Xth International Conference on HIV/AIDS and STDs in Africa The Alliance of Mayors and Municipal Leaders on HIV/AIDS in Africa

INTRODUCTION 

The symposium on HIV, Development and the Role of Local Government occurred within the framework of the X^th International Conference on HIV/AIDS and STDs (ICASA) in Africa and was a collaborative initiative between the city of Abidjan, the Association of Ivorian Municipalities (UVICOCI), ICASA’s organising committee, UNDP and UNAIDS Secretariat. Its purpose was to provide a setting in which mayors and municipal leaders could address the role of local government in responding to the developmental consequences of the HIV/AIDS epidemic. 

Mayors and municipal leaders explored ways in which they could participate more effectively in the formulation of multisectoral responses to the epidemic at local level. Representatives of UNAIDS and UNDP, African political leaders and scientists provided a broad overview of the epidemic in Africa, and more importantly, highlighted the wide-reaching consequences of the epidemic on every aspect of human development. 

However, beyond the statistics and scientific discourse, the participation and testimony of several people affected by the epidemic, men and women, young and old, vividly revealed the human impact of the epidemic. The experience of individuals has shown that the initial responses of fear and powerlessness can give way to hope, positive action and a new beginning. There is thus a need to recognise and harness the critical role of individuals, families and communities affected by the epidemic in promoting and effecting change. 

The symposium was also intended to strengthen existing ties between African mayors and municipal leaders and to establish new ones, in particular through the creation of an Alliance of Mayors and Municipal Leaders on HIV/AIDS. The objectives of the Alliance are the reduction of the socio-economic impact of HIV/AIDS in cities and municipalities, and the promotion and coordination of local, multisectoral approaches to HIV/AIDS prevention and care. 

The success of the symposium and the degree of commitment to action was illustrated by the recommendation that mayors and municipal leaders meet again in Abidjan during the Africities Meetings, thereby placing HIV/AIDS firmly on the local government agenda, and allowing for further development of the partnerships initiated during this symposium.

I. The HIV/AIDS epidemic and its implications 

The opening ceremony brought together the partners involved in launching this initiative, and set the scene for the ensuing discussions. It included presentations from UNDP, UNAIDS, a number of mayors and individuals affected by the epidemic. 

Dr. Peter Piot, Executive Director of UNAIDS¹, gave an overview of the global epidemic, stressing that the epidemic continues to spread in the developing world. Sub-Saharan Africa is one of the world’s most affected regions. Levels of infection vary widely across the continent, but reach up to 10% of the adult population in Southern Africa region. The statistics presented illustrate the enormous human, social and economic implications for the African continent: the epidemic primarily affects men and women in their most productive years economically and socially, thereby depleting countries of their most essential resources. 

The undeniable socio-economic determinants and impact of HIV, in particular the inequalities and inequity that undermine social and economic progress, must increasingly be factored into development policies and strategies. For many countries in this region, the biggest dual challenge is to address the short- to medium-term risk factors and the inequalities and needs for long-term sustainable human development that can reverse the trends.This means the imperative to create — and to maintain — social cohesion and economic progress, often in the face of shrinking resources, high levels of poverty and worsening income inequality.² 

Ms. Jocelline Bazile-Finley, UNDP Resident Representative, and UN Resident Coordinator for Côte d’Ivoire, renewed the commitment and support of the United Nations system to strengthening the capacity of local institutions to respond to the epidemic. 

Ms. Olubanke King Akérelé, representative of UNDP’s Regional Bureau for Africa stressed the impact of the epidemic on sustainable human development, emphasising that the socio-economic gains of the past decades are now being reversed. Rising mortality rates are reducing productivity, depleting all sectors of labour and increasing health costs. Family and community ties are threatened by social stigma, fear and discrimination. She drew attention to the role of good governance as a crucial aspect of an effective response. She articulated some of the key components of an effective and sustainable response to HIV/AIDS including: political leadership, community empowerment, strong collaboration with civil society and mobilisation of the private sector. Fear, stigma and discrimination must be an over-arching concern and must be tackled in every measure.³ 

Strategies encompassing key aspects of good governance  People-centred and gender-sensitive development Supportive ethical, legal and human rights frameworks Involvement of concerned civil society groups Mechanisms and processes which enable informed participation and collaboration of all those involved, in particular those directly infected and affected

II. African mayors and the epidemic 

Mr. Mobio, Mayor of Abidjan and President of the Association of Ivorian Municipalities (UVICOCI) spoke eloquently of the need to continue and expand collaboration between African cities and extend it to cities worldwide. He emphasised the role of mayors and municipal leaders as direct links between local populations, governments and the international community, and their potential as catalysts in encouraging citizens to assume their responsibilities, and in convincing the international community to lend its support to local initiatives. 

