Professor Sheila Tlou mentions the words “HIV/AIDS” and “there is cause for celebration”, in the same breath.
On the eve of the World AIDS Day Celebrations, the UNAIDS Regional Director for Eastern and Southern Africa keeps dropping numbers as she takes me through the successes and challenges in the fight against, and the phrase “cause for celebration” begins to make sense.
Do not be fooled by the title “Professor”, Tlou is not your ivory tower academic who discusses the ravages of HIV/AIDS from the comfort of her arm chair, far from it. She was Botswana’s Minister of Health at a time when the country faced extinction from an HIV/AIDS pandemic.
Now her current job involves coming up with HIV/AIDS prevention, treatment and care strategies to bring down or reduce the HIV/AIDS pandemic in twenty one (21) countries in this region.
She says although Eastern and Southern Africa carry the brunt of the epidemic, the region has had the greatest response to the fight against HIV/AIDS. The figures for the Eastern and Southern block of Africa indicate that by 2013, 7.7 million people living with HIV/AIDS gained access to antiretroviral treatment (ARV’s). This number rose from 6.4 million people in 2012.
Dr Tlou observes that if this number continues to rise at one (1) million people per year, by the end of 2015 there will be nine (9) million people in Eastern and Southern Africa having access to treatment.
Apart from upscaling access to ARV’s another, Dr Tlou is also upbeat about the drop in the number of AIDS related deaths in the Southern and Eastern region of Africa. AIDS related deaths have been brought down by 46% between 2005 and 2013. When it comes to new HIV infections, there is also a cause for celebration. “New infections have declined by a healthy 50%. Our star countries in this regard are Botswana, Ethiopia, Malawi and Rwanda,” observes Tlou.
In relation to HIV/AIDs, treatment is also considered a prevention strategy; for example when ARV’s are used in interventions like Prevention-of-Mother-To-Child-Transmission or PMTCT. PMTCT has been so successful that 90% of children are now being born HIV Free. “In countries like Botswana only 2% of children are born HIV positive,” adds the Professor. The Male Circumcision campaign also helped reduce some HIV/AIDS infection figures.
Despite these achievements there are still major hurdles particularly in certain population groups. For example the rise in new HIV infections within young people; the figure is reflected as 1.1 million new infections a year amongst the youth. Other population groups that remains a sore area when it comes to accessing HIV prevention, treatment and care strategies are the men-having-sex-with-men (MSM), Sex Workers and the LGBTI groups. Professor Tlou says these marginalized groups have the right to access HIV/AIDS services. She emphasizes that there are not condoning the acts but they do say that these groups have the right to access HIV/AIDS services. “Sex workers have an HIV infection rate of 60%. Obviously somebody infected the sex workers and they will also infect somebody else with HIV/AIDS,” adds Professor Tlou. “When the ideas or interventions come from the West sometimes there is resistance to them. So when I speak as an African woman, a mother, a Christian they see I am coming from the right place. All I want to do is love all my children. To curb HIV/AIDS everyone must have access to HIV/AIDS services.”
Another area of concern is the imbalance in the access to treatment between adults and children; adults’ have more access than children. This she says is a direct result of weak health systems. “There is no follow up when it comes to children. Mothers simply do not come back to enroll their children for treatment. Botswana is the only country where children are no par with adults in terms of access to treatment,” she adds. An additional downside for children when it comes to HIV/AIDs treatment is that pharmaceutical companies do not have paediatric formulas for children. “These companies are not producing paediatric formulas simply because there is no profit. Children are being born HIV Free, so they don’t see the need to invest in that business area. But we are encouraging them to produce treatment for children,” she says.
As the world celebrates and commemorates World AIDS DayProfessor Tlou shares more numbers to indicate the impact and prevalence of HIV/AIDS globally.There are fifteen (15) countries in the world which make up 75% of the global burden of HIV/AIDS; and nine (9) of these countries come from her region. South Africa leads this group asit carries 18% of the global HIV/AIDS figure; highly populated countries like Nigeria and India carry 16% and 6% of the HIV burden, followed by Kenya at 5%. USA, Mozambique, Uganda, Tanzania and Zimbabwe all carry 4% of the global figure. Malawi and Zambia both carry 3% each. Brazil, Russia, China and Ethiopia are at the bottom of the list contributing 2% each to the global figures for HIV/AIDS. In some instances it is a low percent but from a highly populous country; 16% of the Nigerian population is a large number. The remaining percentage is carried by other countries of the world. “Countries need to collaborate. HIV knows no boundaries, it doesn’t carry a passport. Where there are ARV’s people should be able to access them regardless of which country they are from,” says the HIV/AIDS activist.
