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CLIMATE At the end of 2015, the internation- al climate negotiations in Paris will reach a crucial stage. The countries that are already feeling the effects of climate change will be looking to France with real expectations. Which countries are they? How are their gov- PREVIEW akzente issue 3/15 ernments and citizens adapting to the changed environmental conditions? And what signals and specific political steps can they expect from the summit in Paris? An- swers to these and other questions will be provided in akzente 3/15. Publisher: Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) GmbH Registered offices: Bonn and Eschborn • Friedrich-Ebert-Allee 40, 53113 Bonn, Germany Tel.: +49 228 44 60-0, Fax: +49 228 44 60-17 66 • Dag-Hammarskjöld-Weg 1-5, 65760 Eschborn, Germany Tel.: +49 61 96 79-0, Fax: +49 61 96 79-11 15 Dorothee Hutter, Director of Corporate Communications Email: akzente@giz.de Internet: www.giz.de/en/mediacenter/akzente.html Responsible: Anja Tomic, Deputy Director of Corporate Communications (GIZ) Content concept and editing: GIZ: Heidi Beha/Miriam Droller (editors), Kerstin Nauth, Jenny Fuhrmann Frankfurter Societäts-Medien GmbH: Helen Sibum (project management), Friederike Bauer, Judith Reker, Oliver Hick-Schulz (layout), Corinna Potthoff (photo editing) English translation: Jodie McGilvary, Laura Ball, Hillary Crowe, Alan Seaton, Gill Lester; Karl Stellrecht (GIZ Language Services) Proofreading: textschrittmacher, Lübeck, Germany Graphic design/lithography: Frankfurter Societäts- Medien GmbH, Frankfurt, Germany Printed by: Wolf-Ingelheim, Ingelheim, Germany Printed on: Arctic Volume, certified to FSC standards Maps: GIZ/Ira Olaleye The maps are for information purposes only and do not constitute recognition under international law of boundaries and territories. GIZ does not guarantee in any way the current status, accuracy or complete- ness of the maps. All liability for any loss or damage arising directly or indirectly out of their use is excluded. Cover: Getty Images/Michael Hall All images: GIZ unless otherwise stated Copy deadline for this issue: April 2015 Published: Quarterly Current issue: May 2015 ISSN: 0945-4497 Articles by individual authors do not necessarily reflect the opinions of the publisher. akzente was honoured with a Gold and a Silver Fox Award 2014. AKZENTE PHotos:ThierryGouegnon(page46),GettyImages/Picardo(page47) 47akzente 2/15 Project: HEALTH CARE AND THE FIGHT AGAINST HIV/AIDS IN RWANDA Commissioned by: German Federal Ministry for Economic Cooperation and Development Term: 2004 to 2013 SUSTAINABILITY A look back at a project and its results THEN The civil war and 1994 genocide left Rwanda’s economy and society in a disastrous state, which in turn impacted on the health care sector. Since many people had fled the violent con- flicts, there was a lack of administrative and medical staff. Infant, child and maternal mortality rates were high, and diseases such as malaria were wide- spread. HIV prevalence exceeded 4% in 2001. There was no comprehensive health insurance, and poorer families in particular ran the risk of losing their livelihoods through the high cost of treatment. NOW Access to health care services has significantly improved. A solidarity- based health financing system means that poorer families can also re- ceive vital treatments and therapies. Over 90% of the population now have health insurance. Between 2005 and 2015, infant mortality decreased from 86 to 28 births per 1,000, while maternal mortality fell from 750 to 325 births in every 100,000. Malaria is now less common than illnesses such as the flu and measles. HIV prevalence has dropped to below 3%, and the number of new AIDS infections fell by more than half between 2001 and 2011. www.giz.de/rwanda Tel.: +492284460-0, Fax: +492284460-1766 Tel.: +49619679-0, Fax: +49619679-1115