Rwanda, Monday For a decade, Beata Uwitije never slept in her own bed at home. It was always a police cell, an alleyway, a bar or one of her client’s homes. But the 37-year-old Rwandan ex-prostitute has made a new start in a village project that aims to re-integrate former sex workers into communities by teaching them other livelihoods. Thanks to the World Bank-funded project in Muhanga, she now earns an income from handicrafts, farming and pig keeping. Ms Uwitije has Aids, her 16-year-old daughter Monique is also a former prostitute, and they need all the help they can get. “Maybe I am the one to blame, maybe my daughter learned from me ... maybe I was a terrible example to my children,” Uwitije says in a faint voice, tears forming in her eyes. Strapped to her back she carries her nine-month-old granddaughter – Monique’s child. A report launched by the World Bank last week hailed Rwanda for taking huge steps to combat HIV and reducing the prevalence rate to about 3 per cent today from 11 percent seven years ago. At the weekend, the tiny central African country hosted some 1,500 delegates attending an HIV/Aids summit where participants shared best experiences in the fight against the disease afflicting more than 25 million Africans. On Saturday, the emphasis was on prevention. Globally, for every one person who starts on antiretroviral therapy today, another six become infected with HIV,” Michel Sibide, deputy executive director of UNAids told the gathering. “If we do not act now to make HIV prevention work better, the queues for HIV treatment will just get longer and responding to Aids will get more expensive and more difficult.” The continent faces a mixed pattern with east and west Africa showing remarkable declines in recent years, but southern Africa remains the epicentre of the pandemic. “The reason behind this is circumcision,” says Mr David Wilson, senior monitoring and evaluation specialist at the World Bank. Male circumcision can help reduce the risk of infection. It is rare in southern Africa, mixed in east Africa and almost uniform in western Africa, Wilson says. Southern Africa has also not done as well as eastern Africa in overcoming the stigma surrounding HIV, he says. Increasing access to life-saving antiretroviral drugs (ARVs) is good news for many in Africa, but some experts caution the pandemic is in danger of being viewed as chronic but manageable. “Treatment has made us complacent and so what we need to do is redouble prevention efforts and make people aware treatment is only a partial solution,” Wilson says. In Muhanga, where Uwitije and her family try to make ends meet, Uwitije says she would be dead already without her ARVs. But she does not want to talk about her health of her teenage daughter, the mother of her grandchild. “Don’t ask me anything about her status,” Uwitije says, tears rolling down her cheeks. “I don’t want to say anything.” The pace of the Aids epidemic is slowing in Africa as communities are empowered to help themselves in tandem with better delivery of condoms and live-saving treatments, the World Bank says in a new report. Launched in Kigali, the study noted a marked increase in access to HIV prevention, care and treatment programmes on a continent where the disease killed more than two million people last year. Another 25 million became infected. “Aids stole into Africa like a thief in the night,” Joy Phumaphi, a former Botswana health minister and senior World Bank official, said in a statement. “All these years later, we still must stay vigilant ... even when it seems that infections are starting to fall and more people are being saved with treatment.” The World Bank report said the epidemic was showing signs of slowing in Uganda, Kenya and Zimbabwe, as well as in urban Ethiopia, Rwanda, Burundi, Malawi and Zambia. “The mobilisation of empowered ‘grassroots’ communities, along with delivering condoms and life-saving treatments, are beginning to slow the pace of the ... epidemic,” the study said, without giving specific statistics for the decrease. Southern Africa, however, remains the epicentre of the disease with unprecedented infection rates, the report added. One recent household survey in Botswana’s second biggest city, Francistown, showed a staggering 70 per cent of women aged 30-34 and men aged 40-44 carried the HIV virus, it said. The study assesses the results of the bank’s six-year, $1.28 billion Multi-Country HIV/Aids Programme (MAP), set up in 2000 to increase access to prevention, care and treatment plans. The scheme tested almost seven million people in 25 countries, distributed nearly 1.3 billion condoms and set up some 1,500 new counselling centres, among other activities. It also financed civil society and youth groups and organisations for people living with HIV, as well as paying for anti-retroviral treatment for 26,699 people in 27 countries. Global funding for HIV has more than quadrupled between 2001 and 2005 to over $8 billion a year, the Bank said. Last week, at the G8 summit in Germany, leaders announced a $60 billion commitment to fight the disease in Africa, although critics said the promised funding did not come with timelines. But the Bank said HIV and Aids would remain an enormous economic, social and human challenge to sub-Saharan Africa for the foreseeable future. “In sum, HIV/Aids threatens the development goals in the region unlike anywhere else in the world,” it said. Reute | 
