Transcript Conference on Millennium Development Goals: Inclusion of People With

Conference on
Millennium Development
Goals:
Inclusion of People With
Disabilities
Bratislava – Slovakia, 14t - 15t May 2007
Millennium Development Goal 6:
Combat HIV/AIDS, Malaria and other
diseases;
By: Mwesigwa Martin Babu
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What are the Millennium Development Goals
(MDGs)
They are a set of commitments that the
international community and the United
Nations (UN) agreed upon during the
UN Millennium Summit in 2000 in order
to promote sustainable development in
developing countries all over the world.
A time schedule to achieving the targets
for each goal was set to be achieved by
2015.
They are eight in number.
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Order of presentation


The relationship between HIV/AIDS, poverty &
disability in developing countries’ context
A brief of Uganda’s progress in the struggle against
HIV/AIDS, 1986 – 2007

The situation of PWDs in Uganda

Achievements of PWDs & HIV/AIDS

A brief review of MDG 6

The Monitoring Tools of MDG 6

An analysis of the Indicators

Way forward

Conclusion
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The relationship between HIV/AIDS, poverty
& disability in developing countries’ context
The relationship between disability and poverty has often
been referred to as a vicious circle. Interesting to note is
that the incidence and prevalence of HIV/AIDS is greatly
linked to poverty and low incomes. Because PWDs
constitute the poorest of the poor in our country; coupled
with the absence of disability HIV/AIDS programming;
interlinked with the stigma and discrimination; stereotyping
and myths about disability; your guess is as good as mine.
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Uganda’s Progress in struggle against
HIV/AIDS, 1986 - 2007

The first HIV/AIDS cases in Uganda were identified in 1982 along
the shores of Lake Victoria in Rakai District in southern Uganda
by Ugandan medical personnel.

By the end of 1992, the national prevalence rate was estimate at
18.3% with some centers registering rates above 30%.

Uganda AIDS Commission, established by Act of Parliament in
1992 – to coordinate the multi-sectoral efforts so as to unify the
national response

Conceptualization of a Multi-sectoral Approach to the Control of
AIDS (MACA) which was adopted by Parliament in 1992.

According to the National HIV/AIDS sero and behavior survey by
the Ministry of Health Surveillance 2004, adult prevalence rates
had been reduced to 6.4% as against the 30% prevalence rates
in 1992.

Uganda acclaimed as a global model of success by the
international community due to the the adopted HIV prevention
approach; the ABC (A=Abstinence, B=Being Faithful to one
partner, C=Condom use).
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The Situation of PWDs in Uganda
Allow me to provide a broad picture on the situation of PWDs so that it is
the basis for the analysis of MDG 6, the target and monitoring
indicators below? i.e.

10% (2.5 million ) of Ugandans are living with disability

Disabled among the 38.5 of Ugandans in absolute poverty

75% of PWDs lacking functional literacy (limited access of
information of HIV/AIDS and other issues )

30 of CWDs complete primary education (ie orphaned unable to
achieve education as provided by the indicator )

health facilities generally inaccessible to PWDs ( the affects
access to therapy)
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Achievements for PWDs vis a vis HIV in
Uganda so far.
Inclusion of PWDs issues in the National HIV/AIDS Strategic Plan
2007 – 2012
•
Discussion is underway towards granting PWDs a Self
Coordinating Entity (SCE) status (Explain what this means)
•
Formation of Disability Stakeholders HIV/AIDS Committee
(DSHAC)
•
Development of strategic partnerships with national HIV/AIDS
actors and stakeholders, such as The AIDS Support
Organization (TASO).
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A review of MDG 6
MDG 6 is – Combat HIV/AIDS, malaria and other diseases.
The target is to ‘halt the prevalence of HIV/AIDS by 2015 and begun to
reverse the spread of HIV/AIDS’
The indicators for MDG 6 are:
•
HIV prevalence among pregnant women aged 15 -24 years as an
indicator is rationalized to mean that the infection rate for pregnant
women is similar to the overall rate of the adult populations – simply
because behind every pregnant woman is a man who played unprotected sex.
•
Condom use as a contraceptive among the married for birth
control and in high – risk sex populations ages 15-24; is used to
monitor progress towards halting and reversing the spread of
HIV/AIDS. This is because condoms are the only contraceptive
method effective in reducing the spread of HIV, and for those
unmarried young populations who experience the highest rates of
HIV/AIDS infection due to having irregular partners, but also for the
married who could scale down infection rates by practicing safe sex
in and out of the marital relationships.
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A review of MDG 6 - cont
•
Ratio of school attendance of orphans to school attendance of
non-orphans aged 10-14 years. As a result of HIV/AIDS claiming
the lives of adults when they are just forming families, orphan
prevalence is rising steadily. It is important therefore to monitor the
extent to which AIDS support programmes succeed in securing
educational opportunities for orphaned children. Otherwise the cycle
of AIDS is perpetuated in the community when ignorance due to lack
of education and its attendant opportunities of getting out of poverty,
through gainful employment and self esteem are not promoted
amongst the younger populations.
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Monitoring tools
It was found appropriate that in order to effectively monitor the
progress of implementation of the Millennium Development
Goals, a set of tools had to be developed to measure the extent
to which the set target had been achieved over the years. The
list of indicators that was developed is not prescriptive and can
change depending on individual country’s choices. I can
imagine how difficult and challenging it must have been for the
team to come up with these particular tools. They are;
The indicators
•
Rationale
•
Data collection and source
•
Periodicity of measurement
•
Gender issues &
•
Desegregation issues
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The indicators
The set indicator for MDG 6 miserably fall short of addressing the
issues and needs of PWDs in Uganda in as far as HIV is concerned.
With all due respect to the framers of the millennium development
goals and the corresponding targets and indicators, one thing is for
sure – There was a high level of unconsciousness about disability
needs and issues. The following analysis is a justification of the
statement I just made.

