Rob Trask writes from Malawi:

Things got serious today. We started early with an 8am meeting with Edith Mkawa, the Secretary for Nutrition, HIV & AIDS. President Joyce Banda (now the most powerful woman in Africa according to Forbes) has given the Malawian government a reshuffle since succeeding President Bingu wa Mutharika in office, and one part of this means more women in more senior positions. The Department for Nutrition, HIV & AIDS is no exception.

With new leadership comes a new strategy: Edith Mkawa intends to engage all of the parties interested in the HIV/AIDS agenda in a multi-sectoral response. This means NGOs (such as Progressio), faith organisations and government, all sitting around one table and working collaboratively to prevent the spread of the HIV infection; provide access for people living with HIV; and mitigating the stigma and discrimination that exists. The Secretary emphasised the influence that the department has in top level meetings, meaning that HIV/AIDS discussions are being considered in the highest echelons of government. I probed the subject of legislative change and statutory protection against discrimination, but perhaps this is a case of one step at a time.

The HIV prevalence rate in the adult population in Malawi has fallen from a high of 16% to around 11%, where things have now stabilised. One question that I'm interested in exploring further is whether the discrimination of people living with HIV has also fallen? I'm hoping our field trip later in the week to communities in Mzuzu, a few hours drive north of here, will help answer this question.

Next was a meeting with MACRO. Wellington, the Executive Director was kind enough to give us some of his time and explain the outreach and counselling programmes that the NGO championed. Crippled by financial limitations the counselling sessions are too often oversubscribed (too few counsellors and too many people living with HIV). I guess to even out this equation there needs to be both investment in support for people living with HIV, and in prevention. Although you can't help but feel that it is ultimately the prevention which will break the cycle.

MACRO's outreach programmes are instrumental in getting the antiretroviral drugs (the essential treatment) to those rural communities that are not within walking distance of a hospital or medical centre. To the credit of the ICS volunteers, this was one of the issues that they highlighted to me during our conversations yesterday - that the remote areas lack the accessibility to treatments.

Malawi is a religious country, the vast majority of people are Christian or if not Muslim (there are only a handful of atheists). Both the Department for Nutrition, HIV & AID and MACRO emphasised the positive role that faith communities can play. Both in the prevention effort and in offering support to those living with HIV. We are scheduled to meet with the Malawi Interfaith AIDS Association (MIAA) later in the week, who represent a cross section of different faith groups, and their collaborative response to HIV/AIDS, so I'll give you an update on this then.

Rob Trask is a finalist in the Guardian International Development Journalism Competition and is visiting Malawi with Progressio to write about the role of faith in responding to HIV.

Photo: Rob (right) and Progressio's Lis Martin (second from left) with Edith Mkawa (Secretary for Nutrition, HIV & AIDS) and (left) Humphrey A. J. Mdyetseni (Deputy Director of Planning, Research and Evaluation).


indeed HIV&AIDS is an issue here in malawi most of people are dying mostly in lake shores women are exchanging sex for fish and again in Mzimba the percentage is high for man living the country and starts working in South Africa leaving their wife suffering behind.

Hi Joeland, thanks for your comment.

It seems to me that whatever angle you look at the HIV/AIDS debate, the driver is always poverty. Be that women selling sex in exchange for food or men leaving their wives to find work.

Yours is a truly remarkable country and I really hope that it can find solutions to these tragic problems.