EDITORIAL
HIV/AIDS in Malawi Tfends of HIV infection Malawi like other countries in the Sub-SaharanAfrica region has been severely affectedby the HIV/AIDS epidemic. Since the first caseof AIDS was identified in May 1985, epidemiological, morbidity and mortality data continue to show a rapidly escalating epidemic. For example, in pregnant women attending antenatal clinics in urban Blantyre, Malawi's largest city, HIV seroprevalencerose from 2.67oin 1986to over 307oin 1998,falling slightly to 28.5Voin 2001. Similar trends have been observedfor other urban centresin Malawi. The national seroprevalencefor adults 15-49 years is 157otranslating into about 850,000 people living with HIV/AIDS. About 500,000 adults and children are estimatedto have died of AIDS or AIDS related diseasesbetween 1985 and 2001. The HIV infection rates are lower in rural Malawi but are on the increase and currently averageaboutll%o for sexually active adults. The majority of new infections appear to be occurring in young adults, especially those aged 19-24 years and girls being particularly affected, with infection rates at least twice those in young men of correspondingage.
continuing issues identified in the MTPI, MTPII took ir: account the multisectoral HIV/AIDS response. Following a review of the MTPII, Malawi developed r National HIV/AIDS Strategic Framework for the period 20t. 2004 in order to upscale and acceleratethe national HIV/AIL response. The National HIV/AIDS Strategic Framework r'. developed in a highly participatory manner and was broad consultative. The processwas aimed at breaking the silence t HIV/AIDS and mobilising the nation to action. The overall go of the National HIV/AIDS StrategicFramework is to reduce tt incidence of HIV and other sexually transmitted infectior (STIs) and improve the quality of life of those infected an affected by HIV/AIDS. For ease of analysis, the Nation HIV/AIDS Strategic Framework is organised into nine inte related thematic areaseach of which has a specific goal, obje tives and strategic actions to be taken. The nine thematic are of the framework are as follows: 1. 2. 3. 4. 5. 6. 7. 8. 9.
Culture and HIV/AIDS Youth, Social Change and HIV/AIDS Economic Status and HIV/AIDS Despairand Hopelessness HIV/AIDS ManagemenllCareand Social Support Preventionof HIV transmission Information, Education and Communication Voluntary Counselling and Testing Orphan.Widows and Widowers
Impact of HIV/AIDS AIDS is mostly affecting Malawians aged 15-49 years. This is also the age range of people who are economically productive. Therefore all aspectsof the socio-economicstructuresare weakenedby the epidemic. It is projected that a minimum of 257a and The major thrusts of the National HIV/AIDS Strateg as much as 50Voof people currently employed in the urban based Framework are to: sectorswould have died of AIDS by the year 2005. - Promote and intensify community basedresponses The various sectors have to face increased costs due to lost - Ensure that gender concernsof the epidemic are included in a working time as the employeesstart getting frequent illnesseson interventions the way to developing full blown AIDS and dying. They have to - Ensure greater involvement of people living with HIV/AIDS incur higher medical care costs and eventually funeral costs. - Intensify responsefor and with the youth These effects of HIV/AIDS on the productive population call for - Integrate care and prevention as the only meaningful way to careful and innovative ways of manpower planning and training. effectively respond to the HIV/AIDS epidemic. The limited health care facilities cannot cope with the everincreasingnumbers of AIDS patientsrequiring more attention to The National HIV/AIDS Strategic Framework is being'impl alternatives such as home based care. Over TOVaof bed occu- mented mostly through: pancy in medical wards of hospitals are due to AIDS related ill- District specific HIV/AIDS implementation plans, which har nesses.In addition, TB caseshave escalatedwith the HIV epibeen developed, costed and prioritised demic. In 2001 alone, the National TB Control Programme - Mainstreaming of HIV/AIDS into the private and publi (NTP) reported over 21,000 casesof TB. This figure is expectsectorsand the civil society ed to increasein the coming years. The poverty status of many families has,worsenedby the large Major challenge in the national HIV/AIDS response number of orphaned children and destitute elderly people who An effective national response to the