BY GEORGE KAGAMEThis week, Rwanda was privileged to host an international conference on HIV/Aids implementers from all over the world. It is estimated over 2000 delegates attended the meeting that was sponsored by the United States President’s Emergency Plan for Aids Relief, along with the Global Fund to Fight Aids, Tuberculosis and Malaria, the World Bank and three United Nations agencies.The conference was preceded by a mini workshop that brought together about 3000 women at Amahoro Petit Stadium led by the First Lady Jeanette Kagame. The concern of the ladies at stadium was to highlight the need for men and women to fight HIV and Aids together.While closing the conference, Jeannette Kagame called upon Rwandans to increase efforts in curbing the pandemic. She said: "You all know that barely 13 years ago; we lost over a million lives in just 100 days. We simply cannot afford to lose any more lives to an affliction we can do something about.”The theme of this year’s meeting, "Scaling Up Through Partnerships” was meant to recognize the rapid expansion of HIV/Aids programmes worldwide. Together, implementers exchanged lessons learned on building the capacity of local prevention, treatment, and care programmes, maintaining quality control, and coordinating efforts. This forum provided an open dialogue about future directions of HIV/Aids programmes, with a strong emphasis on implementation and identification of critical barriers and best practices.Rwanda was chosen to host the meeting in recognition of the country’s leadership in the fight against HIV/Aids and the impressive results it has achieved. The country was also chosen because of its achievements and commitment on the Aids response and the appropriate use of Aids funds. Rwanda is equally credited for her sound partnerships with all stakeholders for the better strategy and coordination of activities involved.Prevalence rate With about 200,000 people living with HIV/Aids, the prevalence rate in the country is estimated to be at 3 per cent in the country of the adult population; however the prevalence figures have variations. In pregnant women it is 2.2 per cent, the infection increases with more sexual partners, among the 15-24 age brackets it is believed to be 1.0 per cent.However the DHS indicates that 380 women for every 100 men in this younger age are infected. The report further states that whatever the age group, prevalence among women always appears higher than prevalence among men. Dr Anita Asiimwe, the Managing Director of TRAC says that the problem of HIV/Aids is no longer a crisis. By the end of 2006, the number of Rwandans who accessed ARVs exceeded 32812 people; this represents 64.3 per cent of all people who were in need of medication in Rwanda, in 2006. Rwanda is among the success stories in Sub Saharan Africa. Also important is the highly efficient system that Rwanda’s Aids Treatment and Research centre has put in place to take ARVs to HIV patients when and as soon as they need them.In many presentations throughout the conference, experts stressed the need to make HIV/Aids programmes and services relevant to the people they serve and to involve local communities in the design and implementation of those programmes.Current strategies in the fight against AIDS and STIs established in 2001, focuses on making information available to everyone involved in evaluating trends, predicting the magnitude of the disease and assessing the impact of various AIDS interventions. By international standards this is a remarkable success story. The Global fund which is at the forefront of financing the fight against HIV/Aids and malaria working with The World Health Organization (WHO) set up a target of providing Anti Retroviral drugs to 3 million people in developing countries by end of 2005, however reports indicate fewer than 300,000 people in these nations receive the medicines.Many speakers committed themselves to increase the efforts against the horror of Aids. Many miles away in Germany, the G8 an exclusive club of the world’s eight largest economies agreed to increase funding activities aimed at reducing HIV prevalence in Africa. The world leaders endorsed $60b to help heal Africa from HIV/Aids and reduce the deep scar that Aids has left on face of the continent.HIV/Aids is a matter of growing concern across the world as a whole, and in particular Sub Saharan Africa, where over 24m people are suffering the diseases making it the world’s area with highest concentration of the scourge, having 70 per cent of HIV/Aids patients. In addition to government ministers, participants also included a wide cross-section of HIV programme implementers, including representatives from faith- and community-based groups and groups of people living with HIV/Aids. ‘‘One of the Global Fund’s highest priorities is to strengthen our partnerships with programmes like PEPFAR and the UN agencies, and with the thousands of local groups, doctors and nurses who actually do the work of treating the sick, caring for the orphans, and preventing new infections,” said Dr. Michel Kazatchkine, Executive Director of the Global Fund to Fight AIDS, Tuberculosis and Malaria. "Better coordination, less paperwork, sharing best practices – these sound dull but what they mean is using all we can for treatment, prevention and care, and helping save more lives. We commend PEPFAR for organizing this conference.”Manpower lossEach year, the relentless advance of HIV/Aids costs more than one million jobs in the worst-hit countries in Sub Saharan Africa, Asia and Latin America. But it is also a growing challenge for a region with lower-prevalence like Europe. According to UNAIDS, the number of people living with HIV in Sub Saharan Africa at the end of 2005 was estimated to 24.5 million people. Critical issues for Rwanda, especially in the world of work, are discrimination and the protection of rights, confidentiality and the re-integration in the labour market of HIV-positive workers on anti-retroviral treatment. Employers have a responsibility to provide employment opportunities to people living with the virus, and reach out to communities to give relevant care and treatment.This blueprint for workplace action is internationally recognized and globally applicable - employers and trade unions in industrialized countries increasingly recognize the value of HIV/Aids policies and use the International Labour Organization code as a point of reference. The ILO’s approach is to mainstream HIV/Aids in its Decent Work Country Programmes, at the same time as collaborating with fellow co-sponsors of UNAIDS in implementation. No country is free of the disease, and several African countries - East and West - are reporting rising infection rates. There’s need to renew vigilance with respect to prevention. The global challenge of the HIV epidemic - even in lower-prevalence regions - was the motivation for this high-level meeting, called for by UNAIDS, Global Fund, TRAC, the World Bank and Rwanda’s ministry of Health.TRAC received a special invitation to present its work owing to the high priority given by the Rwandan Government to workplace action on HIV/Aids. This has been the basis for the long-standing partnership between the UN, the World Bank and Global Fund. Rwanda can provide important lessons to other areas with similar challenges in the economic, social, cultural and political desires to see how lessons learnt from rural behavioural changes, workplace programmes can be adopted from worst-hit regions, and transferred to regions and countries with lower prevalence, with a particular focus on Eastern Europe, Russia and China. The UN and other partners like the World Bank, EU have partnership programme to support countries in Africa to implement workplace policies and programmes through capacity building, socio-economic research, exchange of good practices, and support of public-private partnerships. One example is the co-investment model for extending workplace benefits to the families of workers and the local community.