THE 2013 theme for World AIDS Day is ‘Shared Responsibility: Strengthening Results for an AIDS-Free Generation’.
It is unfortunate that to many people the debate on HIV and AIDS is focused around statistics and reports that say nearly two-thirds of all people living with HIV are found in sub-Saharan Africa, although this region contains only about 10 percent of the world’s population.
While books and books contain facts and information about the effects of the disease on Africa, very little attention is paid to its effects in America.
When it is discussed in America the debate centres on its high prevalence among African Americans despite that they are a minority.
According to figures provided by the Centre for Disease Control, African Americans continue to experience the most severe burden of HIV, compared with other races and ethnicities.
Blacks represent approximately 12 percent of the US population, but accounted for an estimated 44 percent of new HIV infections in 2010.
They also accounted for 44 percent of people living with HIV in 2009.
Since the epidemic began, more than 260 800 blacks with an AIDS diagnosis have died, including an estimated 7 678 in 2010.
Unless the course of the epidemic changes, at some point in their lifetime, an estimated one in 16 black men and one in 32 black women will be diagnosed with HIV infection.
There are several myths surrounding HIV and AIDS, which continue to be propagated, and these are hindering the fight against the disease.
Myth One: AIDS is mostly an African problem.
Fact: Of the 42 million people around the world who live with HIV and AIDS, 70 percent are in sub-Saharan Africa.
But AIDS is not an African problem: HIV and AIDS exist and is spreading in Africa in a socio-economic context created by Western colonialism and, more recently, Western trade and economic policies.
HIV and AIDS continues to spread in the rest of the world, especially in countries or communities within countries where poverty, inequality, and conflict are prevalent.
Eastern Europe and Central Asia have the fastest rates of spread, followed by countries in Asia and the Pacific, the Caribbean, and Latin America.
Myth Two: To stop the spread of HIV, people simply need to give up promiscuous sex and drug use.
Fact: Socio-economic structures around the world constrain many people’s ability to make free choices regarding the behaviours that put them at risk for contracting HIV and AIDS.
Economic insecurity, gender and racial inequalities, labour migration, and armed conflict all limit people’s ability to avoid exposure to the virus.
Myth Three: Money for AIDS in developing countries goes into the pockets of corrupt officials.
Fact: Corruption exists in countries throughout the world.
But it should not slow donor contributions: Individual citizens, groups, the media, and government officials worldwide have shown increasing awareness of and commitment to fighting corruption in recent years.
New international institutions and initiatives, such as the Global Fund to Fight AIDS, TB, and Malaria, have stringent selection and monitoring mechanisms that ensure accountability among funding recipients.
Many countries with long histories of corruption have established successful HIV and AIDS programmes.
Examples include Thailand, Uganda, and Brazil.
Myth Four: The best way to control AIDS in the developing world is through prevention.
Costly treatment should wait until prevention programmes have been fully funded and deployed.
Fact: Prevention and treatment should have equal roles in the fight against HIV and AIDS.
Since wealthy individuals have the chance to prolong and improve their lives with HAART, it contradicts the principles of equity and human rights to allow tens of millions of others to die without treatment.
Countries in which large numbers of working- and parenting-age adults die have suffered and will continue to suffer enormous social and economic losses, from which it will be increasingly difficult to recover.
Efficacy of prevention programmes is limited.
Prevention efforts often clash with a socioeconomic situation that does not allow people to control their exposure to the virus.
Furthermore, even a very successful prevention programme cannot fully stop the spread of the virus in high-prevalence countries.
Prevention and treatment together have a synergistic effect.
Voluntary counselling and testing, a key prevention strategy, is much more successful when tied to a treatment programme for those who test positive.
Myth Five: AIDS treatment in the developing world is impossible because anti-retroviral (ARVs) drugs are too expensive and because developing countries lack the sophisticated infrastructure necessary to deliver the drugs.
In addition, mishandling of ARVs will lead to increased HIV drug resistance.
Fact: ARVs should be a cornerstone in fighting AIDS in the developing world.
Treatment for the poor is no longer prohibitively expensive, due to recent sharp drops in drug prices.
Both generics and cheaper brand names have become available.
The enormous economic costs of no treatment outweigh the costs of treatment.
Evidence shows that treating patients with ARVs can save health systems money.
Relevant infrastructure is actually present in many regions.
The delivery of ARVs can be simplified and modified for resource-poor settings.
New partnerships between resource-poor and resource-rich groups are helping to create infrastructure in places it is lacking.
Drug resistance can be minimised by the creation of locally appropriate guidelines for treatment.
Much of the infrastructure created for national TB programmes can be used to administer ARV therapy.
Myth Six: An HIV vaccine will soon be available, and this will solve the AIDS crisis.
Fact: A vaccine will not solve the AIDS crisis.
While many advances have been made in vaccine research, significant gaps remain in the scientific knowledge needed to develop an effective vaccine. The pace of HIV vaccine research is often slow due to lack of financial incentives to develop such a vaccine.
Lack of coordination among researching groups exacerbates the problem.
Due to the difficulties in creating an effective vaccine, the first vaccines deployed will probably be of low efficacy.
By the time a vaccine has been developed and fully deployed in developing countries, millions and millions of people will have become infected and died of HIV and AIDS if no other steps are taken.
Myth Seven: The pharmaceutical industry’s drive for high profits, together with its political power, means that pricing policies will never change to benefit poor people with AIDS in the developing world.
Fact: ARVs are becoming cheaper in the developing world and can become cheaper still:
Generic versions of ARVs are produced in some countries and are exported to other countries.
The advent of generics has also driven down the prices of branded medications.
History has shown that grassroots movements can influence corporate and government agendas.
Myth Eight: Since resources are limited, officials should concentrate on problems that affect large segments of the population, such as nutrition, clean water, maternal & child health, and immunisations, rather than expensive and complex AIDS treatment that helps only a few.
Fact: AIDS treatment would have far-reaching benefits, since the disease has such devastating social, economic, and general health effects.
AIDS kills primarily young adults in their prime working years; these deaths are devastating to economies.
Agriculture is gravely threatened by HIV and AIDS.
As workers die, food production falls, the nutritional status of the population is undermined, and all aspects of health are affected.
Young children are often left parentless, leading to hunger, poor health, lost educational opportunities, economic and sexual exploitation, and loss of future prospects.
Myth Nine: The AIDS crisis in the developing world has no impact on American interests.
Citizens and politicians have little to gain by fighting the pandemic.
Fact: Halting of the spread of HIV and AIDS will benefit Americans in the areas of public health, the economy, and security.
Ever-increasing tourism, migration, and business travel will transport infectious diseases such as HIV across national boundaries at ever-increasing rates.
TB, made more prevalent and more infectious by HIV and AIDS, will pose a growing threat to Americans.
AIDS reduces profitability of multinational corporations operating in the developing world due to illness-related absenteeism and worker deaths.
AIDS significantly reduces the GDP of countries in many parts of the world, weakens markets, and makes trading partners less reliable.
World economic growth and the American economy suffer as a result.
AIDS destabilises societies and economies in high-prevalence countries, which leads to political instability and collapse.
The CIA has officially designated the global AIDS pandemic as a threat to US national security.
Fighting HIV and AIDS needs a global approach and I for one applaud America for taking a leading role in the fight.
I, however, feel that more could be done by America given that the pandemic is a threat to its national security.
I say less military aid to America’s allies and more towards fighting HIV and AIDS across the globe.