Distinguished ladies and gentlemen, I would like to thank the National AIDS Council and the Ministry of Health for inviting me to the commemoration of the National Voluntary and Counselling Testing Day. Indeed, the theme of “know your status to access care and support” is apt as HIV counselling & testing is truly the gateway to HIV prevention, treatment, care and support.

We know that AIDS is one of the leading cause of death in the region and that every effort should be made to reduce the spread of HIV but we also need to acknowledge that this will not be possible unless we step up very significantly our prevention efforts and also sustain, and in line with our commitment to universal access, expand our treatment programmes, we will not be able to do this unless people know their HIV status.  It is sad that in Zambia today, only about 13% know their HIV status.

Allow me to highlight some of the benefits of VCT:

• I would also like to emphasis the benefit of couples counselling and testing.   It has also been shown that HIV Couples Counseling and Testing decreases the transmission of HIV by more than 60% within discordant couples and reduces sexually transmitted infections and unplanned pregnancies in all couples.   Additionally, couple counseling and testing, if carried out correctly, can further directly increase gender equity in HIV and AIDS programs by promoting the testing of men and women together, which innately increases male involvement; and can potentially reduce post-test violence.  Gender based violence is one of the major impediments to VCT for women.  It becomes a real issue if VCT leads to rejection and possible loss of livelihood

•  Knowing one’s HIV status allows the individual to take action to protect themselves against infection if negative or take action to access services if positive. 
• Whatever one’s status, critical decisions need to be taken to ensure maximum benefit from available services.
• Secondly, VCT is truly a gateway to meeting a host of favourable outcomes and the attainment of the MDGs:-

(a)    Zambia with the rest of the world is committed to the attainment of MDGs on the reduction of maternal and child deaths by 2015.  These will not be achieved unless a serious dent is made to AIDS.  We know that a large proportion of maternal and infant deaths are due to AIDS.   AIDS also leads to an increased rate of stillbirths and deaths in the neonatal period and infancy.  It is therefore important that VCT is integrated into existing maternal and child health services.
(b)    VCT is critical in the reduction of mother to child transmission of HIV or indeed the virtual elimination of mother to child transmission.  I would like to echo the words of Michel Sidibe who said “It is not acceptable that each day 350,000 babies are born with HIV in Africa when this has been virtually eliminated in North America and Europe”.  I might also add that in Botswana, the PMTCT services have managed to bring down the number of babies born with HIV to under 4%.  This can only be achieved if people know their status so that they can access services, not just for a healthy HIV negative baby but for women themselves to access a full range of reproductive health services for their own health benefit and that of their families and communities.  The elimination of mother to child transmission is therefore attainable and we have the means at our disposal to do so.  We have the knowledge, best practices and funds to do so.

Allow me to highlight some significant milestones in HIV prevention, treatment, care and support in Zambia. There has been a drop in HIV prevalence from 16% in 2001 to the current 14.3% . Furthermore, the coverage of the ART programme increased from 32.9% in 2006 to 70% in June 2009; this in addition to the increase in HIV positive pregnant mothers that were receiving anti-retroviral prophylaxis from 29.7% in 2006 to 50% in June 2009. Finally, the 2009 level of new childhood infections represented a 57% reduction of the peak level of new infections in children in 1996.

These achievements would not have been possible without high level political commitment from government, the tireless efforts of civil society organisations and communities, and the support of cooperating partners, foundations, advocates and others.

However, clearly many challenges remain in increasing VCT uptake, and harnessing its potential to increase coverage of services in HIV prevention, treatment, care and support.   While over 1500 VCT sites were established nationwide, only 15% of women and men aged 15-49 received a test in the last 12 months and know their results.   In other words, 85% of Zambians do not know their status.

Challenges to VCT uptake, are varied and systemic, and include limited physical space at counselling sites; continued stigma and discrimination; threat of violence; and system wide human resource challenges, which included the high attrition rate for counselling and testing counsellors. Other challenges include the insufficient coordination of test kit procurement and distribution; the poor distribution of facilities offering CT services, and  inadequate funding and implementation of the quality control programme for rapid testing.

Regarding, the elimination of mother to child transmission of HIV: by the end 2008, 936 Antenatal facilities offered PMTCT services . However, as was noted at Zambia’s first ever prevention convention, the quality of PMTCT services remains a concern: Among  162 ANC clinics offering PMTCT services in 9 districts assessed in 2008, only 6.2% had all basic elements of infrastructure, staff, guidelines, equipment, supplies and registers available in order to offer quality services.
 
We need to continue to strengthen the voluntary counselling and testing component of the overall national strategy and to further stress the elimination of mother to child transmission of HIV within this strategy. This is an ambitious but achievable target that can help ensure the survival of mothers through the provision of basic sexual and reproductive health services, and the promotion of linkages with and referrals to antenatal care, maternal and child health and a full sexual and reproductive health package.

Before I conclude my remarks, I would like to acknowledge and commend the incredible work of Civil Society Organizations, in particular networks of people living with HIV, who continue to ensure that treatment remains a reality for many, and further remind us of the urgency of connecting HIV positive people to prevention, treatment, care and support.

In addition, I wish to commend the important role that development partners continue to play in partnering with the government and citizens of Zambia in tackling HIV.  Finally, on behalf of my colleagues from the UN family, I would like to reaffirm UNAIDS and the co sponsors commitment to supporting countries including Zambia to achieve Universal Access. This is in line, with Michel’s Sidibe’s, the UNAIDS Executive Director’s recent call for the renewal of the Political Declaration of Commitment made by the UN General Assembly in 2006 at the just ended UNAIDS Programme Coordinating Board meeting. A renewal which extends the global commitment and mandate to achieve universal access to 2015—bringing it in line with the MDG deadline: as he notes, “this way we can ensure that one of the MDG targets—to achieve universal access for all—is linked to and reinforced by the other MDGs. This will enable countries to maintain their momentum in reaching and reporting on universal access through 2015.”

Finally, on this National VCT Day, I would like to appeal to all of us to know our status, take advantage of service and I end with a special appeal to men to be supportive of their partners and there is no better way to demonstrate this than through counselling and testing together.  The Youths must also seriously consider VCT and in this regard, there is need for us to create youth friendly VCT and sexual reproductive health facilities.

Thank you.