Country situational analysis [1]

The AIDS epidemic in Mauritius started in 1987 when the first HIV‐positive was detected. The progression was thereafter stable until 2000 when the number of new infections increased by 100%. This increase in annual HIV incidence has continued until 2005 when the epidemic seached a plateau.

Parallel to the exponential rise in the number of new HIV infections there has been a significant shift in the reported mode of transmission of HIV from heterosexual to Injecting Drug Users. In 2000 only 2% of the new HIV infections were among injecting drug users, this increased to 14% in 2002, 66% in 2003, and by 2005, 92% of all new infections were injecting drug users. The number of new infections amongst injecting drug users declined in 2006 to 85.9% and 73% over the last two years. The corresponding decline in the number of injecting drug users means that there is an increase in new infections through heterosexual sex. This permeation into the general population is confirmed by the increase in HIV prevalence among pregnant women (from 0.1% in 2004 to 0.48% in 2088 and 0.40% in 2009), thus increasing incidence amongst newborns.

Whereas in 2002 injecting drug use accounted for 14% of all new HIV infections in Mauritius, this percentage increased dramatically to 92% in 2005. Among detected cases as at December 2009, 73% of positive cases are among injecting drug users [2].

According to the 2010 UNAIDS Report on the global AIDS epidemic, there were 8,800 people living with HIV at the end of 2009. There were 652 people on antiretroviral treatment in the same period, which is equivalent to 22% of all people in need. In the same period, the were 41 HIV positive pregnant women receiveing antiretroviral treatment to prevent mother-to-child transmission of HIV.

Key elements of the national response

The AIDS Control Programme (NACP) was established in 1987 shortly after the first AIDS case was recorded. In 2001 the first National HIV/AIDS Strategic Plan was launched with broad participation from government ministries, civil society, NGOs and the private sector.

The Government of Mauritius has demonstrated strong support to the national response to HIV. The main elements of the national response to HIV in Mauritius are:

• Prevention of HIV among the general population and in key populations at higher risk
• A multi-sectoral national drug control masterplan for 2007-2009 which integrates a national HIV prevention strategy.
• An HIV and AIDS Act that ensures the protection of human rights for people living with HIV
• Expansion of HIV Testing and Counseling services
• A wide condom distribution network in the urban and rural areas
• Provision of free antiretroviral treatment
• An Action Plan for Treatment, Care and support of people living with HIV

Key achievements

• Development of the Action Plan for HIV Prevention among injecting drug users and commercial sex workers for 2003-2008.
• Launch of Action Plan for treatment, care and support to people living with HIV in 2006
• Set up of the Methadone Substitution Therapy Program at the National Detoxificaton Centre in Beau-Bassin in November 2006.
• Launch of the HIV and AIDS Act in December 2006 which guarantees the protection of fundamental human rights of people living with HIV
• Launch of a National multisectoral HIV and AIDS Communication Plan
• Set up of a National AIDS Coordinating Authority with a broad-based multisectoral mandate
• Finalisation of a National Monitoring & Evaluation Plan to ensure the constant monitoring and periodic evaluation of the National Strategic Plan
• Provision of free antiretroviral therapy was made available since April 2002
• Launch of the Needle Exchange Program in 2006
• Launch of the National Multisectoral HIV and AIDS Strategic Framework for 2007-2011 in 2007

Key challenges

• Baseline data on vulnerable children and a clear definition of street children in the Mauritian context so as to be able to design appropriate prevention strategies targeting children at high risk and out of school children in particular including street children.
• No integral data on HIV deaths.
• Low uptake of services and low adherence to antiretroviral therapy still constitutes a major challenge in the management of people living with HIV.
• To reach a 100% uptake of prevention of mother-to-child transmission of HIV protocol by HIV positive pregnant mothers.
• Inadequate psychosocial support to people living with HIV and injecting drug users on MST And NEP
• There are still a limited number of surveys and surveillance data and this constitute major barriers in reporting: funding for iterative surveys is a major limiting factor and still needs international collaboration
• The setting up of a functional surveillance system
• Minimal participation of workplace and business sector in the fight against HIV and AIDS
• Need for capacity building of all partners involved in the fight against HIV have been highlighted, especially technical know‐how to capture funding for the NGOs.
• A functional national M&E System with optimal use of designed tools by both government and civil society organisation partners
• Life skills education in school not yet well defined and catered for mostly by other Ministries and NGOs
• Post‐test counseling and giving negative tests results is still a challenge in some cases.
• Public and Private medical sector involvement should be reinforced specially for the PMTCT protocol.
• Stigma and discrimination still present.
• Rodrigues and outer island‐ Capacity building for implementation of programme and M&E still needed
• Written policies for all HIV issues to help remain focused

Useful links

• National Strategic Plan
• National AIDS Committee
• 2010 UNGASS Report

Contacts

UNAIDS Country Office
Galaxy Andraharo, Bâtiment Ariane V, BP 1348
+261 20 23 366 32
+261 20 23 641 84

NACP Secreteriat
Prime Minsters Office 4th Floor Cernee House La Chausee Street Port Louis - Mauritius Tel: + 00230 213 8328 Email: nas@mail.gov.mu

_______________________________________________________________________________________________________________________________________________

1. All epidemiological data comes from the country's 2010 UNGASS report, unless otherwise stated.
2. HIV Sentinel Surveiilance, AIDS Unit, MOH &QL