WE BRING YOU THE FULL SPEECH OF PM CLEOPAS DLAMINI AND USA AMBASSADOR JEANNE M. MALONEY IN COMMEMORATION OF THE WORLD AIDS DAY

REMARKS BY THE HON. PRIME MINISTER

H.E CLEOPAS SIPHO DLAMINI

COMMEMORATION OF WORLD AIDS DAY 2021

BUHLENI

1 DECEMBER 2021

Sanibonani maSwati lamahle.

• Before I begin my remarks, may I start by appreciating all of you, in particular the Regional Administrator, for the warm and heartfelt welcome. Your hospitality combined with the beautiful weather and the breath-taking natural beauty of this region are indeed something worth appreciating. I am happy to address you at a time when the Kingdom of Eswatini is currently receiving good rains. This is an opportunity for all of us to invest in our soil in order to sustain ourselves as a Nation.

• The Kingdom of Eswatini is honoured to join forces with the international community in commemorating World AIDS Day 2021. Ever since the United Nations declared December 1 a special preserve for AIDS commemoration, the Government of the Kingdom of Eswatini has ensured that this day is observed and that all stakeholders; be it at organisational, sector or community level, are afforded an opportunity to be part of this occasion. Today’s event follows the successful hosting of regional commemorations held over the past month; where regional stakeholders took stock of the progress made in their respective responses to the epidemic. 

• I am happy that the Kingdom has recently begun embracing the use of technology during the commemoration of World AIDS Day hence some of our stakeholders, both national and international, have joined today’s celebration through digital means. May I take this opportunity to welcome all persons who have taken their time to be part of this memorable day.

• The 2021 Global World AIDS Day theme; ‘End Inequalities. End AIDS. End Pandemics’ resonates with our multi-sectoral HIV and AIDS response as a country. This is because inequalities remain prevalent in the HIV and AIDS response as we strive to reach remote communities, providing services to all who need it without any form of discrimination and closing the gender gap in the access of HIV services.

• Eswatini is also alive to the many epidemics afflicting the country and causing jeopardy for People Living with HIV (PLHIV). We are, however, working tirelessly towards ending AIDS. For this reason, the theme has been adapted to the local context in line with the vision of Ending AIDS by 2022.

• The 2021 commemoration presents an opportunity to remind ourselves that while considerable progress has been made towards ending AIDS as a public health threat, the HIV epidemic is not over yet. Young people, in particular, remain disproportionately at risk. This is worsened by the COVID-19 pandemic which has seen schools closed for extended periods, resulting in high teenage pregnancies and incidents of Gender Based Violence; an indication that our efforts in prevention of new infections must be doubled.

• We are proud, however, of the milestones we have achieved as a country when it comes to HIV interventions. That we have achieved the 95-95-95 milestone set for 2030, ten years ahead, is something we should continue to celebrate. The daunting task, however, is to maintain and sustain epidemic control and turn the tide against AIDS forever in line with His Majesty King Mswati III’s vision of having an AIDS free Eswatini by 2022. With the support of partners, emaSwati have ensured that this vision is achieved even though the gains remain fragile. Let us continue with our unparalleled collaboration and team work to sustain and cement our gains.

• It pleases me to also note that in keeping with the theme, this year’s commemoration is inclusive of different sectors of society in a bid to close the inequalities gap. Inequalities affect different population groups such as persons with disabilities. I am encouraged to note their participation in the national response to HIV and AIDS and it would be encouraging to witness more programmes led by people living with disabilities. I therefore encourage all stakeholders to work on integrating the specific needs of this population group to the national HIV and AIDS response through designing programmes and material suitable for their use.

• Hearing that the World AIDS regional commemorations also embraced men was inspiring as there remains a critical need to increase the uptake of HIV services by men. Regional dialogues highlighted some of the obstacles prevalent in the different Tinkhundla centres as captured in the Eswatini HIV Recent Incidence Surveillance (EHRIS), such as increasing new HIV infections, men’s reluctance to access HIV Services as well as an increase in Gender Based Violence (GBV).

