ADDRESS TO THE NATION BY
THE PRESIDENT
HIS EXCELLENCY ALHAJI DR AHMAD TEJAN KABBAH
ON THE OBSERVANCE OF WORLD AIDS DAY
1 DECEMBER 2002
Fellow Citizens,
Today is World Aids Day. A day that has been set aside throughout the world to talk about aids, to highlight its effects and bring to the forefront of public opinion the fact that aids is a scourge that is real; it kills, wipes out whole families, creates orphans, destroys homes and livelihoods, with all its attendant evil that retards development. On this day people must be sensitized about Aids and advised on how to avoid the disease through abstinence, behaving very carefully, and controlling how we can do things that are natural but at the same time exercising the utmost caution.
2. It is for this reason that I have decided to deliver this World Aids Day message in my capacity as Head of State and as Chairman of the newly-formed National Aids Council.
3. The theme of this year is "Live and let live", with emphasis on stigmatization and discrimination.
4. Available statistics on HIV and AIDS portray a bleak future for all developing countries, including Sierra Leone. The identified factors contributing to the spread of HIV and AIDS include: poverty, ignorance, illiteracy, prohibitive cost of AIDS drugs, an aversion to discussing sex in some communities, and unsafe sexual practices.
5. Since 1987, 3,599 persons have been tested positive for HIV/AIDS in Sierra Leone. There are 794 registered cases of which 438 have died. Preliminary results of a recent HIV survey done in April 2002, reported an average national HIV prevalence rate of 4.9%, with a range from 4.0% in areas outside Freetown to 6.1% in Freetown. This means that about 250,000, that is, a quarter of a million of Sierra Leoneans are infected, and that 1 out of every 20 people in our country are HIV positive. Knowledge levels on the disease are low, and access to appropriate information and services are severely limited.
6. We often look towards science to solve medical problems. HIV/AIDS has not been an exception to that rule. Since its discovery in 1981, we have hoped for a cure and a decline in the incidence of one of the most feared diseases in modern history. Today, more than 40 million people are living with the HIV virus, and the pandemic is still growing. Hopefully, there will be a cure some day. But that may be a long way in the future.
7. It is worth emphasizing that AIDS is a biological phenomenon caused by a virus. But it is not just about science and medicine. It is also a social phenomenon. The response to this epidemic is determined by governments, communities and individuals. Dealing with the social problems related to HIV/AIDS is just as much a public health issue as a development problem.
8. The stigma around the disease could be attributed to cultural or religious beliefs, or lack of appropriate health education. Another element is the urge to blame. However, by blaming individuals we as stakeholders and communities may fail to take responsibility and action. This can lead to denial. People living with the virus may not admit it. So, denying the existence of HIV/AIDS is equally dangerous. We need to address the related social problems and to strengthen health care for those already infected, and prevent infection for those that are vulnerable. This may involve taking pragmatic and honest appraisal of drug abuse, prostitution, and indiscriminate risk behaviour including sleeping with multiple partners. And for this to succeed, we need to remove the hostile climate of stigmatization and discrimination around HIV/AIDS.
9. Throughout human history, many diseases including the plague, leprosy and tuberculosis, have carried such stigma. People with these diseases were often shunned, isolated and even mistreated. The prejudice was fuelled by lack of knowledge or by beliefs based on the premise that those who contract the diseases were ill-fated or are the objects of some divine punishment for indiscretion.
10. Today, people with HIV/AIDS are often ostracized and rejected by their own communities, even by loved ones. Often they are blamed for their illness. The disease is considered a deserving punishment for "immoral" or "bad" behaviour, such as drug abuse, risky behaviour and infidelity. In other words, it is often regarded as a "fitting punishment" for what is seen as an immoral or perverse behaviour.
11. Making moral judgments over our fellow human beings who are already victims of HIV/AIDS serves little purpose. It does not help the sick get better. It does not prevent infection or stop people from taking drugs. Blaming people does not help stop the disease from spreading. In fact it does the reverse. It increases the negative impact of the pandemic, and creates obstacles to fighting and treating the disease. It usually causes the disease to spread further because stigmatized groups tend to become more hidden, and opportunities for providing them with information and treatment are diminished.
12. Blaming certain groups also allows societies to avoid the responsibility of dealing with the epidemic. This denial can be dangerous. People at risk may also be in denial. They may assume a false sense of security by believing only "outsiders" or marginalized groups can become infected.
13. Ultimately, HIV transmission is tied to complex social patterns and behaviours that cannot be readily explained. People with HIV/AIDS require understanding rather than intolerance. I urge all of us to understand the situation and condition of our unfortunate fellow human beings. The infection and disease could afflict any one of us.
14. This is why we should urge our fellow citizens to ABSTAIN from promiscuity, and try to inculcate the habit of using condoms. But above all, and to be absolutely safe, we should be DISCIPLINED, disciplined not only in the pursuit of pleasure, but also in the day-to-day activities at work and at home.
15. On a wider scale, the dynamics of the HIV epidemic are often related to inequality, poverty, discrimination and the low status of women. For example, the poor are usually less informed, have very little or no access to condoms and treatment for sexually transmitted infections. Furthermore, poverty can force women and in some cases even men into prostitution. Migration, urbanization and rapid cultural modernization have also increased the epidemic.
The National HIV/AIDS Council of which I am Chairman, and the National HIV/AIDS Secretariat within my office, in collaboration with our multi-sector partners, are developing a number of strategies to stop stigmatization and discrimination. These will include:
- Information and awareness campaigns
- Involving people with HIV/AIDS as advocates for change
- Care, Counseling and support services for those infected and affected by HIV/AIDS to deal with the disease
- Training of health workers in responding to, and interacting with those infected with the disease
- Setting policy guidelines for access to prevention, care, and assurances of confidentiality
- Strengthening laws that can help challenge discrimination against those infected with the disease, and provide supportive environment for people living with the disease
- Reviewing Government policy on HIV/AIDS treatment, including anti-retroviral treatment, and the sale of relevant drugs for alleviating the suffering of AIDS patients
- Encouraging political, community and religious leaders to provide leadership in public information campaigns.
17. Fellow citizens, in addition to the National Aids Secretariat, which is linked directly to my office, Government has established a Cabinet sub-committee for HIV/AIDS. After extensive consultations among stakeholders, a National policy was drafted and then reviewed by Cabinet and was finally ratified by Parliament in March 2002. A Credit Agreement between my Government and the World Bank to the value of $15 million became effective on the 3rd of October this year. Under this Agreement, a Sierra Leone HIV/AIDS Response Project (SHARP) has been established within my office. The project has four main components, namely: Capacity-building, policy coordination and refugee activities; Multi-sector responses for HIV/AIDS prevention and care; Health sector responses to Sexually-Transmitted Diseases (STD) and HIV management; and Community and civil society initiatives.
18. On this observance of World Aids Day 2002, we cannot overemphasize the importance of public information campaigns, campaigns that can change individual and societal attitudes regarding HIV/AIDS.
19. Our campaign in the next 12 months and even beyond should be aimed at ensuring that all forms of discrimination and stigmatization concerning HIV/AIDS are addressed and eliminated so that we can concentrate on stopping the spread of Aids and finding a cure for those who are already infected.
20. Thank you for your attention.