RESPONDING TO HIV/AIDS

The spread of the HIV/AIDS epidemic in Mauritius is now mainly driven by injected drugs use. Seychelles for its part is experiencing a rapidly deteriorating drug abuse situation. In response, the UN System (UNAIDS, UNDP, UNODC) will therefore concentrate its support in 2008 on the inter-connected issues of HIV/AIDS and substance abuse, particularly among Most At Risk Populations (MARPs, i.e. sex workers, detainees).

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Background

Mauritius
In recent years, Mauritius has been experiencing a preoccupying exponential increase of its HIV/AIDS infection rate, with a prevalence of more than 5% among Intravenous Drug Users (IDU), and an overall upward trend now reaching 1.8% within the 15-49 age group. Erratic compliance with Prevention of Mother to Child Transmission (PMTC) prophylaxis, observed in the case of pregnant sex workers on intravenous drug use, also adds further cause for concern. Over an estimated 12,000 HIV positive persons, only 3,000 have been detected, out of which only 2,000 are being actively followed up. The persistence of risk-taking behaviours among Most At Risk Populations (MARPs) and their implications for a potentially rapid extension of the disease to the wider population now place Mauritius in a situation of emergency which will require the sustained mobilization and close coordination of all national stakeholders.

Aware of this necessity, the Government of Mauritius and NGOs jointly undertook, with the support of UNAIDS and WHO, the development of a National Multisectoral Strategic Framework (NSF) for 2007-2011. To accompany the various phases of its implementation, a Multisectoral Communications Strategy was also formulated with the technical assistance of UNAIDS. In May 2007, a National AIDS Secretariat (NAS) was officially established, and positioned as lead coordinator of the national response, in line with the “Three Ones” Principle advocated by UNAIDS. The proclamation, in August 2007, of an HIV/AIDS Preventive Measures Act marked yet another crucial step in the building of a conducive legal and institutional framework, and created the basis for a wider consensus and stronger unity of action among national State and non-State stakeholders. An immediate positive effect of this legislation has been the scaling up of a Needle Exchange Programme (NEP) rolled out by the Ministry of Health, and relayed on the ground by a network of partner NGOs. Significant progress has also been registered from a harm reduction perspective, with the launch of a Methadone Substitution Therapy (MST) Programme in November 2006, which also received technical assistance from UNAIDS and WHO.

Seychelles
Universal Access target settings were facilitated by UNAIDS in September of last year with the provision of national and international consultants. The epidemic in Seychelles, which initially seemed to be driven by sexual transmission (both heterosexual and man-to-man) now appears to be shifting toward IDU-related transmission. UNAIDS has been assisting Seychellois authorities with the conduct of an evaluation which will allow a clearer determination of the weightage of each type of transmission. The results of this study will be available during the first quarter of this year, and should provide valuable information which will usefully inform the implementation of Seychelles’ National Strategic Plan.

What UNDP is doing in this field

Mauritius
In 2008, given the fact that the HIV/AIDS epidemic in Mauritius is now mainly driven through injected drugs use, the UN System will concentrate its support on the inter-connected issues of HIV/AIDS and substance abuse among Most At Risk Populations (MARPs, i.e. sex workers, detainees). A Joint Programme is currently being formulated between UNODC, UNDP, WHO and UNAIDS to address this specific nexus. Technical assistance from UNAIDS, and WHO and the Office of the UNRC will also be combined to assist Mauritius in its preparation / submission of a proposal to the eighth call of the Global Fund to fight AIDS, Tuberculosis, and Malaria (GFTAM). Support will also be lent to Rodrigues, whose migrant population transiting to and from Mauritius constitutes an increasingly vulnerable group which will require close monitoring and tailored preventive/response strategies. Targeted capacity-building assistance, already provided last year by UNFPA and UNAIDS in the form of Training of Trainers sessions, will be renewed again in 2008. UN inter-agency expertise was mobilised in 2007 to evaluate the Rodrigues Action Plan and will be again this year to support the elaboration of the next Strategic Plan and the setting up of a Rodriguan sub-national AIDS Unit.

Seychelles
In order to address the rapidly deteriorating drug abuse situation and its implications for the spread of HIV/AIDS, UNODC Kenya and UNDP will consider the possibility of formulating a Joint Programme on HIV/AIDS and IDUs in Seychelles.

WHO Seychelles, which recently initiated the preparation of its next Country Cooperation Strategy (CCS), will also seek to define its HIV/AIDS component within the broader framework of a unified UN support to the national response, alongside UNFPA’s sub-programme on sexual and reproductive health, and the technical assistance channelled through UNAIDS.

Summary of Ongoing Projects

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