SUDAN: Universal access still a long way off in the south

JUBA, 3 February 2010 (PlusNews) - Southern Sudan's poor infrastructure, largely illiterate population and dearth of health facilities and workers mean that despite five years of peace, HIV programmes are still in their infancy.

There are no national-level statistics on HIV prevalence or incidence, further hampering the fight against the pandemic, but a 2007 site-specific antenatal surveillance by the US Centres for Disease control found prevalence levels ranging from as low as 0.8 percent in Leer, Unity State, to as high as 11.5 percent in Tambura, Western Equatoria State.

"We use an estimate of 3.1 percent for the south, and we know that the epidemic is more concentrated in big towns and areas near the border with our neighbours who have higher prevalence, such as Kenya and Uganda, but so far we have not conducted a survey of HIV indicators," Bellario Ahoy Ngong, chairman of the South Sudan AIDS Commission (SSAC) told IRIN/PlusNews.

Ngong said HIV was spread mainly through heterosexual transmission, and was worse in the areas where trading opportunities had expanded since the Comprehensive peace Agreement with the north was signed in 2005.

"There has been a lot of movement of people since we attained peace, and in the big towns like Juba, Yei and Yambio, sex work has increased along with trade," he said. "Unfortunately, our people have very low knowledge of HIV transmission and prevention, so they are very vulnerable."
Health system reconstruction

Dr Samson Baba, director-general of the Ministry of Health's directorate of external assistance and coordination, said the plan would give 85 percent to 90 percent of people access to "acceptable levels of healthcare" within 10 years.

"Through the Multi-Donor Trust Fund [a World Bank mechanism to coordinate the reconstruction and development of Sudan], we are creating a basic healthcare package that stipulates the minimum standard of care that should be available at all health centres within the country," he told IRIN/PlusNews.

"We are also embarking on an ambitious training programme for health workers ... using NGOs to train local staff, sending locals abroad for training, and developing our own training institutions," he said. "At current training levels, it would take us 66 years to satisfy our midwife gap, but with our accelerated plan it should take 10 years."

The government intends scaling up its ART sites to at least 20 by the end of 2011, with at least one in each of the south's 10 states, and to double the number of people on ART.

"Achieving universal access will be a slow process because of all the difficulties," said WHO's Busulwa, "but there is strong political commitment and the government does want to take ownership of the programmes, so it will eventually happen."

Source:plusnews.org/