An alarming statistic is that out of the thirty five (35) million people living with HIV/AIDS globally only half of them know their status. This is one of the biggest gaps which need to be filled and hence the reason why this years’ theme for World AIDS Day in the region is ‘Know your status’. “We have set ourselves an ambitious target of 90/90/90 if we are to end HIV/AIDS by the year 2020,” she says further elaborating on this concept, “90% of all people should know their status, 90% of all people needing treatment should be on treatment and 90% of all people on treatment should have their viral load suppressed,” she adds. On29th November, to celebrate World AIDS Day, Botswana, Ethiopia, Lesotho, Namibia, SA, South Sudan and Tanzania will be doing HIV testing campaigns to try and break the current Guinness World Record set by Argentina in 2012; the country managed to test 3733 people in eight (8) hours.
In her capacity as Regional Director of UNAIDS, Professor Tlou, who has also served as a professional nurse and is a woman of endless accolades, hobnobs with a lot of influential people. A few weeks back she had a global fashion icon and highly successful businesswoman visiting her office in the petite form of Posh Becks (Victoria Beckham). Earlier in the year she played football for a great cause with President Museveni of Tanzania when they launched the country’s ‘Protect the Goal Campaign’ a initiative aimed at using sport to get the HIV message across to the youth. This campaign is part of a global campaign launched at the FIFA World Cup 2010 in SA. Professor Tlou uses this access to get her strategies and ideas across to the leaders and policy makers of the Southern and Eastern Region of Africa.
This region that Professor Tlou leads is susceptible to cultural practices which are said to drive and increase HIV infection rates. “We must end Gender Based Violence. We must end Child Marriages. Part of my advocacy is to end child marriages” she states. She has visited countries like Malawi and Ethiopia only to find that girls as young as 10 years old are being married off. The professor met with the Paramount Chief of Malawi during her trips and as result of this meeting they have now proposed to declare to the presidential office that children should legally marry at the age of twenty one (21). What is even more daunting is that these early marriages are sometimes a result of poverty. The parents will marry off a child, so the family can get bride money and pay school fees for the other children. “We are working with the World Bank who have done some studies and now have a concept to give families a minimum of five (5) US dollars a month provided the child stays at school,” says Professor Tlou.
In KwaZulu Natal (SA), she met with King Zwelithini of the Zulu nation and they discussed the idea of outlawing the cultural practice of ‘marriage by abduction’ or ‘Ukuthwalwa’. “A woman is kidnapped and turned into a wife. She doesn’t even know the man she is going to marry,” adds Professor Tlou. Women and adolescents in Africa need to be empowered she says. “The Millennium Development Goals (MDG’s) state that children should stay at school or be educated for nine (9) years. What have you acquired after 9 years of education? This just makes women glorified house keepers,” she adds.
Dr Tlou has been aRegional Director since 2010. She loves her job with a passion. She recalls that the first ever case of HIV/AIDS she came across was back in 1984 when she was already involved in the HIV/AIDS response. She met a woman from Uganda, whose husband had passed due to AIDS and she was being discriminated against. “I vowed then to do what I can to fight this disease. And that is what I have done all my life. Maybe that is why as Minister of Health I didn’t get too involved in politics because my focus has always been and will always be matters of HIV/AIDS. It is the only work I know.”
Professor Tlou has three (3) children; two sons and a daughter. Her husband, Professor Thomas Tlou (Historian, diplomat, vice-chancellor) sadly passed in 2010 as she was about to start her job with UNAIDS. “He and I were very close. Even as I nursed him, I knew as a medical professional that he will die. It was very hard. I visit his grave to chat with him and update him on what is happening,” She says by the time he passed he knew about this job offer from the UNAIDS and was happy for her. “This job came as a God sent. It helped me to focus my attention elsewhere,” she says adding that, “What I love most about my job is that I can be as creative as I want to be with interventions. No red tapes. I am in the best placed position to do what I do best. Africa is so welcoming and it feels good.”