• Moreover, men are not adequately accessing and utilising HIV services, which misses an opportunity to work with them and transform gender norms that contribute to new HIV infections among women and men. Although some programmes do include men, it is reported that some typically label men as ‘the problem’ or ‘the transmitters of HIV’. This not only reinforces the dangerous assumption that HIV prevention falls under the domain of women, but it also risks alienating men who might otherwise be open to becoming more engaged in the health and well-being of themselves and their partners.

• Failure to ensure men’s access to and use of HIV services yields predictable outcomes. Not only do men get sick unnecessarily, but their sexual partners, families, communities, and the health systems that serve them are also harmed. May I implore men here today that as leaders and heads of homesteads, you are expected to lead by example in health-related matters in order to lead long and healthy lives.

• As we get closer to achieving our goal of Ending AIDS as a public health threat, greater attention must also be given to the startling disparities in HIV prevalence amongst girls and young women, and the structural vulnerabilities that perpetuate their risk in the context of HIV. While packaging programmatic interventions targeting adolescent girls and young women, more should be done to develop ambitious programmes to engage their male sexual partners. This will help challenge harmful norms and advance gender equality.

• Gender Based Violence is an opportunistic factor to HIV and can set the country back from the gains made in the response to HIV and AIDS. Gender-based violence has been shown to increase women’s risk of HIV acquisition. The End of AIDS will not be possible without advancing gender equality. Men must be engaged to challenge harmful norms and gender inequalities, which perpetuate the risks and vulnerabilities of both men and adolescent boys.

• It is, therefore, prudent that health systems are strengthened to address the special needs of men and adolescent boys, and specific structural determinants such as consent laws that pose additional challenges to access HIV services. Addressing these issues effectively means moving beyond laying blame and starting to develop interventions to encourage uptake of prevention, testing, and treatment for men.

• Such efforts must be informed by a human rights approach to health and inclusive of men in all their diversity, with particular attention to those men who are most vulnerable to HIV. In order to successfully address the blind spot around the HIV burden among men and adolescent boys, it is critical to count on the engagement of multilateral bodies, private sector, donor agencies, national authorities and civil society organisations.

• Moreover, comprehensive knowledge of HIV among young people remains far too low, therefore, comprehensive sexuality education is essential for young people to be able to protect themselves from HIV. It also helps young people avoid unintended pregnancy and other sexually transmitted infections, encourages them to seek out health-related information and services, promotes values of tolerance, mutual respect and non-violence in relationships, and supports a safe transition into adulthood.

• Having said that, the country remains proud of the multisectoral HIV and AIDS response for the landmark of altering a crisis into a milestone. There is still a vital need to raise money, increase awareness, fight prejudice and improve education.

• Greater mobilisation of communities is urgently required to address the barriers that hinder communities from accessing health facilities. The strong advocacy role played by communities is needed more than ever to ensure that AIDS remains on the political agenda, that human rights are respected and that decision-makers and implementers are held accountable. Therefore, let us put people at the centre of the response and aim to unite our communities and partners across and beyond the HIV response.

• At this point, I would like to appreciate our partners in the Eswatini multi-sectoral HIV and AIDS response, in collaboration and supporting the role of NERCHA such as the Ministry of Health, Government sectors, UNAIDS and UN Co-sponsors, the World Bank and donor partners, Partners including the Global Fund and PEPFAR, bilateral and other multilaterals, the Private sector, traditional sector and communities, Civil Society and faith based organisations as well as People living with HIV who have risked their privacy for the benefit of other emaSwati in ending stigma and discrimination. I would like to also thank the Embassy of the Republic of China, Taiwan in the Kingdom of Eswatini, for the massive contribution they have made towards this year’s commemoration. We have no doubt that the assistive devices meant for persons with disabilities will go a long way in improving their lives for the better.

• Let us focus our attention on transforming health and life outcomes for people living with and affected by HIV and create strategic priorities to maximise equitable and equal access to comprehensive people-centred HIV services, break down legal and societal barriers to achieving HIV outcomes and fully resource and sustain HIV responses and integrate them into systems for health, social protection and humanitarian settings.

