s 50th independence anniversary. Congo, the Democratic Republic of the Congo and Burundi. extensive proven gas reserves. The coun- the world. The number of languages try has undertaken several reforms in re- currently catalogued is 521. The official Nigeria cent years, with a focus on infrastructure language, English, was chosen to facili- For Nigeria, the celebrations came on improvements based on strong public/ tate the cultural and linguistic unity of October 1, the date in 1960 when the private sector collaboration. the country. country achieved its full independence In pursuing the goal of regional eco- Nigeria’s rich cultural heritage pre- from Great Britain. Under the auspices of nomic cooperation and development, cedes its independence. The oldest sculp- President Goodluck Jonathan, the land- Nigeria helped create the Economic Com- tures found in Nigeria were from the mark occasion saw a host of events take munity of West African States (ECOWAS), Southern Zaria and Benue areas of central place across the country. These included which seeks to harmonize trade and in- Nigeria. They consist of terracotta figures parades, aerial displays, banquets and a vestment practices for its 15 West African and figurines made by a people who national children parliament, as well as member countries. Over the past decade, achieved a high degree of cultural sophis- the unveiling of special commemorative Nigeria has played a pivotal role in the tication. These sculptures, together with works. support of peace in Africa. other cultural elements, have been The Federal Republic of Nigeria is Virtually all the native races of Africa named the Nok Culture. The Nok Culture located in West Africa and consists of are represented in Nigeria. Today, there is dated between 500 BC and 200 AD. 36 states and a Federal Capital Territory, are estimated to be more than 250 ethnic Nigeria is famous for its popular Abuja. The city of Lagos is the country’s groups in the country. The variety of cus- music and has some of the most advanced commercial hub. The country is currently toms, languages and traditions among recording studio technology in Africa, experiencing its longest period of civilian these groups gives Nigeria its rich cultural providing attractive commercial oppor- rule since independence. diversity. While no single group enjoys tunities for music performers. Since the Nigeria has the third largest econ- an absolute majority, four major groups 1990s the Nigerian movie industry, some- omy in Africa, after South Africa and make up 60 percent of the population: times called “Nollywood,” has also Egypt. Considered an emerging market, Hausa-Fulani in the north, Yoruba in the emerged as a fast-growing cultural force it is listed among the “next eleven” west and Igbo in the east. and was rated in 2009 by the UNESCO economies. It is the 12th largest producer Nigeria is the most populous country Institute for Statistics as the second- of petroleum in the world and also has in Africa and the eighth most populous in largest movie industry in the world.

OFID QUARTERLY OCTOBER 2010 53 OPEC

IN ORT G S PP TA U B S IL I T Y OPEC Anniversary Exhibition

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T I 1960–2010 R showcases Member Countries E P F S U R O ELLING P Held at the end of September in Vienna’s historic Kursalon, OPEC’s Anniversary Exhibition proved to be the highlight of the Organization’s Golden Jubilee celebrations. The 10-day event, OPEC Secretary General, Abdalla Salem El-Badri (center), which featured colorful displays from all 12 Member Countries, cutting the ribbon at the attracted thousands of visitors - from members of the local opening ceremony, which was attended by Member diplomatic corps to the Viennese public, students and tourists. Country Ambassadors and OPEC Governors, among other dignitaries.

54 OFID QUARTERLY OCTOBER 2010 OPEC PHOTOS: OPEC/DIANA GOLPASHIN, OFID/RANA WINTERSTEINER

Each afternoon saw a breath- taking display of cultural shows from the Member Countries. Comprising musical bands, dancers and singers in national costume, fashion shows and many other artists, the perform- ances were the high point of the exhibition.

Dr. Elisabeth Vitouch, President, European Affairs Commission of Vienna City Council, represented the City of Vienna.

In his opening address, Mr. El-Badri pointed out that the exhibition showcased the cultural, ethnic and historical richness of Member Countries.

OFID QUARTERLY OCTOBER 2010 55 IN ORT G S PP TA U B S IL I T Y

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T I R 1960–2010 E P F S U R O ELLING P OFID joins in celebrations

OFID’s participation in the anniversary event included an attractive information stand on the theme “Their future is our mission,” which featured a colorful wall panel depicting young beneficiaries of the institu- Left to right: HE Dr. Zuheir Elwazer, Ambassador of Palestine to Austria; OFID Director-General tion’s work. It also staged Mr. S. Al-Herbish; HH Prince Mansour Bin Khaled Al Farhan Al Saud, Ambassador of Saudi Arabia its own cultural afternoon. to Austria; OPEC Secretary General Mr. El-Badri, Mr. Fuad Al-Zayer, Head of Data Services Department, OPEC.

PHOTOS: OPEC/DIANA GOLPASHIN, OFID/RANA WINTERSTEINER

OFID staff member Jorge Goncalvez (left) treated visitors to a mesmer- izing display of “action painting,” raising €4,000 for a local charity, while youngsters from the OFID-sponsored VORLAUT children’s choir sang a medley of traditional Austrian songs.

56 OFID QUARTERLY OCTOBER 2010 www.ofid.org

Securing a better future for the world’s poor

Sustainable development is all about results that last. Results that continue making a difference from one generation to the next. It’s about healthy, well-educated populations, clean water and food security, and an end to isolation.

For over 30 years, OFID has been at the forefront of the fight against poverty. Working hand-in-hand with needy communities, we’ve helped build schools, health centers and roads. We’ve provided energy and water supplies. And we’ve helped our partner countries develop vibrant private enterprise sectors.

Their future is our inspiration.

OFID Uniting against Poverty Parkring 8, A-1010 Vienna, Austria P.O. Box 995, A-1011 Vienna, Austria Telephone: (+43-1) 515 64-0 Fax: (+43-1) 513 92-38 www.ofid.org