In the face of rapidly growing urban populations, increasing poverty and limited resources, mayors and municipal leaders must share their efforts and experience in formulating effective responses across the continent. His words conveyed a strong message of hope and dynamism for those mayors and municipal leaders who are already witnessing the frightful reality of the epidemic in Africa.⁴ 

"We are, Dear Colleagues, at the heart of the city’s daily life, at the heart of concrete, immediate and sustainable action."  "While it is true that HIV/AIDS is a health issue, it is also true that it must be included in local and urban management. Local communities and government must be focal points in the response to the epidemic, because municipal authority is implicated in community-based activities and actions." Mayor Mobio

The importance of local government’s commitment and involvement was echoed in the speech of Mr. Emile Constant-Bombet, Minister of Interior and National Integration of Côte d’Ivoire, who also highlighted the importance of partnerships between South and North, between countries in the South and between municipalities themselves. Responses to HIV/AIDS should extend beyond Health Ministries, and should be integrated within other public institutions as well as within private and community-based organisations. 

Mayors from different African countries shared their insights and responses to the HIV/AIDS epidemic. Some voiced their awe at the reality of the epidemic, and their concern at the lack of awareness among large sections of the populations of their respective cities. 

Participants discussed the need to become better informed, to raise awareness and to encourage the involvement of political and community leaders. They recognised the role they can – and must – play in designing more effective responses at the local level. Dr. Mamadou Diop, Mayor of Dakar, acknowledged the importance of establishing an on-going dialogue with affected people, local NGOs and the international community. He also called upon local leaders to address the epidemic within their own sector of activities, where they will be most credible and effective.

 III. The "Voices Panel"

Through this Panel, participants faced the human reality of the epidemic. The five presenters included a broad spectrum of affected people, demonstrating that the epidemic is not confined to any particular segment of a population. Each presentation illustrated a different aspect of the epidemic. A young Ivorian graduate told of her initial despair upon learning that she was HIV positive, and how she has been comforted by family and friends. Lucy, a grandmother, recalled that HIV was "like a distant drum" which had nothing to do with her until two of her sons became infected and died, leaving her with six grandchildren to care for, shattering her hopes for a happy grandmotherhood and forcing her into the role of a single parent with few resources. Kevina, a fourteen year old from Uganda, described how the death of both her parents left her caring for six siblings and a blind grandfather. An Army major also from Uganda, infected for 12 years, explained how loneliness and despair in the face of infection can become transformed into hopeful work and AIDS activism.

These stories proved to be a powerful mechanism for personalising the epidemic; for helping people to identify with those affected, and in so doing, making them confront the possibility of being directly affected. Like Lucy, many believe the epidemic will not affect them (or their family) or that it only affects so-called "high-risk groups" with whom they do not identify. The major’s testimony created a sense of identification and connection, demonstrating how an educated man, one with significant social and moral status (in many ways comparable to mayors and municipal leaders) was also vulnerable to infection. 

My names are Kevina Lubowa. I am 14 years old. I have 4 brothers and 2 sisters younger than me. I come from Uganda. I am studying in Primary six. I have come here to say something about AIDS and its problems. AIDS means acquired immune-deficiency syndrome. It’s a terrible disease. It killed both my mother and father in 1992. It killed all brothers and sisters of my father. It has killed many men and women in Uganda. Some houses have been closed. But our house was not closed because my father and mother left me with four brothers and two sisters. I look after them. I also look after my grandfather who lives near us, because his wife died and nobody was there to look after him. He is 84 years old. He lost his wife in 1992. The grandfather does not see. He has eye problems. It is me who looks after the family. From school, I go to bring water from the well. I take a jerrycan on my head. I tell my brothers and sisters to go in the bush and collect firewood. Sometimes, when we don’t have fire, we go and get it from our neighbours. We cook potatoes, matooke, pumpkins and cassava. But my brothers do not want cassava; they want only matooke. Our banana plantation is now a forest We dig in our plantation on holidays and on Saturday. Our food is not enough. Some days we don’t get food. We eat cassava with boiled water as sauce. We don’t have money to buy sugar or tea leaves. In the evening I make up beds for my young sisters and brothers. Every week we cut grass to use as our mattresses. We all sleep together and cover ourselves with blankets. Sometimes we sleep in the corner of the house because our house is leaking. Our blankets get wet and we put them near the fire or in the sun to dry. There is the problem of disease. We get sick and go to the dispensary. At the dispensary they want money but we don’t have the money. They give only tablets. We foot from home to the dispensary. You cannot stop a car because they also want money. Old women help us and give us leaves and mululuza to chew. This helps to get rid of fever. Because I am a girl people think I am weak. So they come home and steal our cassava and firewood. Because I am a girl even when I see them I can do nothing. Some people in the village are not friends. They shout at us. They don’t give us advice; we don’t have any one to call father or mother; we feel sad when we see other children laughing with their father and mother. In short, this is how I find life. But other orphans have the same life. They don’t have blankets; they don’t eat meat; they don’t have sugar; they sleep in huts. Some go to eat at the neighbours or they get one meal a day. At school, life is good. The teacher calls us orphans, but I don’t want that name. Even other children don’t want that name. We think we are animals. My friends, I am concluding by saying that the life of an orphan in Uganda is bad. Some people want us to work as their house girls and house boys. Now we want good food, blankets, education and many other things. We also want to live in good houses. So orphans need help. We need to grow and to be proud and happy people. Let me stop here. Thank you very much. Merci beaucoup. Kevina

