President Paul Kagame on Monday emphasised the importance of open dialogue as a means to address and prevent HIV/AIDS and sexually transmitted infections.

"Open dialogue saves lives. When it comes to sexually-transmitted infections, stigma and silence are real killers, just as much as the underlying viruses. Shame discourages people living with HIV from learning and accepting their status and accessing the healthcare needed to live a full life.", Kagame said.

"ICASA exists in order to break down the taboos that impede prevention and early treatment. You are the ones to speak loudly, and clearly. We have come too far in this struggle, to do otherwise,” he added.

He was addressing participants meeting in Kigali for the 20th International Conference on AIDS and Sexually Transmitted Infections in Africa (ICASA).

The opening was attended by the President of Mozambique, Filipe Nyusi, as well as First Lady Jeannette Kagame alongside First Ladies from Botswana, Chad,  the Republic of Congo, Ghana and Niger. 

Also present were the Director-General of the World Health Organisation (WHO), Tedros Adhanom Ghebreyesus; Professor John Idoko, President of ICASA; Winnie Byanyima, Executive Director of UNAIDS; Peter Sands, Executive Director of the Global Fund to fight AIDS, Tuberculosis and Malaria, as well as thousands of delegates.

Describing AIDS as an epidemic without borders, Kagame indicated that much of the success in the campaign to halt the spread of the virus can be credited to global cooperation.

"It is, therefore, vital to continue raising the level of support for initiatives such as the Global Fund, Gavi, and PEPFAR, which have made such significant contributions,” he noted. "Governments in Africa, for their part, must prioritise domestic financing for healthcare. Doing so creates a sustainable, long-term foundation for these valuable partnerships.”

The Head of State indicated that open dialogue is critical when it comes to fighting stigma and silence that people with sexually transmitted infections go through.

Similarly, shame discourages people living with HIV from learning and accepting their status and accessing the healthcare needed to live a full life, he said.

"ICASA exists in order to break down the taboos that impede prevention and early treatment. You are the ones to speak loudly and clearly. We have come too far in this struggle to do otherwise,” he said.

Kagame commended various partners that have supported Rwanda’s HIV control efforts over the years.

According to the Ministry of Health, Rwanda has made significant gains in the fight against the HIV epidemic. 

Today, over 90 per cent of all people living with HIV in Rwanda know their status and almost all of them are on life-saving treatment. Of those, 90 per cent have achieved viral suppression.

Kagame suggested that strong national health systems are the right strategy for managing current and future health threats, highlighting infrastructure, people and trust as the prerequisites to achieve it.

"We need modern facilities within a reasonable distance of where people live. Two, [we need] people. That means highly-skilled medical professionals as well as managers and administrators,” he noted.

Participants at the 20th International Conference on AIDS and Sexually Transmitted Infections in Africa (ICASA) in Kigali on December 2, 2019. / Emmanuel Kwizera

Trust, another prerequisite, the President said enables citizens to believe and act on health guidelines from public institutions and change their behaviour accordingly.

"This is why community health workers have been instrumental in improving health outcomes in several countries including Rwanda,” he said.

But for that to be realised, it requires the political will and good governance, according to the President.

"Good politics and governance have everything to do with health. There is no substitute for building an inclusive, caring society,” he said.

Progress made

Ghebreyesus commended Rwanda’s progress towards the fight against the HIV epidemic, highlighting the country as one of the few countries to achieve the 90-90-90 targets prior to 2020.

Under its fast-track target known as 90-90-90, by 2020 UNAIDS aims to have 90 percent of people with HIV knowing they are HIV-positive, 90 per cent of diagnosed people on treatment, and 90 per cent of those on treatment able to use the medication to suppress the amount of virus in their bodies to a low level.

The WHO Director-General highlighted that millions of people are now on HIV treatment.

"Even better, millions of people are NOT on treatment because they have the tools to protect themselves. We’ve accelerated research and development. We’ve pushed back the boundaries of science and are now in hot pursuit of a cure,” he said.

According to Diane Gashumba, Rwanda’s Health Minister, the country’s fight against the HIV/AIDS Epidemic is grounded in the principle that those affected should be at the centre of the response.

"The integration of HIV treatment into maternal and child services has led to more equitable access to prevention and treatment,” she said.

President Nyusi of Mozambique commended Rwanda’s progress towards the fight against HIV/AIDS, adding his presence aimed to draw lessons from the kind of good practices deployed elsewhere to fight the HIV epidemic.

"In addition to drawing experience, we have come to Kigali to reaffirm the determination of our Government to combat the HIV/AIDS epidemic and proliferation of infectious diseases,” he noted.

Later, President Kagame and Nyusi attended the African Leadership Meeting on the sidelines of ICASA. 

The meeting, an initiative of the African Union, focused on how to increase domestic investment in health.

Kagame, who also serves as the AU Champion for Domestic Health Financing, also emphasised the need for partnerships, saying they are indeed essential for sustaining the gains made in global health.

However, he argued that it is past time for governments to allocate adequate resources in national budgets for healthcare from which citizens benefit so much.

"Spending more money is not a silver bullet. Funds must be spent well on programmes that work and are sustainable,” he said.