HIV/AIDS and Poverty
The poor have little access to
prevention services such as condoms or any form of treatment.
Only about one in five people at risk for HIV have access
to prevention information and services (19).
Fewer than 5 per cent of people
who need them get anti-retroviral drugs (20).
Action against the epidemic has been impeded by the
slowness of leadership, at all levels, to recognize
and admit the nature of the advancing crisis. The universal
culture of silence that surrounds sexual behaviour has
kept eyes averted and voices silenced.
In June 2001, a UN General Assembly Special Session on AIDS
focused global attention on the crisis. UN Secretary-General Kofi
Annan used an African Summit on HIV/AIDS and Other Infectious
Diseases, convened in Abuja, Nigeria, in April 2001, to issue a call
for action and propose a Global Fund to Fight AIDS, Tuberculosis
and Malaria. The aim of this fund is to increase support for
AIDS and related malaria and tuberculosis programmes in developing
countries from under $2 billion annually to $7-10 billion.
The Global Fund announced its first round of grants for treatment
and prevention in April 2002, awarding a total of $378 million
over two years to 40 programmes in 31 countries. This important
advance also highlights the continuing failure of the international
community to meet the needs of the developing world. Funds contributed
in the first year fell painfully short of the target.
Effective strategies to turn back
the epidemic involve a combination of treatment, education
and prevention. Such strategies must go beyond medicine
and health care and reach into the community. They call
for close consultation with the people they seek to
assist (21). Strong
and committed leadership that leads by example as well
as exhortation is a prime necessity.
The examples of imaginative, courageous local efforts in Senegal,
Thailand and Uganda to mitigate the pandemic provide good
news from around the world. Strong leadership can support and
strengthen such community action.