HIV prevalence among pregnant women aged 15 -24 years as
an indicator

Reproductive health services in Uganda are not responsive to needs of
disabled women. The services are not disability friendly, and are
characterized by a lot of stigma and discrimination towards women with
disabilities by service providers.
A study undertaken to establish - Reproductive Health and HIV/AIDS
among Persons with Disabilities in Uganda in three districts of
Kampala, Katakwi and Rakai; DWNRO 2003 – offers a very grim
picture about disabled women’s attempts to access reproductive health
services.
Correspondingly, the tool of data collection and source that may be
used to track the progress of this particular indicator can not provide
specific information on persons with disability.


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The indicators – cont.

Condom use as a contraceptive among the married for birth
control and in high – risk sex populations ages 15-24 cannot
also be sufficiently used to establish the levels and progress of the
target amongst the disabled population for a number of reasons.

One: 99% of people who use condoms do so with consent. For
persons with disability, where sex is by chance for disabled men
and most often by coercion for the disabled women, the chance that
one will use a condom is very rare.

Secondly: Sex education and the attendant sub topics like condom
usage do not address the information needs of specific disability
categories. How for instance can a visually impaired person
distinguish between a damaged and safe condom? What about the
ability to negotiate consensual sex acts – when the power balances
in terms of demanding for and satiating one sexual desires for
PWDs is tilted unfavorably against them? How about the issues of
negative stereotypes that still abound in developing countries about
disability and PWDs?
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The indicators – cont.


Ratio of school attendance of orphans to
school attendance of non-orphans aged 10-14
years as an indicator cannot be used to quantify and qualify
children with disabilities and their levels of knowledge about
HIV. Though Uganda launched a very successful Universal
Primary Education (UPE) programme and has registered high
turn over of children from primary to secondary education levels
in the last three years, the ability of the programme to retain
children with disabilities and those with special learning needs
has been a total failure. This has been due to lack of planning
for this category of children. Implication is that the chance that
the PWDs as a section of the population shall continually live in
perpetual poverty and ignorance is very high. The correlation
between poverty and HIV is a well known matter that I should
not delve so much into.
The monitoring tool for this indicator is correspondingly
incapable of really establishing the real progress of PWDs in as
far as achieving MDG 6 is concerned.
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Way Forward

I could go on and on. As I said, the purpose of my presentation is to
stimulate debate. From whatever perspective, direction or angle one
looks at MDG 6, its target and the monitoring tools, a lot is still desired to
enable PWDs in the developing communities be part and parcel of the
aspirations of the framers of the Millennium Development Goals at the
onset of this century – “……….a strong commitment to the right to
development, to peace and security to gender, to the eradication of
the many dimensions of poverty and to sustainable human
development”
I can only say that they owe
the entire disabled
population of this world an
apology, and corresponding
commitment to ensuring that
PWD issues and concerns
are given due regard in all
national and international
development endeavors.
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DPOs working in Partnership in Uganda
The DPOs that are working together in Partnership in Uganda
include the following;
Others include:
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Conclusion
This can only be possible, when everybody perceives us as follows:







WE are unable not because of our disability.
WE are unable because of major deficiencies in addressing our
issues and needs in an appropriate manner that would take care
of us.
WE are unable because the environment disables us.
WE are unable due to our continued exclusion in decisionmaking processes at planning, budgeting and programme
implementation levels.
WE are unable because our disability is presumed more visible
than our humanness.
WE are unable because you consciously and unconsciously
disregard us.
We demand that you place our humanness above our disability.
We demand that you start perceiving disability as a human rights
issue. By doing these persons with disability will be accorded
what every other human being aspires to 'dignity'
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Finally
Allow me to quote Tony Blair’s words when he was
launching the African Commission Report two years ago
– “There can be no excuse, no defense, no
justification for the plight of millions of our fellow
human beings in Africa today. There should be
nothing that stands in the way of our changing it.”
This should be the attitude of the international
development partners towards persons with disabilities
in regards to HIV/AIDS programming all over the world.
I thank you very much.
Thank you
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