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ContactsMamadou BallChair, UN Theme Group on HIV/AIDS andWHO ReprensentativeTelephone: +269 73 00 36Fax: +269 73 18 25E-mail: firstname.lastname@example.orgSétou KabaUNAIDS Country Coordinator (also Mauritius, Madagascar and Seychelles)Telephone: +261 20 23 366 32Fax: +261 20 23 641 84E-mail: email@example.com
The AIDS response is coordinated by the National AIDS Control Committee, a multisectoral structure that brings together the government, civil society and the private sector. The AIDS response is one of the seven main strategic lines of action and is among the 35 programmes assigned as priority by the Poverty Reduction Strategy Paper and the Strategic National Control Plan for 2005 – 2009. One of the objectives of the plan is to keep HIV prevalence below 1%.
A noteworthy feature of 2006 was the implementation of the plans of action for AIDS control developed by the various stakeholders, including nongovernmental organizations and entrepreneurs.
The law still discriminates against women in certain areas, although this is not the case in the law on inheritance and property rights. Women who live in towns enjoy a better status than those who live in rural areas. The age at marriage is generally 14 – 15 years, with girls more likely than boys to marry at an early age. Adolescents make up 57% of the population and more than half of them (53%), particularly those not attending school, are unaware of the existence of HIV and of AIDS.
The obstacles to HIV prevention are:• the need to coordinate the actions of the National AIDS Control Programme and Prévention Information Lutte contre le SIDA, in particular preventive measures that are carried out by a number of partners, such as communication to bring about changes in behaviour, and distribution of condoms; • high levels of stigmatization of and discrimination against people living with HIV, which accounts for the low levels of HIV testing;
The obstacles to care and treatment are:• insufficient or even non-existent infrastructures to provide proper care for people living with HIV; • low level of involvement in care activities of people living with HIV; • limited logistic capacity to distribute the drugs needed for HIV-related infections and to stock antiretroviral drugs; • lack of protocols for prevention of mother-to-child transmission.
Efforts have been made to improve not only awareness, but also the availability and uptake of means of preventing sexually transmitted infections. A strategy for safe reproductive health, including condom use, has been developed.
A policy for the reduction of mother-to-child transmission, together with a plan covering several years, was adopted in February 2005. Since 2002, there has been a policy framework, to promote health education for young people and direct preventive actions, taking into account specific social and cultural aspects.
Challenges and emerging issues for 2007The main challenges facing the country are:• the lack of resources, and in particular human resources, to implement and strengthen preventive and care measures;• the lack of firm commitment on the part of the government to HIV control;• coordination of control activities, with a focus on the “Three Ones”;• establishment of a Joint UN Team on AIDS, bringing together the three UN agencies present in the country.
Activities in 2006UNAIDS focused its support to Comoros on developing an understanding of the “Three Ones” principles while continuing to mobilize resources for the implementation of the Strategic National Programme’s operational plan for 2005 – 2009.
A plan for monitoring and evaluation has been developed with the technical assistance of an international consultant.
UNAIDS has also emphasized the principle of having a single team for the different agencies present in the country.
Plans for 2007• Assisting with the drafting of an operational plan for universal access. • Developing a joint UN support plan for HIV. • Developing a budgeted national plan for monitoring and evaluation to support the National Strategic Plan 2005 – 2009.• Advocating preventive measures targeted at people most at risk to HIV infection (sex workers and men who have sex with men). • Helping to integrate a gender perspective into HIV control measures. • Organizing strategic meetings at the regional level (e.g. Indian Ocean Commission and African Development Bank). • Assisting the Joint UN Team by providing strategic information on HIV.