Saturday, June 03, 2006

Large Scale Failure

I am ashamed for the delegates at the UN AIDS Conference who refused to identify those at-risk groups simply because these people's lifestyles go against some moral code. That attitude willfully ignores the fact that while Prostitutes, Prisoners, Drug users and Homosexuals are not only most at risk of contracting HIV/AIDS, they are also the largest source of spreading it as well. How can any strategy be expected to work if we sweep this important fact under a rug.

The plan to address the global epidemic needs to be a multi-pronged strategy, not focussing on one or two specific issues involving treatment and prevention:

1) Universal Primary Education. In his book 'Race Against Time' Stephen Lewis noted that in Uganda, the effect of receiving at least a primary education halved the prevalence of HIV/AIDS among young adults to 6%, from 12% among those individuals with no formal education.

2) Front Line Intervention. Those vulnerable groups, particularly prostitutes, need aggressive intervention programs that both teach these people how to practice safe sex or drug use, and works with prostitutes and drug users in particular to escape those dangerous lifestyles.

3) Access to Anti-retroviral drugs. Access has been poor because of roadblocks like tied aid and conditionality, Intellectual Property patent laws, and simple ignorance of how to use them correctly. Countries need the freedom to obtain cheap, safe and reliable ARVs in order to balance National Health and an economy supported by able-bodied citizens. That means cutting the strings of tied aid and addressing the Pharmaceutical Industry's old trick of donating older stocks of ARVs that are near or past their effectiveness dates. At the clinical level, people need to be properly educated on the proper use of ARVs to increase their effectiveness.

4) De-stigmatization. Campaigns at all levels of society need to impress upon everyone how HIV/AIDS is spread and that HIV Positive people can still be safe and productive members of society rather then being made pariahs and outcasts. At any level, we can no longer permit the ignorance to breed the stigma attached to this and other infectious diseases.

5) Finally, Commitment. At these conferences, everyone strives to present the optimistic, generous, appropriately respectful face each state and organization is expected to present, because these conferences have become institutionalized, with the same people arguing the same concepts. It's time to break out of the mould, and if a country is going to commit X amount of dollars, live up to the commitment. A minute handful of the industrialized countries live up to promises like the 0.7% of GDP pledge for international development. It's time to put the money where the mouth is.

Of course, all of these strategies need to take place against a backdrop of success in reaching the Millenium Development Goals, because HIV/AIDS is so woven into every aspect of life, it's impossible to address one without the other.


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