HP+ Engages Mali Government, Obtains Signature to Dakar Declaration
Update: In March 2018, an implementation roadmap to the Dakar Declaration was finalized and disseminated.
December 13, 2016
On December 9, 2016, Mali became one of the final ECOWAS (Economic Community of West Africa) countries to sign the Dakar Declaration on Factoring Key Populations in the Response to HIV and AIDS. Madame Dr Marie Madeleine Togo, Mali’s minister of health and public hygiene, signed the Declaration, formally engaging her country in the regional movement to improve access to and use of HIV and AIDS services by key populations. HP+ had been working with the Ministry of Health and Public Hygiene and the National High Council to Fight against AIDS (HCNLS) for several months to obtain a signature on the Declaration.
Efforts related to the Dakar Declaration date to a consultation held in Dakar, Senegal in April 2015. The meeting, hosted by the West African Health Organization (WAHO), USAID, and PEPFAR, convened ministers of health and justice, heads of national AIDS commissions, public prosecutors and inspector generals of police, technical experts, and members of civil society. Attendees developed the Declaration and outlined how ECOWAS member countries would work to increase access to and use of HIV and AIDS services for key populations, and pursue policies toward those ends.
Mali’s endorsement now clears the path for HP+ to work with Malian government and civil society stakeholders to develop a roadmap for the country to advance the expectations outlined in the Declaration. The HP+ team will work closely with the HCNLS to develop this roadmap, along with Malian human rights-focused associations and those focused on people living with HIV and AIDS.
In Mali, the HIV prevalence among men who have sex with men is 17 percent, compared with a prevalence of 1.3 percent among adults ages 15–49. Many of these men are married (about 50%), due to social stigma around homosexuality, and thus their wives are also at risk for exposure to HIV. The strong stigma these men experience leads to delays in care-seeking behavior, and providers do not know how to address them or treat their health needs—an issue similar to that faced by commercial sex workers. In addition, men who have sex with men are not well-represented in committees or technical working groups (such as the Global Fund Country Coordinating Committee), where they could assist in making decisions about services for key population groups. Mobilizing resources to address the needs of key populations is also complicated by the stigma around their behaviors.
Following the April 2015 consultation, the Declaration was prepared and signed by most ECOWAS countries. Specific components include reducing stigma, enhancing community service provision, building the capacity of health sector actors serving key populations, improving data collection and use, and engaging in continuous advocacy for the rights of key populations.