The Challenge

Ireland's Reponse

The Results

The Challenge

• Over 33 million people are living with HIV, 2.5 million become newly infected every year and over 2 million people die of AIDS annually.
• Sub-Saharan Africa continues to be the most severely affected region in the world and is home to over 22 million people living with HIV or 68 percent of the global total.
• AIDS remains the primary cause of death in Africa.

Over the past 25 years, HIV & AIDS has spread to all countries across the globe and is likely to become the leading cause of death (due to an infectious disease) in the 21st century.

AIDS is now an epidemic of truly historic proportions. AIDS in Africa is leading to famine, child death and a reversal of development progress. On the doorstep of the European Union, in Eastern Europe, AIDS is now a major public health problem and threat to social and economic development.  The rate of growth of the HIV epidemic in the countries of the former Soviet Union is greater than anywhere else in the world.

The impact of HIV & AIDS is devastating. It primarily affects adults in their productive years (18- 45 years). Its effects are not only felt at individual, family and community levels but also have a profound effect on the social and economic development of countries.

The HIV & AIDS epidemic has a particularly troubling impact on children- over 11 million children in Africa have lost one or both parents to AIDS, whilst 640,000 children under the age of 15 are infected with HIV.

Twenty-five years into this epidemic the world is wakening up to the dimensions of this crisis. More resources are now available to respond to AIDS. More organisations – be they governments, civil society, churches, businesses or development agencies – are actively involved in the fight against this disease. More evidence is being accumulated to assist in the planning of effective programmes.

Ireland’s Response

Ireland has made a high-level political commitment to the global HIV & AIDS. Endorsing the HIV-related international development targets of the Millennium Development Goals, Ireland has prioritised the fight against HIV as fundamental poverty and vulnerability reduction. HIV & AIDS is one of four priority issues that inform all of Irish Aid’s work. This means that HIV & AIDS must be taken into account in the planning, implementation and evaluation of all Irish Aid interventions.

Ireland has acquired a high profile international reputation for its commitment to the fight against HIV/AIDS which has destroyed the lives of so many millions of men, women and children. We spend over €100 million annually on combating HIV and other communicable diseases. Our assistance is targeted at those countries most affected by the pandemic including Uganda, Tanzania, Ethiopia, Mozambique, Lesotho, Zambia, Zimbabwe, South Africa and Malawi.

Irish Aid supports the fight against HIV and AIDS in Africa through many different approaches. These include:

• District programmes to ensure our support reaches grass root level. An example is Irish Aid funding - in partnership with the Clinton Foundation and the Lesotho Government - of the construction and staffing of seven clinics offering HIV treatment to communities in remote mountain areas of Lesotho.
• National programmes, such as our support of the programme to increase the availability of antiretroviral drugs (ARVs) in Mozambique. This is done in partnership with the Government of Mozambique.
• Cross-country initiatives, such as those focused on the Southern and Eastern African states, where we support regional programmes to expand ARV treatment, manage cross-border transmission of the disease and improve research and learning among countries including Tanzania, Uganda, Mozambique and Zambia.
• Global programmes, such as the Clinton Foundation, UNAIDS and the Global Fund to fight AIDS, TB and Malaria.

We also support cutting edge research initiatives in the areas of vaccine development and the development of new prevention tools. We invest in empowering women and girls to protect themselves against infection. We support the fight through national governments, civil society programmes, and international public-private partnerships such as the Clinton Foundation.  Our approach is saving lives.

In partnership with the Clinton Foundation, Ireland has increased its funding to the Governments of Mozambique and Lesotho to improve the accessibility of HIV treatment in rural areas and in particular to women and children. The Clinton Foundation established the Clinton HIV/AIDS Initiative in 2002 which focuses on increasing people’s access to antiretroviral treatment through strengthening national health care systems and negotiating lower prices for antiretroviral treatment and diagnostics; the Initiative also focuses on preventing the transmission of the disease from mothers to their children. 

Ireland has contributed €115 million to the Global Fund to fight AIDS, TB and Malaria over the period 2002-2009. Almost 60 percent of Global Fund resources are allocated to sub-Saharan Africa. The Global Fund is an international financing institution, which invests the world’s money to fight AIDS, Tuberculosis and Malaria.  To date it has committed US$ 18 billion in over 140 countries to support large-scale prevention, treatment and care programmes against the three diseases.  As a result of Global Fund support, 2.3 million people are receiving antiretroviral treatment, 79 million HIV counselling and testing sessions were conducted, 3.7 million orphans were provided with medical services and community care, and 445,000 HIV positive pregnant women have received services for the prevention of mother to child transmission.