• The journey is never ending; we have battled with this pandemic for over three decades and let us not lose focus. When adversity strikes, that’s when you should be the most calm. Take a step back, stay strong, stay grounded and press on.

LAUNCH OF SECOND PHASE PLHIV PROJECT

• Before I officially conclude my remarks, today is a double celebratory moment as we are launching the 2^nd phase of the People Living with HIV Livelihood Programme supported by NERCHA. I am delighted to see the massive amount of work being done in the various communities by People Living with HIV Support Groups who have grabbed this opportunity with both hands.

• It is encouraging to see how far the programme has grown since 2019 when the Prime Minister’s Office launched Phase 1 of the project. We applaud NERCHA for the support as I am told that the recruitment process for Phase 2 Support Groups has been completed. This leaves me with only one duty, which is to mark the People Living with HIV Livelihood support project officially launched.

• Ngalawo magama, singuhulumende wembube sitsi sitimisele kubambisa live kuncoba i-AIDS, letinye tifo nekubandlulula.

Thank you and may God bless us all.

Remarks by Ambassador Maloney

World AIDS Day National Commemoration

Wednesday, December 1, 2020

Buhleni

I am honored to be here today in recognition of World AIDS Day and the tremendous progress that has been made toward fighting the HIV/AIDS epidemic.  This progress was made due to the leadership and collective efforts of the government of the Kingdom of Eswatini, civil society, multilateral and bilateral partners and the private sector. As the global community continues efforts to control the COVID-19 pandemic, we must not forget the persistent challenge of the HIV epidemic, now entering its fifth decade and far from being over.  HIV/AIDS remains a major public health crisis here in Eswatini.  In this year alone it is estimated over 2000 people died of HIV-related causes and over 4000 were newly infected with HIV.  These figures have declined markedly from their historic peaks, but HIV continues to take a devastating toll. 

Globally, the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) remains the largest commitment made by any nation ever to address a single disease.  

It is an investment in saving lives – an historic symbol of our friendship as nations and the generosity of the American people.  Seventeen years ago, when PEPFAR began work in Eswatini, fewer than 500 people were on life-saving anti-retroviral therapy.  Now, PEPFAR is supporting more than 196,000 adults and children who are receiving antiretroviral therapy and nearly 9,000 emaSwati who began HIV treatment in the past year.

What is significant about this moment in history is that, despite the challenges, Eswatini currently has all the tools needed to control the HIV epidemic and ensure another generation never experiences the devastation of the past.  We have medication available for all people living with HIV—medication that is safer and more effective than ever before.  We have systems set up to allow most people to pick up their medication and have their viral load tested only twice a year.  We have effective prevention options like PrEP, a once-a-day pill proven to prevent HIV infection. 

Again, the tools are available to control the HIV epidemic. 

Now it is imperative to reach the youth with prevention services and information on how to protect themselves.  The 30 percent of emaSwati who are over the age of 35 well remember the horror and devastation HIV/AIDS inflicted on Eswatini.  If you do the math, 70 percent of the population of Eswatini is under the age of 35.  Of that 70 percent of youth,, over half had not even born yet in 2005, when HIV caused life expectancy to reach a tragic low of 40 years old.  The stigma attached to HIV may mean that many youth don’t know why family members and friends died in such numbers. 

The youthful population and the circumstances into which girlsand young women begin engaging in sex continue to be a dangerous combination – 30 percent of new infections are in young women aged 15-24.  In addition to protecting young women, we need to ensure that men are accessing testing and treatment services – both to protect their own health and prevent transmission to others.   HIV is indeed a scourge, but one we have the tools to control.       

As we reflect on the HIV pandemic in 2021, we have additional concerns that threaten the progress we have made together. 

The ongoing challenges in delivering health services, as well as the social, economic, and health impacts of the COVID-19 pandemic and civil unrest are major threats to the progress made.  This is a moment in time where we need to refocus our efforts on preventing new infections, address the social and gender inequality issues facing youth and the nation as swiftly as possible, and avert a backslide in HIV progress. 

