9. The human tragedy of AIDS

The death toll continues to overwhelm

In a little over two decades that have elapsed since AIDS was first diagnosed, the disease has killed more than 20 million people worldwide. Three-quarters of them lived in sub-Saharan Africa, a region in which nearly one in 10 people--mostly women--now carry the HIV virus.

The misery and suffering that AIDS has inflicted on families and communities are just part of the story. On a regional scale, the disease has undermined whole demographic structures. Unlike most diseases, which tend to single out the very young and the old, AIDS has struck people in the prime of their lives. In practical terms, this means mothers, fathers, teachers and farmers--the very individuals on whom developing countries depend in order to lift them out of the poverty trap.

Africa is the epicentre of the AIDS disaster. But it is also the crucible in which a number of successful policies have been formulated for tackling the disease. Nations like Uganda and Senegal have reduced their HIV infection rate substantially partly because they intervened at a relatively early stage in the epidemic.

Unfortunately, positive progress is still the exception rather than the rule. Scarce resources are being wrongly directed, while drug patents are keeping the cost of treatment far beyond the reach of most sufferers.

According to the International Monetary Fund, children who lose a parent to AIDS in rural Tanzania are 50 per cent more likely to suffer malnutrition than those who are supported by both parents. And studies in Latin America have shown that children who are orphaned by AIDS are much less likely to continue attending school.

Figures like these highlight the connection that exists between AIDS and poverty. This, in turn, means that a growing case can be made for targeting international financial assistance towards AIDS prevention efforts.

Here too, though, there is still some way to go. The Poverty Reduction Strategy Papers (PRSPs) that are being drawn up by developing countries in order to qualify for funding under the Heavily Indebted Poor Countries initiative represent a powerful lever for pulling funds into AIDS prevention programs. However, a review of the first 25 PRSPs by the Joint United Nations Programme on HIV/AIDS (UNAIDS) concluded that they did not adequately reflect the link between AIDS and poverty, nor set out in any detail what policies might be put in place in the short and medium term to stem the rising tide of HIV infection.

To compound the difficulties, AIDS carries a stigma--not only in developing countries but worldwide--which can cause policy-makers simply to turn their back on the problem.

Though the development of AIDS drugs is a sophisticated science, most of the weapons available for halting the spread of the disease are low-tech. The real failure of the last 10 years has been a lack of commitment by national leaders, too many of whom have chosen to look the other way.