Irish Aid works with other donors to deliver a regional programme for AIDS. This works to bolster the AIDS units in both the East African Community (EAC) and the Southern African Development Community (SADC). This programme also delivers training to countries in the regions and generates high quality evidence around relevant issues such as the link between HIV and nutrition.

Ireland has prioritised the needs of children in its work on HIV and AIDS. This involves increasing access to treatment and counselling; improving nutrition and supporting programmes to raise awareness around HIV and AIDS. We have provided special support to two international task teams; one dealing with children affected by AIDS and another with AIDS in the education sector. These teams are tasked with research and analysis of how children in particular are affected by HIV and AIDS and how best they can be protected through education, treatment and social protection measures.

The Results

Significant progress has been made in a number of countries in reducing the prevalence of HIV and AIDS and reducing death rates associated with HIV infection. Wherever Irish Aid supports the national response to HIV, an important feature of our programme is assistance towards the national body – usually national AIDS councils - responsible for oversight, coordination and monitoring of the epidemic.

The following selection of highlights provides a brief view of the scope of our work and its achievements.

Global Fund: Ireland’s contribution to this Fund has lead to significant achievements including over 2m people on HIV treatment, up from 1.1 million in 2007.

Uganda for example has succeeded in reducing the rates of infection from over 18% (25-30% in urban areas) in 1992 to about 6% today. This is an enormous achievement. Ireland has played its part in this improvement.

Mozambique: Over 130,000 people are now on HIV treatment, up from 78,000 a year ago and up from less than 2,000 people at the end of 2002.  7% or 9000 of these were children. This constitutes approximately a 33% coverage rate.  215 sites are offering anti-retroviral treatment.   Over 48,000 women are accessing drugs to prevent HIV transmission from mother to child.

Lesotho: In three years of partnership with the Clinton Foundation, seven health facilities have been refurbished with equipment, and provided with staff to improve service delivery.  Over 27,000 have received counselling and testing for HIV; 4000 people are accessing HIV treatment, nutritional support is provided for all patients and their families on HIV treatment.  Over 800 village health workers have been trained in the management of HIV and AIDS and 150 nurses employed to work in the rural mountainous health sites.

Malawi: Between 2003 and 2007, the HIV prevalence among pregnant women aged 15-24 years-old declined by 25% from 17.6% to 13.2% in urban areas.

Ethiopia’s programme involves Irish support towards national and regional leadership and oversight of the country’s response alongside Irish support to expansion of testing services and integration of HIV with reproductive health programmes. Ireland also gives special attention to building a more effective HIV programme in the education sector for the benefit of both students and teachers. A number of NGOs and an NGO umbrella body are also supported and over a recent four year period, through these organisations 5.1 million people have been reached with information and education on HIV, over 750 orphaned children received social support for schooling and nutrition, 5 multipurpose resource centres were established for young people, over 177 million condoms were distributed alongside the provision of other reproductive health services and commodities. Between 2003 and 2005, the HIV prevalence among pregnant women aged 15-24 years-old declined by 35% from 8.6% to 5.6%.

In Zimbabwe Irish Aid supports Home Based Cared delivered by a number of NGOs that are members of the Zimbabwe AIDS Network. These NGOs are responsible for delivering almost 20% of all Home Based Care in the country and work to document lessons learnt has helped elevate Home Based Care as a priority in the national response. Irish support to the Zimbabwe AIDS Network itself has built up its internal systems to strengthen the capacity of its members and to act as a mandated representative in national fora.

Irish support in Zimbabwe also includes contribution to pooled funding under the auspices of the UN. This pooled fund is directed towards access to anti-retroviral treatment and to supporting a comprehensive response to HIV at district level.

In Tanzania gender dimensions of the epidemic are prioritised in Irish Aid programming, with Ireland leading on work to deal with how gender based violence (including sexual violence) is an important factor in the spread of the HIV epidemic. 

In Zambia and Uganda Ireland gives particular attention to children orphaned by AIDS and children made vulnerable to HIV and by HIV in their families and communities. The Zambian programme also supports an umbrella body for NGOs working in AIDS and Irish support has assisted with delivery of home based care through NGOs.

Ireland’s HIV work in South Africa has strengthened the national council for AIDS with special emphasis on programming and resources directed towards women and children while support to UN reform at country level has led to more unified approach to AIDS amongst UN agencies. Through support to civil societies at national level and in Limpopo province, Irish Aid assists orphans, vulnerable children and women.