The Commission on HIV/AIDS and Governance in Africa,
a United Nations initiative announced by Secretary General Kofi Annan in February 2003, has begun discussions in the Ethiopian capital, Addis Ababa. Over the next two years the 20 commissioners, mostly drawn from Africa’s leaders, have the task of devising policies to help African governments cope with the impact of the virus on the economic, social
and political stability of Africa. The new commission will look at what happens to a society when a large portion of the population is HIV positive and will tackle the issue of education, the health sector, the police, political leadership and other critical sectors affected by increased mortality due to the disease.

The commission brings together global experts on AIDS as well as government officials, including one commissioner
who is living with HIV. “Our task is to help governments and other players to map out best practices on what has worked and what could be done to scale up the fight against HIV/AIDS,” asserts Ugandan born Milly Katana, who was diagnosed with HIV 13 years ago. “A very visible example is the education sector where teachers are dying faster than they can be trained,” said Katana.

Former Zambian president Kenneth Kaunda is one of the commissioners. Kaunda, whose 30-year-old son, Masuzyo, died of AIDS related complications over a decade ago,
said the new UN drive would streamline the fight against the virus. “I made this loss public because that is how we are going to fight this wall of silence that surrounds AIDS,” the 78-year-old added. “I feel that loss all the time but there are millions of people who have perished in
sub-Saharan Africa.”

Kingsley Amoako, head of the Addis Ababa based
Economic Commission for Africa, will chair the commission, which has members from the Global Fund to Fight AIDS, Tuberculosis and Malaria; the Opec Fund; UNAIDS; the
World Bank and the World Health Organisation. Their research should help politicians – including finance, education and health ministers – to come up with policies that will help to protect the future of their countries.

The six-day ICASA conference in Nairobi will begin to assess the continent’s life-or-death struggle against AIDS in the context of a new phase, which sees money and medications at last joining the fight. With luck, this conference may mark the moment when the war begins to turn: when campaigners find they are not limited to dishing out condoms but can start handing out the drugs that have controlled the pandemic in rich countries. “The main challenge today has changed to one of programme implementation,” said a top official with UNAIDS.

Two years ago, when the big forum was held, Africa’s
AIDS crisis presented an unremittingly dark picture.
Grim statistics jostled for media space with chronic shortages of funds and a pitiful lack of drugs. Since then the statistics have become ever more terrifying. About 30 million people living south of the Sahara, have AIDS or the human immunodeficiency virus (HIV) which causes it, according to UNAIDS. The region accounts for about three-quarters of
the global total of people infected by the disease.

Just a few tens of thousands have access to the antiretroviral drugs that, for many in the wealthy west, have transformed AIDS from a death sentence into a manageable disease. Hope has finally come. Money is at last beginning to flow in significant volumes, although it remains far short of the figure of $10.5 billion a year that the United Nations has said is needed to make headway on a global scale.

On the pharmaceutical front, African countries are at last getting access to cheap antiretrovirals. ‘Big pharma’ has slashed the prices of many of the drugs. And last month, World Trade Organisation (WTO) members agreed that poor countries can import cheaper generic copies of patented medicines under a ‘compulsory licensing system’ if they are unable to manufacture the drugs themselves. The next step is implementation. Called ‘capacity-building’, it is the vital business of setting up supply networks and storage bases, and recruiting and training personnel said Salim Abdool Karim, a professor at South Africa’s University of Natal.

There are big variations in the performance of African countries on AIDS. The continent’s brightest stars are Senegal and Uganda, where early action to combat discrimination and encourage safe sex has helped keep infection rates relatively low or has stabilised them.