Stop AIDS, Keep the Promise “Lead, Empower & Deliver”

WORLD AIDS DAY, 2008

This year’s World AIDS Day also marks the 20th anniversary of World AIDS Day campaign. Since 1988, the global community living with HIV has committed itself to respond to the HIV/AIDS epidemic globally and collectively using the most effective strategies and investing whatever resources it may require to contain and reverse the epidemic. However, the latest UNAIDS global report indicates clearly that the battle is far from being over in any part of the world. The Executive Director of UNAIDS himself admits, “What really concerns me is that while we’ve made measurable progress on access to treatment, we don’t have the same impact when it comes to HIV prevention. Is it because we need more time, or are we not on the right track?” This is a stark reality that leaders at all levels need to face and deal with.

The theme for 2008 is focused on leadership with a message that leaders at all levels are expected to lead, empower and deliver. Despite much effort to ensure leaders keep their promise to halt the epidemic by investing more resources and focus of addressing larger challenges that contributes to the spread of the epidemic, progress in halting HIV is falling far short of targets. Over 25 million people have been lost to AIDS so far, and more than 4 million people are infected with HIV. This is despite the number of promises by world leaders to provide services to curb the rates of infection and to bring down death rates. Promises are not kept because there is lack of leadership – globally and locally.

World AIDS Days can be a difficult and emotional time when people reflect on the damage that has been done by the epidemic and the lives that have been lost. However, it is also a valuable time to examine the progress that has been made and, more importantly, to focus on the work that is still to be done in halting the spread of the virus, improving access to treatment and health of the people who are affected by it, and in eradicating the stigma and prejudice that are still too often associated with HIV.

At the beginning of the epidemic, HIV was diagnosed in relatively few women and young girls. Today, more than a quarter of a century later, women account for more than half of all new HIV infections. Around the world, about 15.4 million women are living with HIV. Structures and systems that sustain women’s vulnerability such as domestic violence, sexual assaults, rape, human trafficking, early or forced marriage and most importantly denying equal access to choices need to be exposed and challenged, if HIV epidemic amongst women is to be contained.

To make prevention work, it is important that a bold and radical approach to school education and to out-of-school education for young people as well as for older people be initiated through the HIV programmes. That means resources need to be allocated. It means that support and training will be required for teachers, youth workers and community workers. It also means that there must be political courage and a willingness on the part of Government—at national and local level—to challenge entrenched attitudes and not allow resistance to the taking forward of certain radical work on sexual and reproductive health. It certainly means taking on proposals for campaign on stigma and prejudice against those who have HIV, for work to increase testing uptake, and a proper look at primary prevention strategies – even if it may require greater resources. It requires a strategic vision for the future, beyond World AIDS day events.

The figures which get presented on World AIDS Day are always worrying, but the greater concern is the number of people with HIV who do not know that they have the virus. It is estimated that people who are unaware of their own HIV infection could account for between 53 and 70 per cent of all new sexually transmitted HIV infection.

Late diagnosis has implications for the individual’s health. It can lead to diseases such pneumonia, TB heart, liver disease and some cancers. Reports indicate that nearly half of infected people who are diagnosed late show signs of an immune system that has already been compromised and around 7 per cent have an immune function that has been significantly damaged. Around a quarter of the HIV deaths that occur each year could be avoided through earlier access to diagnosis and treatment.

The stigma that world AIDS day seeks to remove is part of the problem of late diagnosis. People are unwilling to get tested because of the fear of others finding out or because of the stigma. The delay in diagnosis can have a devastating effect on their health and the health of others. A new campaign is desperately needed—not the old poster or banner campaign—that will raise awareness and increase the level of information that people can access.

Guest Editorial by Neichü Angami on the occasion of World AIDS Day