Going somewhere slowly? An assessment of the pace of local government HIV/AIDs multisectoral responses in African cities

Abstract

Sub-Saharan African (SSA) countries have the highest rates of HIV prevalence in the world accounting for an estimated 71% of all new infections (UNAIDS 2010). HIV prevalence is greatest in urban informal areas, caused largely by the proliferation of a variety of risk environments that facilitate the rapid spread of HIV/AIDS. As a strategic response to the complex nature of the HIV/AIDs epidemic in urban areas, decentralised multisectoral HIV/AIDs responses at the local government level have been adopted. These are seen as a sustainable way of dealing with the spread of HIV/AIDs in a number of African cities, in line with internationally accepted recommendations. Now that a number of local governments in African cities have adopted HIV/AIDS multisectoral responses, the question can be asked to what degree is this is this response being implemented in these countries, and what challenges are faced by cities as they adopt this approach? This article reviews HIV/AIDS multisectoral responses in African cities, and discusses the challenges that face urban local governments as they implement these responses.