Investing in girls and young women is at the center of the PEPFAR program.  Since 2015, PEPFAR’s flagship DREAMS program has invested more than $815 million across the world for adolescent girls and women to help them become Determined, Resilient, Empowered, AIDS-Free, Mentored, and Safe.  Over the past year, we have expanded the geographic reach of the DREAMS program in Eswatini because it works. 

It delivers services, mentorship, and training; empowers them with a network of peers and resources; provides them with small group and one-on-one counselling sessions; tackles issues of gender inequality which leave adolescent girls disproportionately vulnerable to HIV, teaches them about HIV prevention and testing; gives them family planning support; removes barriers impeding their access to facility-based services, and so much more.  All of these services seek to meet the needs of these girls where they are, delivered through both facility and mobile outreach settings. 

We also know that persons with disabilities are at higher risk of acquiring

HIV due to multiple physical, mental, economic and/or social challenges

they may experience.  And we know that persons with disabilities may

face numerous barriers in accessing services to either prevent or treat HIV.

When a civil society representative for people with autism asked that we do more for people with disabilities, we were listening. 

In response, the United States awarded three grants specifically for supporting HIV service delivery, including education, prevention services, testing and linkage to treatment for people living with disabilities. 

As the COVID-19 pandemic swept the globe, the investments made through PEPFAR became instrumental in combatting this new virus.  PEPFAR-supported public health, clinical care, laboratory, supply chain, and data platforms have been – and remain – vital in the ongoing fight against COVID-19.  PEPFAR responded immediately to adapt service delivery, accelerate program innovation, and drive policy change to better serve our clients.  This included dramatically expanding decentralized distribution and multi-month dispensing of life-saving antiretroviral medications to keep clients in care and reduce their exposure to COVID-19.  

Through these and other actions, PEPFAR has not only ensured continuity of life-saving HIV treatment for people living with HIV, but also expanded treatment access.  Thanks to these efforts, our latest data for this year show that Eswatini has increased the number of people on HIV treatment while maintaining high rates of viral suppression —a huge accomplishment.

Health management information systems, created with PEPFAR assistance for HIV programs, have assisted in collecting and using data on COVID-19 cases, deaths, and vaccinations.  Health care supply chains forged with U.S. financial and technical resources have delivered COVID-19 test kits, personal protective equipment, laboratory reagents, and other essential commodities.  PEPFAR-supported health care workers are also supporting COVID-19 vaccine readiness and administration.  The collective expertise of the health workforce already in place was ready to respond to this new medical crisis.  Few of these capabilities would have been available at scale or with the needed sophistication without the HIV investments made both by donors and by the government.   

The United States is proud to invest in the future of emaSwati through PEPFAR and all our health sector investments.  By the same token, we must also work together to help Eswatini heal from the recent civil unrest.  As the government and citizens of Eswatini approach national dialogue, we urge that preparations be in full collaboration with civil society.  Inclusive, peaceful, and constructive dialogue on issues of concern to emaSwati will help Eswatini be a nation where all can reach their full potential.

The theme of this year’s World AIDS Day is End Inequalities, End AIDS, End Pandemics.  We have the tools we need to do this, particularly as related to COVID-19.  The U.S. has donated hundreds of thousands of doses of COVID-19 vaccine to prevent the spread of the virus.  Many doses are currently unused, and we urge emaSwati to get vaccinated!  It’s free, it’s safe, and it’s available right now.  Please act now to vaccinate and help protect yourself, your loved ones, and your community from the worst effects of COVID-19.

Thank you to our implementing partners for their tireless work to support the people of Eswatini in preventing HIV and helping those with HIV to live long, productive lives.  And I offer my deep gratitude and respect to the everyday heroes, either affected by or infected with HIV, who advocate for, support, share information with, and inspire the youth.

We are at a crossroads in the global AIDS response, and the choices we make now will have profound implications for years to come.  After decades of progress, our work is not yet finished.  If we falter, thousands more emaSwati risk infection with HIV, and thousands now living with HIV could die.  But if, together, we confront the challenges before us with conviction and compassion, we can pave the path to end the HIV epidemic and to secure a better future for all emaSwati. 

Siyabonga.