6 Combat HIV/AIDS, malaria and other diseases
Where we are?
Although the HIV prevalence rate in Rwanda is lower than in many other sub-Saharan countries, it is still the main killer of those over five years of age and comes after only malaria as the cause of death for children under five years. The Government remains strongly committed to fighting the disease (Ministry of Health 2009b; National AIDS Control Commission 2010).
Data from the 2010 DHS (NISR et al 2010) found HIV prevalence of 3 per cent in the general population aged 15-49 years. There was no decline in prevalence between 2005 and 2010. HIV prevalence is higher amongst women than men, 3.7 per cent for women compared to 2.2 per cent for men and in urban areas, 7.1 per cent compared to 2.3 per cent
Rwanda has seen a great achievement in mother-to-child transmission rate with a dramatic decline from an estimated 21.5 per cent rate in 2005 to 2.6 per cent in 2010. However, following this decline between 2005 and 2008 the rate has remained stable.
As part of the key implementation bottlenecks it is important to raise the issue of condom use. Although there is some evidence from the most recently available Annual Behavioural Survey that condom use has increased dramatically (National AIDS Control Commission 2010) it has not yet and aged 25–29 years are the most likely to use condoms. Utilization rates vary from 14.1 per cent of women living in rural areas to 62 per cent of men living in urban areas (NISR 2009, P21).
Integrating further HIV/AIDS care into the routine health services and providing training to health professionals in sexual and gender based violence, has been identify as one of the priorities for Interventions to Accelerate Progress to Achieve MDG 6 A + B
In Rwanda, malaria continues to be a major cause of morbidity and mortality, although remarkable progress is being made in reducing the burden of the disease, with a strong emphasis on prevention. According to the latest DHS, there has been a decline in malaria cases, while at the same time there has been an increase in health service utilisation.
The President’s Malaria Initiative was launched in 2005 and has worked with the national malaria control strategy to support the four major malaria prevention and treatment measures: Insecticide –treated mosquito nets; Indoor residual spraying; intermittent preventive treatment for pregnant women; Diagnosis with rapid diagnostic tests/microscopy treatment with artemisinin-based combination therapy. The aim is to remove malaria as a major public health problem. Between 2005 and 2011 1.5 million ITNs, 1.5 million ACTs and 110 thousand RDTs distributed. Health workers have been trained in treatment with ACTs and in IPTp. Since 2005 the mortality and morbidity rate for malaria amongst the under-fives and those five years and over has declined significantly, for example, the under-five Malaria proportional mortality rate fell from 60.2 per cent in 2005 to 13 per cent in 2010 (see table below).
Malaria Proportional Mortality under 5 Years, 2005 – 2010
The 8 Millennium Development Goals
- 1 Eradicate extreme hunger and poverty
- 2 Achieve universal primary education
- 3 Promote gender equality and empower women
- 4 Reduce child mortality
- 5 Improve maternal health
- 6 Combat HIV/AIDS, malaria and other diseases
- 7 Ensure environmental sustainability
- 8 Develop a global partnership for development
Targets for MDG6
- Halt and begin to reverse the spread of HIV/AIDS
- HIV prevalence among population aged 15-24 years
- Condom use at last high-risk sex
- Proportion of population aged 15-24 years with comprehensive correct knowledge of HIV/AIDS
- Ratio of school attendance of orphans to school attendance of non-orphans aged 10-14 years
- Achieve, by 2010, universal access to treatment for HIV/AIDS for all those who need it
- Proportion of population with advanced HIV infection with access to antiretroviral drugs