Dr. Christine Kaseba, First Lady of Zambia: Access to HIV services open to all

Dr. Christine Kaseba, First Lady of Zambia, made headlines when, during remarks at a UNAIDS reception in Lusaka on 5 November, 2013, she asked for open discourse on public health issues for men who have sex with men and stated that HIV services including Anti retrovial treatment is open to all.

"May I thus appeal to the delegation to consider requesting WHO to re-instate the issue of males having sex with men as a public health issue so as to allow open discourse on the matter. I must hasten to say that though homosexuality is criminalised here in Zambia, access to HIV services including Anti retroviral treatment is open to all. We do not discriminate on the basis of sexual orientation, age colour, sex or social status."

Full text of Dr. Christine Kaseba's remarks

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Your Excellency, UNAIDS Deputy Executive Director, Mrs Jan Beagle
Honorable Ministers present
The UNAIDS Regional Director for Eastern and southern Africa, Prof Sheila Tlou
Permanent Secretaries
Senior government officials
UNAIDS Programme Coordinating Board delegation,
UN colleagues
Representatives from civil society
Distinguished Guests, Ladies and Gentlemen

Good evening.

A warm welcome to our visiting UNAIDS Programme Coordinating Board delegation. I am aware that your visit is short and the schedule very tight but I hope that you have had chance to walk around in the evening to explore and experience the warm hospitality of the Zambian people. I also hope that your brief visit will stimulate enough interest for you to come back to explore the beautiful and magnificent natural wonders and wild animals that this country boasts of!

We are honored with your visit to Zambia and recognition of the country’s progress in the response to AIDS.

Thanks to our political leaders for the commitment, sustained investment from our donors and cooperating partners, the positive actions from all stakeholders including the private sector, faith based organizations and civil societies, the country has made significant progress in the fight against HIV especially in the reduction of annual new HIV infections among children by 51percent. More than 95% of pregnant women access Anti retroviral drugs during pregnancy for prevention of mother to child transmission of HIV. With implementation of Option B plus, we are confident that we will not only continue scoring further successes but will also improve coverage for post natal mothers and children among whom coverage is disappointingly low.

It is true that we have made gains in our response to HIV but we cannot become complacent. Whilst we are encouraged by the reduction in overall national HIV prevalence to 14%, there is cause for concern as the gender face of HIV has not changed. Zambia’s women and young girls remain vulnerable carrying the bigger burden of HIV at 16.1% compared to men at 12.3%. Among young women aged 15-24, HIV prevalence is more than twice that of men in this age category

There is no doubt that we, as a country, need to explore strategies aimed at correcting this imbalance. The silence on men having sex with men has to be lifted given the rising incidence of HIV in men in Zambia and the evidence we have from other countries where new HIV infections are on the increase amongst this sub population. Personally I am concerned about the vulnerability of our women married to or in intimate relations with men who also have sex with men. We have anecdotal evidence especially in colleges where young men are enticed into having sex with men but at the same time also have young girlfriends on the side. If not checked this will derail the positive strides that this country is making. May I thus appeal to the delegation to consider requesting WHO to re-instate the issue of males having sex with men as a public health issue so as to allow open discourse on the matter. I must hasten to say that though homosexuality is criminalised here in Zambia, access to HIV services including Anti retroviral treatment is open to all. We do not discriminate on the basis of sexual orientation, age colour, sex or social status.

Ladies and gentlemen,

It is also worrying that as the quality of life improves for most men and women in Zambia, diseases, such as cervical cancer that have a direct and fatal link to HIV continue to claim the lives of many women – most of whom are HIV positive. Given the vast investments in fighting HIV, inattention to cervical cancer and other Non communicable diseases will reverse all the gains that this country and other countries have made.

We continue to work diligently to mitigate such losses. This year in May 2013, the pilot HPV vaccination demonstration program introduced has reached close to 80% of its targets for both in school and out-of school pupils. Although, much more needs to be done to effectively integrate cervical cancer screening into HIV services throughout Zambia, and to build the capacity to screen, refer and treat, we have seen a rapid expansion of cancer screening and treatment nationwide.

In this regard, the contribution of initiatives such as the Pink Ribbon Red Ribbon Initiative, led by the George W. Bush Institute, PEPFAR, Susan G. Komen for the Cure, UNAIDS, and several corporate partners has been significant for Zambia. We would not have recorded such success without its partners. Please accept our gratitude.

The young people of today are thankfully too young to remember the horrors of 20 years ago when we were all losing people we loved to AIDS on a daily basis. These young people live in a world driven by mobile phones, social networks and instant information. We have an obligation – as citizens, as leaders, and as parents – to ensure that they know how to protect themselves and can access services when they need to do so. Considering that 50% of Zambians today are below 14 years, they present this country a window of hope only if we can reach them when they are still young. If we are serious about an HIV free generation tomorrow, then we must produce a socially responsible generation today. Many of our young people who have contracted HIV through mother to child transmission are now in the reproductive age group and we need to start considering the issues of disclosure by parents so as to safeguard them from other infections and others who may have intimate relations with them. Our children are entitled to inherit a healthy and productive Zambia – not an ever-growing health bill and burden.

Distinguished Visitors, ladies and gentlemen

This week will be the 3rd National HIV Prevention Convention. The theme is “Count down to 2015: Effective HIV Prevention through community Empowerment and sustainable Financing”. We are glad that you are participating in the meeting and we look forward to sharing best practices and new scientific knowledge to encourage evidence based programming.

The meeting will also disseminate findings of the joint Mid term Review of the national HIV and AIDs Strategic Framework.

It is pleasing that Government through the National HIV/AIDS/STI/TB council is taking forward the concept of the investment case by refining the current strategic plan for better impact. The plan will thus be able to secure the impressive gains in the national response to HIV. This plan which will be the basis for Zambia’s 2014 HIV Global fund application is fully aligned with decentralized planning, leadership and coordination. Thankfully Government has continued increasing the domestic budget allocation to ARV procurement but there is still need for more funding for the country to address the double burden of infectious diseases and looming epidemic of Non communicable diseases.

Given the evidence and the progress you have seen on the ground, we are counting on you for continued support.

I would therefore like to take this opportunity to request the UNAIDS Deputy Executive Director and the board members, to use your influence on policy making, forging stronger partnerships at global and country level and increased global funding to fight these challenges that affect many countries in the world. It is only through our collaborative efforts that we can address such problems and achieve victory.

I would like to assure you of my own personal commitment and that of the President, to the fight against cancer and HIV to improve the health conditions of women and girls in Zambia. Together we stand and together we shall succeed.

Thank you.