High Level Dialogue on ending
AIDS by 2030
Strengthening the assessment of AIDS and
Health in the APRM mechanism
by Joseph TSANG MANG KIN
Member, APR Panel of Eminent Persons
25 November 2014, UNECA, Addis Ababa
1
Outline of presentation

Introduction

APRM Assessment Framework for Health and HIV/AIDS

APRM Normative Framework for AIDS and Health

Assessment of AIDS and Health across APRM themes

Case study: South Africa

Case Study: Uganda

Conclusion
2
Introduction



The African Peer Review Mechanism (APRM) is a mutually agreed
instrument voluntarily acceded to by the member states of the
African Union (AU) as a self-monitoring mechanism.
Founded in 2003, its mandate is to encourage conformity with
political, economic and corporate governance values, codes and
standards, among African countries so as to accelerate socioeconomic development.
To date 34 AU Member States have acceded to the APRM and 17
have been peer reviewed by the APR Forum.
3
APRM Assessment Framework for Health
and HIV/AIDS

APRM countries are assessed on Four Thematic areas:
i) Democracy and Political Governance, ii) Economic Governance
and management, iii) Corporate Governance and iv) Socio-Economic
Development.

APRM deals with the problem of Health and HIV/AIDS both directly and
indirectly in the APRM Questionnaire by:
 Assessing the normative framework (signing, ratification, & domestication
of international and African Codes & Standards)
 Assessing the implementation of the commitments (outcomes-based)

Monitoring of Progress Reports on implementation of National Plan of
Action (NPOA) submitted yearly.
4
APRM Normative Framework for AIDS
and Health
APRM Standards and Codes, directly dealing with Health and HIV/AIDS, include the:
 African Charter on Human and peoples’ Rights (1981);
 African Charter on the Rights and Welfare of the Child (1990);
 World Summit on Social Development Plan of Action (1995);
 Convention on the elimination of all forms of discrimination against women
(1979)
 UN MDG (2000)
 African Youth Charter (2006)
 Protocol to the African Charter on Human and People’s Rights on the Rights of
Women in Africa (2003)
Other health instruments used during assessment not specifically listed in the APRM
Questionnaire: African Health Strategy 2007-2015; and Abuja Call for Accelerated
Action Towards Universal Access to HIV and AIDS, Tuberculosis and Malaria
Services in Africa by 2010.
5
Assessment of AIDS and Health across
APRM themes



Democracy and Political Governance: under Rights of Women, Rights of the
Children, and Rights of vulnerable groups. The assessment examines legislation,
policies, and institutional framework in place to promote right to health and
combat AIDS among these groups.
Corporate Governance: organizational compliance with human rights and labour
laws; corporate social responsibility in the area of health and combatting
HIV/AIDS.
Socio-economic Development: more emphasis on social issues, notably health
and HIV/AIDS.

Strengthening policies, delivery mechanisms and outcomes in key social
areas including HIV/AIDS
 Measures taken by government
• Legal, policy, institutional steps
• Volume, criteria for resource allocation
• Participation of all stakeholders
 Outcomes on social indicators
6
• HIV prevalence disaggregated by sex, age, region
Case study: South Africa







SA fourth APRM Member State to be peer reviewed in July 2007 by APR Forum.
Country Review Report (CRR) identified HIV/AIDS pandemic as major cross-cutting issue.
Estimated 5.3 millions living with HIV/AIDS by end of 2005 making SA second in the world
with highest number of people living with HIV
By March 2006, only 130,000 patients were on state funded ARVs program
CRR identified critical areas needing government attention: treatment (increased public
access to ARVs), protection of women and children from rape; providing strong and clear
leadership by addressing “Aids denialism”; stop violence against women; promote
preventive measures (know your status, condom, behavioral change).
It worked: Government implemented a multipronged strategy (combining prevention and
treatment).
The 3rd Progress Report on implementation of APRM NPOA presented January 2014 reveals:





Over 2 million people were on antiretroviral (ARV) treatment by mid-2012 , leading to increased life
expectancy of people living with HIV
Increased of ARVs sites (3000 sites in 2012)
Medical male circumcision government drive to limit the spread of HIV
Reduction of HIV transmission from mother to child from 8% in 2008 to 3.5 in 2011.
Introduction of single dose pill reducing the risk of patients defaulting
7
Case Study: Uganda


The seventh APRM country to be peer reviewed in June 2008 and hard hit by HIV
pandemic with adult prevalence rate of 18 % in the early 90s.
CRR identified Government response to HIV/AIDS as best practice:









Strong political leadership by President Museveni in the campaign against HIV/AIDS
Open and multi-sectoral policy approach pursued by the government
Massive campaigns on prevention based on ABC- Abstinence, Be faithful and Condom use
Improved access to treatment with free ARVs
First voluntary counseling & testing clinic (VCT) in Africa
Training of health workers in the villages to provide needed health services including
VCT, preventing mother to child transmission (PMTCT) and ART programs
Successful public private partnerships implementing HIV/AIDS projects involving key
government ministries, CSOs, CBOs and private sector companies.
Acquisition of an ultra modern pharmaceutical facility for producing some of the drugs,
including ARVs. This has helped to bring down the costs and increase access to more
people.
Result was a dramatic reduction of HIV prevalence from 18.5 % beginning 90s to
6.5% in 2006 though increased to 7.2% in 2012.
8
Conclusion




APRM offers platform to strengthen assessment of AIDS and Health in Africa
APRM not only assesses and monitors the extent to which commitments are
implemented, it also provides the opportunity for policy makers and ordinary
citizens/stakeholders to hold each other accountable. Hence the need to
strengthen the Mechanism as a monitoring and accountability mechanism.
In line with its mandate, the Common Africa Position on post 2015 Development
agenda, and AU Agenda 2063, APRM will continue to review and urge member
states to sign and ratify UN and regional instruments, including those on
HIV/AIDs and ensure implementation and compliance.
Together and with a strong political commitment, the call for ending epidemics of
HIV/AIDS, TB and Malaria by 2030, can be a reality.
9