HIV/AIDS epidem have lost their bread winning children and spouses.The visible requires input from all Malawians and other partners includin effects of the epidemic have lead to the realisation and accept- donors, according to their capacitiesand comparative advantag ance that HIV/AIDS is a serious national'public health, social Specifically.the responserequires: and economic crisis requiring to be addressedas a major priori- - Strengthening the health delivery system to provide th ty by the collective actions of individuals, families, communibackbone for intervention in care and prevention ties, the private and public sectors. - Maintaining high political commitment and involvement in tl fight againstAIDS The national response to the HIV/AIDS epidemic - An expanded responsethat includes the involvement of a Malawi's response to the HIV/AIDS epidemic.began in 1986 sectorsboth public and private with the implementationof a Shorl Term Plan (STP 1986-1988), - Broad involvement of people living with HIV/AIDS includin which emphasised issues of blood safety and Information traditional leadersand religious leadersin the plalning and Education and Communication (IEC). This was followed by the execution of HIV/AIDS interventions first Medium Term Plan (MTP 1989 to 1993), which also - Greater emphasison community basedresponsesthat build c emphasisedissues of blood safety, Information Education and existing social capital in the communities Communication (IEC) and added management of Sexually - Designing interventions against HIV/AIDS that take inl Transmitted Infections (STIs). The second Medium Term Plan account the gender dimension of the epidemic and emphasiz (MTP II) was implemented from 1994-1998. In addition to the protection of lulnerable groups including women and childre 2"
Malawi Medical Jom
EDITORIAL - Resourcd"mobilizationstrategiesthat will ensure adequate resourcesfor the national HIV/AIDS responseall times - S1-stemsfor monitoring and evaluation for both programmes and the state of the epidemic - A broad HIV/AIDS policy framework to guide the implementation of intervention Biziwick Mwale Director, National AIDS Commission
This issue of Malawi Medical Journal was supported by a generousdonation from the Centers for Disease Control (CDC), Atlanta, Georgia, USA, and by the Blantyre Integrated Malaria Initiative (BIMI), Blantyre, Malawi.
HIV/AIDS in Malawi Tfends of HIV infection Malawi like other countries in the Sub-SaharanAfrica region has been severely affectedby the HIV/AIDS epidemic. Since the first caseof AIDS was identified in May 1985, epidemiological, morbidity and mortality data continue to show a rapidly escalating epidemic. For example, in pregnant women attending antenatal clinics in urban Blantyre, Malawi's largest city, HIV seroprevalencerose from 2.67oin 1986to over 307oin 1998,falling slightly to 28.5Voin 2001. Similar trends have been observedfor other urban centresin Malawi. The national seroprevalencefor adults 15-49 years is 157otranslating into about 850,000 people living with HIV/AIDS. About 500,000 adults and children are estimatedto have died of AIDS or AIDS related diseasesbetween 1985 and 2001. The HIV infection rates are lower in rural Malawi but are on the increase and currently averageaboutll%o for sexually active adults. The majority of new infections appear to be occurring in young adults, especially those aged 19-24 years and girls being particularly affected, with infection rates at least twice those in young men of correspondingage.
continuing issues identified in the MTPI, MTPII took ir: account the multisectoral HIV/AIDS response. Following a review of the MTPII, Malawi developed r National HIV/AIDS Strategic Framework for the period 20t. 2004 in order to upscale and acceleratethe national HIV/AIL response. The National HIV/AIDS Strategic Framework r'. developed in a highly participatory manner and was broad consultative. The processwas aimed at breaking the silence t HIV/AIDS and mobilising the nation to action. The overall go of the National HIV/AIDS StrategicFramework is to reduce tt incidence of HIV and other sexually transmitted infectior (STIs) and improve the quality of life of those infected an affected by HIV/AIDS. For ease of analysis, the Nation HIV/AIDS Strategic Framework is organised into nine inte related thematic areaseach of which has a specific goal, obje tives and strategic actions to be taken. The nine thematic are of the framework are as follows: 1. 2. 3. 4. 5. 6. 7. 8. 9.
