National HIV/Aids policy: a call for renewed action

Malawi has been severely affected by HIV/AIDS. The first case of AIDS in the country was diagnosed in 1985. Since then, epidemiological data show an escalating epidemic. In a sample of pregnant women attending antenatal clinics in urban Blantyre, HIV seroprevalence rose from 2.6% in 1986 to over 30% in 1998, decreasing only slightly to 28.5% in 2001. In 2001, Malawi's national adult prevalence (15-49 years) was estimated at 15%, translating into almost 740,000 adults living with HIV/AIDS (National AIDS Commission [NAC], 2001). HIV prevalence is almost twice as high in urban areas, at 25%, as in rural areas, at 13%. Annual deaths due to HIV/AIDS are estimated at over 80,000, amounting cumulatively to 555,000 deaths since 1985.

The goals of the National HIV/AIDS Policy are:

• to prevent the further spread of HIV infection
• to mitigate the impact of HIV/AIDS on the socioeconomic status of individuals, families, communities and the nation.

These goals will be achieved by pursuing the following specific objectives:

• to improve the provision and delivery of prevention, treatment, care and support services
  
• to reduce individual and societal vulnerability to HIV/AIDS by creating an enabling environment
• To strengthen the multi-sectoral and multi-disciplinary institutional framework for coordination and implementation of HIV/AIDS programmes in the country.

The policy statement indicates that the Malawi Government, through the NAC, shall do the following:

• Implement a national HIV/AIDS Monitoring and Evaluation (M&E) plan to assess the success of the national response to HIV/AIDS and to inform and guide future strategies and interventions
• Ensure that any necessary capacity building is carried out so that all partners are able to provide required information for the national M&E system.
• Promote efficient use of data and resources by making sure that indicators and sampling methodologies are comparable over time.
• Conduct anonymous, unlinked HIV/AIDS/STI sentinel surveillance.
• Carry out periodic behavioural surveillance among target groups.
• Improve surveillance data management and use, including regular dissemination of relevant surveillance data to its partners and to the general public.