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Introduction
It may not make the headlines, but southern Africa must still be considered the
location of one of the world’s most serious humanitarian crises. The scenes may not
be as compelling as those that emerge from dusty and desperate refugee camps or
from the devastation caused by an earthquake, but the numbers tell of an
extraordinary human tragedy. Life expectancy in the six most affected countries of
southern Africa1 has declined by an average 22 years as a result of HIV/AIDS. At
least one child in five in these countries is expected to be an orphan by 2010 – and the
ratio is even higher in some countries.2 Child mortality rates are rocketing in the
region. These six countries are experiencing slowed or negative population growth
rates, but not because of a reduction in the number of births. It is because of the
increase in deaths.
A deadly combination of food insecurity, HIV/AIDS and weakened governance
capacity – on top of crippling chronic poverty – is driving a decline in development
indicators in the region. This translates into a deep crisis of livelihoods, with millions
suffering from illness, hunger or lack of access to basic services. As a result,
hundreds of thousands of women, children and men are dying much younger than
normal.
Governments and the international community have made progress in the last two
years since dramatic food shortages drew attention to the situation in the region and
shocked many into action. A potential famine has been averted. Farmers have been
helped to recover their production in many places with seeds and inputs. With
emergency funding, millions of children have been inoculated against disease.
Millions of dollars have been allocated to countries in southern Africa to fight
HIV/AIDS through global funding mechanisms such as the Global Fund for
HIV/AIDS, Tuberculosis and Malaria, the United States President’s Emergency Plan
for AIDS Relief (PEPFAR) and the World Bank’s Multi-Country HIV/AIDS
Programme (MAP). Perhaps most important, more governments are engaged and
committed to taking the necessary steps to fighting the pandemic and helping their
citizens rebuild their livelihoods.
The Special Envoy of the Secretary-General for Humanitarian Needs in Southern
Africa travelled to the region from 14 to 22 June 2004 to review the crisis and its
response, accompanied by representatives of the Food and Agriculture Organization
of the United Nations (FAO), the United Nations Children’s Fund (UNICEF), the
United Nations Development Programme (UNDP), the United Nations Population
Fund (UNFPA), the Joint United Nations Programme on HIV/AIDS (UNAIDS), the
World Health Organization (WHO), the Office for the Coordination of Humanitarian
Affairs (OCHA) and WFP. The mission visited Malawi, Mozambique, Swaziland and
Namibia.3
Despite the progress made in responding to the crisis so far, much more needs to be
done – and there is no time to waste. A crippling lack of capacity is affecting the
public sector across the region, especially in the areas of agriculture, education and
health. In most cases, training institutions are unable to keep up with the attrition rate
of teachers, extension workers and healthcare professionals because of economic
migration or prolonged illness and deaths related to HIV/AIDS. Losses at senior and
managerial levels will also have a long-lasting effect. In Malawi, the Ministry of
Health reports a stunning 90 percent vacancy rate for physicians and a 60 percent
vacancy rate for nurses in the state health system. The United Nations needs to help
rebuild and replenish the human and technological resources of the civil services of
these countries as a matter of great urgency.
Capacity issues are also causing substantial delays in using the external funds
already allocated to many countries of the region for combating HIV/AIDS. Finding
ways to translate the funds into tangible actions that improve peoples’ lives is an
urgent and major challenge. Moreover, these funds should not necessarily be
focused narrowly on the treatment of HIV/AIDS: they should also be used to address
some of the root causes of the pandemic.
In the response to the ongoing crisis, the international community must stay focused
on the people we are collectively trying to serve. Everything we do must be centred
on improving the lives of vulnerable people, especially women, children and young
people, who need the most help. We need to understand vulnerability better by
strengthening our assessment processes and to link our responses to a livelihoods
approach. Most important, we need bold new initiatives that can be scaled up
dramatically and that will make a positive impact on the lives of a significant number
of people.
The United Nations has a fundamental role to play in all these efforts, but there will
have to be significant changes in the way it does its business. The mission met with
United Nations country teams across the region that are struggling to do what they
can; they need more support from the highest levels of their agencies, and they need
to work together more closely to form a United Nations response rather than adopting
agency-specific approaches to the situation. The Resident Coordinators are extremely
important in creating coherence and a collaborative environment, but all agencies
need to make a stronger commitment to the Resident Coordinator system and to
create collegial, respectful and humble partnerships with each other and with governments and civil society. Strong partnerships and joint programming will allow
the United Nations to take the response in southern Africa to the next level.
Footnotes:
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Lesotho, Malawi, Mozambique, Swaziland, Zambia and Zimbabwe.
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UNICEF. 2003. Africa’s Orphaned Generations.
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Zimbabwe was included in the original mission itinerary, but the visit was cancelled after the
Government indicated that the proposed dates were not appropriate. The Government has indicated
that an invitation for the Special Envoy to return would be forthcoming at a later date. Namibia was
included in the mission itinerary as a result of the Government’s appeal in November 2003 for
international assistance to address problems of drought and HIV/AIDS in the northern parts of the country. Despite its middle-income status, Namibia has one of the most dramatic disparities in income
distribution; social indicators in the north are comparable with other countries in the region. During
meetings with the country team and Government, it was agreed that the country should be included
among those affected by the crisis in southern Africa.
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