Culture and HIV/AIDS Youth, Social Change and HIV/AIDS Economic Status and HIV/AIDS Despairand Hopelessness HIV/AIDS ManagemenllCareand Social Support Preventionof HIV transmission Information, Education and Communication Voluntary Counselling and Testing Orphan.Widows and Widowers
Impact of HIV/AIDS AIDS is mostly affecting Malawians aged 15-49 years. This is also the age range of people who are economically productive. Therefore all aspectsof the socio-economicstructuresare weakenedby the epidemic. It is projected that a minimum of 257a and The major thrusts of the National HIV/AIDS Strateg as much as 50Voof people currently employed in the urban based Framework are to: sectorswould have died of AIDS by the year 2005. - Promote and intensify community basedresponses The various sectors have to face increased costs due to lost - Ensure that gender concernsof the epidemic are included in a working time as the employeesstart getting frequent illnesseson interventions the way to developing full blown AIDS and dying. They have to - Ensure greater involvement of people living with HIV/AIDS incur higher medical care costs and eventually funeral costs. - Intensify responsefor and with the youth These effects of HIV/AIDS on the productive population call for - Integrate care and prevention as the only meaningful way to careful and innovative ways of manpower planning and training. effectively respond to the HIV/AIDS epidemic. The limited health care facilities cannot cope with the everincreasingnumbers of AIDS patientsrequiring more attention to The National HIV/AIDS Strategic Framework is being'impl alternatives such as home based care. Over TOVaof bed occu- mented mostly through: pancy in medical wards of hospitals are due to AIDS related ill- District specific HIV/AIDS implementation plans, which har nesses.In addition, TB caseshave escalatedwith the HIV epibeen developed, costed and prioritised demic. In 2001 alone, the National TB Control Programme - Mainstreaming of HIV/AIDS into the private and publi (NTP) reported over 21,000 casesof TB. This figure is expectsectorsand the civil society ed to increasein the coming years. The poverty status of many families has,worsenedby the large Major challenge in the national HIV/AIDS response number of orphaned children and destitute elderly people who An effective national response to the HIV/AIDS epidem have lost their bread winning children and spouses.The visible requires input from all Malawians and other partners includin effects of the epidemic have lead to the realisation and accept- donors, according to their capacitiesand comparative advantag ance that HIV/AIDS is a serious national'public health, social Specifically.the responserequires: and economic crisis requiring to be addressedas a major priori- - Strengthening the health delivery system to provide th ty by the collective actions of individuals, families, communibackbone for intervention in care and prevention ties, the private and public sectors. - Maintaining high political commitment and involvement in tl fight againstAIDS The national response to the HIV/AIDS epidemic - An expanded responsethat includes the involvement of a Malawi's response to the HIV/AIDS epidemic.began in 1986 sectorsboth public and private with the implementationof a Shorl Term Plan (STP 1986-1988), - Broad involvement of people living with HIV/AIDS includin which emphasised issues of blood safety and Information traditional leadersand religious leadersin the plalning and Education and Communication (IEC). This was followed by the execution of HIV/AIDS interventions first Medium Term Plan (MTP 1989 to 1993), which also - Greater emphasison community basedresponsesthat build c emphasisedissues of blood safety, Information Education and existing social capital in the communities Communication (IEC) and added management of Sexually - Designing interventions against HIV/AIDS that take inl Transmitted Infections (STIs). The second Medium Term Plan account the gender dimension of the epidemic and emphasiz (MTP II) was implemented from 1994-1998. In addition to the protection of lulnerable groups including women and childre 2"
Malawi Medical Jom
EDITORIAL - Resourcd"mobilizationstrategiesthat will ensure adequate resourcesfor the national HIV/AIDS responseall times - S1-stemsfor monitoring and evaluation for both programmes and the state of the epidemic - A broad HIV/AIDS policy framework to guide the implementation of intervention Biziwick Mwale Director, National AIDS Commission
This issue of Malawi Medical Journal was supported by a generousdonation from the Centers for Disease Control (CDC), Atlanta, Georgia, USA, and by the Blantyre Integrated Malaria Initiative (BIMI), Blantyre, Malawi.
