Founded in 1957, AMREF has been helping to save and transform lives across Africa, providing much needed care in marginalised communities. Since the 80s, it has been at the forefront of the fight against HIV/AIDS in countries like Kenya, Uganda and Tanzania. Helping with the vision to ensure the dignity of individuals affected by the HIV/AIDS burden is Dr Noerine Kaleeba. Described as the ‘Angel of Africa,’ Kaleeba is a pioneer, who has made significant difference in the lives of people with AIDS and their families, at political and strategic levels throughout the world.  Currently serving in a voluntary role with AMREF as Deputy Chair of the International Board of Directors, DivaScribe caught up with Dr Kaleeba her during her recent trip to London, where she elaborated on Africa’s progress in combating the HIV/AID epidemic and why the work is not over just yet.

 

 

Divascribe: Community is at the heart of AMREF’s work in Africa, how would you describe the current state of health of that community that forms part of the core mandate of AMREF’s mission on the continent?

Dr Noerine Kaleeba: African families and communities continue to be affected by the same challenges of poverty and limited access to health services which prompted the founders of AMREF to explore innovative ways to reach the poorest and most remote. Access to water, sanitation, nutritious foods, and proper medical care for the most remote communities continues to be a real challenge.      

 

DivaScribe:  How would you describe the current state of the average African family affected by the HIV/AIDS burden either as a result of a father or mother losing their life to the disease, a family member being affected or a child who is orphaned by it?

Dr Noerine Kaleeba: As an African woman, widowed by AIDS two decades ago, a mother of four biological and numerous AIDS affected children I can relate directly to the devastating impact of this pandemic on African families. This ranges from the emotional devastation of bereavement, the unrelenting stigma associated with the AIDS diagnosis, the day to day hustle of parenting children as a single parent and the fear that as they grow they might get caught into the same web of HIV.  In my country Uganda, virtually every family has been affected by HIV and the term “living with AIDS” applies to most communities. This has overstretched the traditional extended family to the extent that they can no longer cope without external support. 

 

DivaScribe:  There is always a heightened awareness leading up to World AIDS Day. After which there seems to be a fatigue on all sides. Why is World Aids Day still as relevant today as it inaugural year?

Dr Noerine Kaleeba: World AIDS day is a day of global commemoration-we remember those we have lost, express solidarity with those living with HIV and renew our commitment to the total defeat of AIDS. During the first decade of the AIDS pandemic many of us hoped and prayed for the final World AIDS day - we hoped for that final day when we would all meet to celebrate the defeat of HIV/AIDS. We always hoped that there would be a quick scientific fix that would resolve all challenges. This is the third decade of our commemoration and that day of realising total defeat of HIV/AIDS is still very far beyond the horizon. So we must commemorate each year, renew our commitment and remind each other that HIV/AIDS is still here.

 

DivaScribe:  How well has Africa fared in its fight against the HIV/AIDS in the last 20 to 30 years and where is the continent today in terms of getting to grips and dealing with the current state of HIV/Aids head on?

Dr Noerine Kaleeba: Sub-Sahara Africa remains the region most heavily affected by HIV/AIDS; as late as 2010 the bad news continued because about 68 percent of all people living with HIV resided in this region, which is only 12 percent of the global population. Almost half the global AIDS related deaths were in Sub-Sahara Africa and less than 20 percent of people eligible are for ARVS were them. However, as we end the third decade we have a glimpse of some good news: A drop by more than 26 percent in the projected number of new infections. In 22 countries of sub-Sahara Africa, including the larger countries like Nigeria, a decline in new infections has been observed for the first time. And we are finally at a stage, where in many countries people with HIV or AIDS live with dignity, with decreasing levels of stigma and increasing numbers of those eligible for Anti-Retroviral (ARV) are able to access them; fewer children are being born with HIV and even those who are infected are getting diagnosed early and are accessing treatment. We cannot however afford to be complacent: a great number of people who are already infected do not know their status and in some cases the manner in which they get to know their status (i.e. without counselling) does not enable them to take charge of their lives and use the knowledge appropriately. At the same time global resources continue to shrink making it difficult for countries to implement proven interventions to fight AIDS. 

 

DivaScribe:  Are we as Africans doing enough, especially where our social; responsibility is concerned and how much more work have we got to do in order to get to par with the rest of the world?

Dr Noerine Kaleeba: I have witnessed heroic efforts by Africans to address HIV/AIDS particularly at grassroots level where volunteers have mobilised to do home based care, to conduct youth to youth programmes and to care for orphans and vulnerable children. But of course this basic fabric of the African caring society has increasingly been stretched, and this is where support from African organizations like AMREF has been critical. Because AMREF is an African organization, run by Africans in the countries we have programmes we have been able to provide appropriate support to communities and government primary health care facilities without overwhelming them. We empower communities and harness their strengths-we don’t replace community efforts. AMREF now wants to harness the power of Africans in the Diaspora and provide them a channel through which they can translate their already existing passion to care for their folks back home into practical actions for a healthy Africa.

