DHULIKHEL DECLARATION

Between, March 11-14 over 300 delegates convened in Dhulikhel for the First National Congress of PLHAs in Nepal. The delegates represented over 56 districts and more than 100 community based organizations led by people living with HIV/AIDS.

Regrettably, no government representatives attended, despite extensive efforts to invite them.

The Congress met against the background of Nepal’s growing HIV epidemic. Officially, over 10,000 Nepalese live with HIV, of which a vast majority of them are poor and marginalized and are in dire need of support. Poverty and low literacy are some of the key factors that is fueling this epidemic in an unprecedented manner globally. Without the implementation of more effective programmes, the current public health system will collapse and fail.

Despite the rapid increasing trend in infection, Nepal has made some progress since our last Consultation in 2005. Today there are over 1500 people on ARV treatment, over 100 CBOs are established and run by people living with HIV/AIDS employing more than 600 PLHAs and serving over 5000 members. While this marks substantial progress – shown by the fact that at the last PLHA consultation there were less than 200 people on ARVs and only a handful of CBOs in existence – it is still not enough. People are still dying due to lack of ARV treatment while the drugs expire in the shelves in Kathmandu . Livelihood support for PLHAs is non-existent, discrimination towards PLHAs are often reported and the mother-to-child transmission prevention programme remains sub-optimal and the coverage of the programs are undeniably low and disproportionate.

The greatest challenge yet is AIDS denialism at the political level and discrimination at the policy level. For instance viral load testing is essential within 3 months of starting ARV treatment to determine treatment success. However the government is not ready to share the existing viral load machine with PLHAs that was procured for Avian Flu – if it occurs in Nepal. Unless and until the highest political leaderships publicly accept the facts about the HIV epidemic and demonstrates firm leadership over the matter, treatment and prevention will remain sub-optimal, and millions will suffer the consequences.

The First National Congress of PLHAs was rich in discussion and debates. It highlighted the enormous challenges faced by PLHAs across the country and the struggle for HIV prevention and treatment. Our members have drawn up numerous resolutions and are committed to intensifying our current efforts. We have agreed to use our networks to mobilise people to advocate for the improvement of health-care services, speedier rollout of ARVs, better access to medicines for opportunistic infections, food security through livelihood support programs and properly implemented basic services.

The National Congress pledged to prioritize women and children’s issues and women’s leadership in the context of HIV/AIDS. The congress also commits to building stronger leadership among people living with AIDS within the organization.

Resolutions

1. Adoption of the Executive board for 2008 – 2010

A 13 member executive board was elected through a democratic, transparent and documented process.

Mr. Rajiv Kafle and Mr. Basanta Chetteri were unanimously elected as the President and General Secretary for a second term in office.

New Board Members

Mr. Rajiv Kafle, "President"
Ms. Mathura Devi Kunwar (Far Western Region), "Vice President"
Mr. Basanta , "General Secretary"
Ms. Muna Sherchan (Western Region), "Secretary"
Ms. Natisa Rai (Central Region), "Treasurer"

Members

Mr. Krishna Gurung (Eastern Region)
Ms. Preeti Subba (Eastern Region)
Mr. Dipen Pokhrel (Central Region)
Mr. Suresh Lama (Western Region)
Ms. Chitra Pun (Mid Western Region)
Mr. Tilak Khadka (Mid Western Region)
Ms. Chandra B.K. (Mid Western Region)
Mr. Jagat Bhandari (Far Western Region)

2. Adoption of the National Advocacy Agendas for 2008 – 2010
Treatment and Care:
a. Ensure continuation and rapid scale up of VCT, diagnostic, treatment and care programs up-to district levels
b. Ensure continuation and scaling up of support to community based organizations led by PLHAs through the challenge fund model.

Meaningful Involvement:

a. Ensure participation of PLHAs at the constituent assembly and respectful involvement of PLHAs upto District AIDS Coordination Committees and all policy level bodies
b. Enforce guideline ensuring organizations working in AIDS to employ HIV positive staff in meaningful positions
Livelihood Support and microfinance:
a. Ensure the creation of a government funding scheme for HIV positive women and AIDS orphans
b. Ensure skill development, micro-financing and income generation activities specially focused on PLHAs

Express our sincere thanks to all external development partners

We would like to thank all bi-lateral and multilateral donors and technical support agencies for their unparalled commitment and support to the people living with HIV/AIDS in Nepal. We would specially like to thank Department for International Development (DFID), United Nations Development Program (UNDP) and The Global Fund to Fight AIDS, TB and Malaria (GFATM) for their support on mobilizing resources to community based organization across the country through the challenge fund model. We would also call upon the donors to continue funding such innovative and successful programs.

Thank You