Similarly, Lucy and Kevina’s difficult situations suggest, in profoundly human, and more specifically gendered terms, how the epidemic has far-reaching socio-economic consequences as the number of productive members in families decreases, and grandparents and older siblings must fulfill the role of parents. The ensuing disruption of social and familial structures also results in substantial psychological and personal difficulties that Lucy and Kevina poignantly described.

Both the major and Lucy struck a hopeful note with their accounts which described the transforming potential of HIV/AIDS work, advocacy and activism, showing how affected people can be advocates and providers of compassionate support and care.

 IV. Conclusion 

The first symposium of African mayors and municipal leaders was a success. It brought together mayors and municipal leaders from several major cities of Africa together with other participants, from a broad range of socio-professional areas (politicians, health practitioners, teachers, lawyers, journalists, etc…). 

Results of the symposium  The Declaration of Mayors and Municipal Leaders of Africa on HIV/AIDS. The creation of the Alliance of Mayors and Municipal Leaders on HIV/AIDS in Africa.5 The inclusion of the Alliance of Mayors on the agenda of the upcoming Africities meeting in January 1998.

 

The Declaration and the creation of the Alliance expressed the determination of mayors and municipal leaders to define and implement more effective responses to the epidemic. They represent the first steps of a process which needs to be sustained and extended through concrete actions designed and implemented with all concerned groups, in particular with those most directly affected. This determination was also expressed by Mr. Mobio, who wished the Declaration to become a stepping stone for a collaborative process between African nations. The Alliance must help to increase the awareness and involvement of mayors and municipal leaders across the continent in the response to the epidemic. 

The HIV/AIDS epidemic is a challenge to the socio-economic development of African countries. The Abidjan Symposium on HIV/AIDS, Development and the Role of Local Government sought to address the role of mayors and municipal leaders in the response to some socio-economic dimensions of that challenge. It recognised that the direct relationship between local government and citizens can be a starting point in the formulation of more effective responses. It sought to mobilise development partners and recommended that the HIV/AIDS issue be included within the framework of the Africities meetings of January 1998, in Abidjan.

V. Next Steps 

The 1998 Africities-Villexpo conference in Abidjan provided an opportunity for the first meeting of the HIV/AIDS Alliance of Mayors and Municipal Leaders. The specific goals of this meeting were to promote the Alliance and for its members to review a set of draft statutes⁶ and the draft action plan presented by the Coordinator of the Alliance, Mayor Mobio of Abidjan. 

A preparatory consultative meeting,⁷ presided by Mayor Mobio, was held on 28^th January 1998. At this time, initial reactions to the draft statutes were solicited from a number of mayors (or their representatives) and suggestions for modification sought prior to the formal plenary meeting. Between them, participants at this meeting represented the offices of twenty Mayors from seven countries. 

The plenary session of 29^th January 1998 was presided by the Mayors of Abidjan and Lusaka, respectively Coordinator and Deputy Coordinator of the Alliance. The meeting involved seventy participants including fifty mayors, or their representatives, from eleven African countries,⁸ the press, representatives from several UN agencies, and observers from among the participants attending the Africities-Villexpo 1998 conference. 