 

DivaScribe:  Are African governments better equipped today to address the disease than they were over a decade ago or is there still a big need to rethink the treatment mandate they currently operate on?

Dr Noerine Kaleeba: African governments have traditionally struggled with shifting priorities within their limited budgets. But it is also on record that they did not prioritise the HIV/AIDS response and have always relied on external aid and funds, to fund HIV/AIDS programs. They have therefore relied heavily on the mandate set by whoever is providing the finances. The treatment agenda was actually born out of global activism by several of us who have been personally affected by HIV/AIDS. We urged quite eloquently that access to treatment is a human right and that treating people with HIV was not only a human right but it was also critical to prevention. But now that the message has hit home loud and clear we must also highlight the fact that we will never be able to provide quality care to those who need it as long as new infections continue to occur.

 

DivaScribe: In your opinion, how have attitudes changed over the years towards HIV/AIDS on the continent over the years and have we moved past the stage of stigmatisation or do we still have a lot of work to do?

Dr Noerine Kaleeba: We have made a few positive steps in addressing HIV/AIDS related stigma and discrimination but a lot more has to be done. One can find in most African countries heroic efforts by men and women living with HIV/AIDS to give the pandemic a human face, to stand up against stigma and to encourage others to adopt safe behaviours. But in the majority of cases the people who stand up are ones who do not have much influence on the systems which perpetuate stigma. A high level people often feel that they have too much to lose by coming out in the open.

  

DivaScribe: When it comes to helping people who are currently living with HIV/AIDS, and are still very afraid of letting others know, how can we deal with that fear, so people can be open and free and be able to help others with their experiences?

Dr Noerine Kaleeba: Coming out with one’s HIV status is a very personal decision. No one should ever feel pushed or coaxed to come out against their better judgement.  I have family members living with HIV who are very open, and others who have chosen not to be open, and I respect their decisions. The bottom line is that coming out should be good for the person first and foremost before they can help others. Counselling is the only intervention which helps people to make appropriate decisions and anyone considering coming out should talk with their counsellor first.

 

DivaScribe:  What does next 10 years hold for Africa as far as combating the HIV/AIDS is concerned?

Dr Noerine Kaleeba: The next ten years will be full of challenges and hopes. We are at a stage where we know what can be done to turn this pandemic back. We have known for many years that change in behaviour is critical. Along with proven scientific interventions like safe male circumcision and treat for prevention the UNAIDS vision of “zero transmission,” HIV prevention is becoming a viable option for us in Africa. But we continue to be challenged by limited resources, stigma and relative complacency. There are also continuing challenges of access to testing and counselling, access to maternal and child care services as well as access to treatment. These will continue to hound us. 

 

DivaScribe:  What are someone of the challenges currently faced by AMREF and hindering its ability and capacity to deliver its work?

Dr Noerine Kaleeba: All of the challenges faced by Africa in responding to HIV/AIDS are also faced by AMREF because we work with the people and experience their daily struggles. The biggest challenge is resource constraints as they limit the scope and impact of our programs - more so because we often access funding on a project basis, and yet people do not live their lives according to the timings of project funding. Investing in behaviour change has to be long term but the funding we often access is time bound.

 

 

 

About Dr Noerine Kaleeba

Globally recognised for her efforts in facilitating meaningful involvement of people living with and affected by HIV/AIDS, believed to be one of the key pillars of Uganda’s relative success in addressing the AIDS pandemic. Dr Kaleeba is a trained a physiotherapist, specialising in orthopaedics and community rehabilitation. In 1987, Kaleeba and 15 friends, all of whom had been affected by HIV/AIDS started a support group which blossomed into a pioneer movement to address stigma, restore hope and dignity of people and families living with HIV/AIDS in Uganda, The AIDS Support Organisation (TASO Uganda). As its first director, Kaleeba developed TASO into a global model of HIV prevention, AIDS care and support.  Since its inception, TASO has provided care for over 200,000 Ugandans, with 11 service centres across Uganda.

Kaleeba was among the small group of people to join Dr Peter Piot in setting up UNAIDS, and became a UNAIDS staff member in January 1996, based in Geneva. After serving 10 years as a partnership and community mobilisation adviser for the program, she retired from UNAIDS at the beginning of 2006. She then worked for a collaborative of four UK-based foundations: The Diana Fund, Comic relief, The Elton John AIDS Foundation and the Children Investments Fund Foundation to develop a holistic program for children orphaned or made vulnerable by HIV/AIDS within the National HIV/AIDS response framework for Malawi until July 2008.

Kaleeba has been awarded several international awards in recognition of her national and global anti-AIDS efforts, including The Belgian King Baudouin Prize for Development, awarded to TASO in 1995, the Senegalese Order of the Lion 1991, as well as three Honorary Doctorates from Nkumba University in Uganda 2000, Dundee University, Scotland, and the School of Diplomacy and International Relations, Geneva, Switzerland. She has been a Knight of the Republic of Italy since June 2009, and has served on various national and international bodies, including the World Health Organization’s Global Commission on HIV/AIDS, the Global AIDS Policy Coalition and the Uganda AIDS Commission.