The Mayor of Abidjan presented the main objectives of the session: the examination and adoption of the Alliance Statutes and the presentation of a proposed plan of action for the Alliance. He also reminded participants of the purpose and objectives of the Alliance: 

• To facilitate multi-sectoral responses at local level
• To create a forum for information sharing and consultation
• To strengthen solidarity between all concerned partners
• To implement the Abidjan Declaration 

Ms. Mauerstein-Bail⁹ reiterated UNDP’s commitment to supporting the activities of the Alliance through its local offices and regional projects, and through other offices of the UN system at country level. 

Dr. Msiska addressed the development implications of the HIV epidemic on African societies and cited examples of effective community responses. He highlighted four key principles underlying successful responses: accepting the seriousness of the problem, participation of those who are both infected and affected, non-discrimination and support. 

Possible Areas of Future UNDP Support  Inclusion of Mayors and their staff in HIV and Development training activities, including facilitated study tours;  Mobilisation of resources to facilitate the provision of supplementary support to local funds; Support for studies and publications which document existing experience of inter-sectoral collaboration involving mayors or which explore the current and future role of mayors.

Prof. Kanté then presented the proposed Statutes, which are based upon two key principles: the simplicity of the legal form of the Alliance and the non-bureaucratic nature of its structure. Some key concerns were raised in the ensuing discussion. These included the desire for a more structured legal association, concerns pertaining to the name, membership and role of the Coordinating Committee, questions about the duration of the term of office of coordinator, and the issue of potential sources of funds for the Alliance and their management. The Statutes were revised to include critical points and then approved by the plenary assembly (Annex 8). 

The Secretariat is based in the Coordinator’s office and will subsequently rotate. Mr. Ibo, officer in charge of the Quality of Life Programme for the Ivoirian capital was designated Alliance Secretariat focal point. Mr. Mamadou Diop, Mayor of Dakar was named as second Deputy Coordinator and five members selected to form the Coordinating Committee.¹⁰ 

As chairperson and Deputy Coordinator of the Alliance, the Mayor of Lusaka, brought the meeting to a close with a moving statement of his vision of the potential contribution of mayors and municipal leaders in galvanising community responses to the epidemic. A follow up meeting was held on 31^st January 1998 in order to review the meeting, to define action necessary to operationalise decisions made at the meeting and to identify the parameters of further collaboration between the Alliance and UNDP. The next major meeting of mayors is the African Cities (Villes Africaines) to be held in Rabat in June 1998.

Endnotes:

1. The Joint United Nations Programme on HIV/AIDS (UNAIDS) is the collaborative effort of six UN agencies: UNDP, UNESCO, UNFPA, UNICEF, the World Bank and WHO.
2. For the complete transcript of Dr. Piot’s presentation, see Annex 3.
3. For the complete transcript of Ms. King Akérelé's presentation, see Annex 2.
4. For the complete transcript of Mr. Mobio's presentation, see Annex 1.
5. The Mayor of Abidjan, Mr. Mobio, was designated as the coordinator of the Alliance for the next two years. The Mayor of Lusaka, Mr. Fisho Mwalé, will assist Mr. Mobio in his duties.
6. These were prepared by Prof. Babacar Kanté, Dean of the Faculty of Law and Political Science of the University of St. Louis, Sénégal. The complete document can be found in Annex 8.
7. A number of individuals played a key role in the preparation of the meeting: Ms. Mina Mauerstein-Bail, Manager, HIV and Development Programme, UNDP; Mr. Alpha Boubacar Diallo, Manager, HIV and Development Regional Project for Africa; Mr. Gary Engelberg, Training Consultant, Africa Consultants International; Prof. Boubacar Kanté, Dean, Faculty of Law and Political Science of the University of St. Louis, Sénégal; Dr. Roland Msiska, UNAIDS. Invaluable support was provided by Jocelline Bazile-Finley, UNDP Resident Representative, Côte d’Ivoire; Alioune Badiane, UNDP’s Urban Management Programme; Alioune Sall, UNDP’s Synergy Project; Agathe Lawson, UNAIDS; and local UNDP staff.
8. The countries were: Burkina Faso, Cameroun, Côte D’Ivoire, Gabon, Ghana, Kenya, Namibia, Mauritania, Sénégal, South Africa and Zambia.
9. For the complete transcript of Ms. Mauerstein-Bail’s presentation, see Annex 4.
10.  Accra (Ghana) for West Africa, Douala (Cameroun) for Central Africa, Kampala (Uganda) for East Africa, Nouakchott (Mauritania) for North Africa, and Walvis Bay (Namibia) for Southern Africa.