Winning the Fight Against Aids?

[Guest guest]

allAfrica.com

GUEST COLUMN

1 December 2008

Posted to the web 1 December 2008

By Katito

The global fight against Aids is not a losing battle – at least not

entirely. On the positive side, more money is being ploughed into

combating the disease: last year, global investment into HIV/Aids

programmes was six times the amount in 2001.

More countries have a firmer grasp of the extent of the epidemic - in

2004 only 102 countries maintained consistent records, whereas in

2008 45 more have better, more rigorous information about the

epidemic.

More encouragingly, since 2000 the percentage of people living with

HIV has stabilised. In several countries, the rate of new HIV

infections has steadily declined, according to UNAIDS, a United

Nations programme tasked with tracking the spread and prevention of

HIV/Aids globally.

Other encouraging trends are that more people have access to Aids

treatment and are better informed and equipped to prevent

transmission, according to a report released earlier this year by

UNAIDS.

However, the significance of this modest evidence of progress should

not be taken for granted. Increased investment in treatment and

prevention suggests that there is an increasing sense of urgency, and

political will, to tackle the epidemic. Secondly, a global reduction

in infection rates suggests that much needed behavioural changes

among vulnerable groups might be taking place, and that there is

reason to be optimistic that the trend may continue. Lastly, progress

made thus far testifies to the increasing power and value of civil

society globally, given that the drive to fight Aids has been in

large part fuelled by networks of hardy and persistent activists.

Nonetheless, while there has been progress globally, sub-Saharan

Africa remains the epicentre of the disease, with 22 million of an

estimated 33 million Aids-infections worldwide. While the rest of the

world makes progress, the region strains not only to combat the

disease but also to contend with growing numbers of Aids orphans (75

percent of children that have lost parents to the disease live in the

region) and other knock-on effects, foremost among them decreased

economic productivity and social disintegration.

The battle against the epidemic remains fierce and formidable in the

region and will require a continuation of existing tactics as well as

access to prevention and contraception, investment in treatment and

other more generic strategies such as counselling and education.

A set of strategies aimed at tackling the psychological and cultural

factors that fuel the spread of the disease in the region is

necessary and equally important.

It remains permissible, and even commendable, for men to have

multiple sexual partners, despite the tremendous risk that this

presents. This and other similar perceptions shaped by cultural

beliefs substantially increase the likelihood of men engaging in

risky sexual behaviour by as much as three times, according to a

UNAIDS study in Botswana among other countries in the region.

Cultural and religious perceptions have also contributed to the

deafening silence on the uncomfortable social behaviour that

contributes to the spread of the disease. The role of commercial sex

workers and men who have sex with men in the spread of the disease

remain little-acknowledged issues that should be candidly discussed

and boldly tackled. More importantly, the lack of frank discussion,

research and policy on these taboo issues stifles the prospect of

developing comprehensive and relevant solutions to the epidemic.

Granted, changing entire cultures and deeply entrenched psychological

beliefs is a formidable and difficult task. However, sub-Saharan

Africa's political leaders have a critical role to play in shaping

the psychological beliefs that help sustain the epidemic. More

pointedly, these leaders have the ability – and the imperative - to

create policies that can forcefully re-shape those beliefs that

sustain the epidemic.

In several African countries, policies to protect and promote the

rights of groups vulnerable to the disease, including commercial sex

workers, do not exist. Yet, if meaningful headway is to be made in

the fight against Aids, vulnerable groups need the full protection of

the law and equal access rights to services and legal recourse should

they face discrimination. This is particularly critical to helping

boost the confidence of these 'at-risk' groups in seeking early

testing and prompt treatment. Granting these groups the right to

raise awareness of little-known aspects of the nature of Aids without

the fear of recrimination could also significantly alter how the

epidemic is understood, and perhaps help shape better-informed sexual

choices.

As the fight against Aids shows signs of progress globally, it is

critical for the sub-Saharan Africa - the region showing the least

progress - to build on current successes in increasing awareness and

access to treatment. And African leaders must face the crucial

challenge of confronting a regional fear of questioning uncomfortable

cultural beliefs. These leaders have the ultimate responsibility of

making laws to counter these cultural prejudices that have hitherto

helped sustain what has become an extremely formidable and costly

epidemic.

Katito is a researcher on the Governance and African Peer

Review Mechanism (APRM) programme at the South African Institute of

International Affairs based in Johannesburg.

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allAfrica.com. All rights reserved. Distributed by

AllAfrica Global Media (allAfrica.com).

----------------------------------------------------------------------

----------

[Guest guest]

allAfrica.com

GUEST COLUMN

1 December 2008

Posted to the web 1 December 2008

By Katito

The global fight against Aids is not a losing battle – at least not

entirely. On the positive side, more money is being ploughed into

combating the disease: last year, global investment into HIV/Aids

programmes was six times the amount in 2001.

More countries have a firmer grasp of the extent of the epidemic - in

2004 only 102 countries maintained consistent records, whereas in

2008 45 more have better, more rigorous information about the

epidemic.

More encouragingly, since 2000 the percentage of people living with

HIV has stabilised. In several countries, the rate of new HIV

infections has steadily declined, according to UNAIDS, a United

Nations programme tasked with tracking the spread and prevention of

HIV/Aids globally.

Other encouraging trends are that more people have access to Aids

treatment and are better informed and equipped to prevent

transmission, according to a report released earlier this year by

UNAIDS.

However, the significance of this modest evidence of progress should

not be taken for granted. Increased investment in treatment and

prevention suggests that there is an increasing sense of urgency, and

political will, to tackle the epidemic. Secondly, a global reduction

in infection rates suggests that much needed behavioural changes

among vulnerable groups might be taking place, and that there is

reason to be optimistic that the trend may continue. Lastly, progress

made thus far testifies to the increasing power and value of civil

society globally, given that the drive to fight Aids has been in

large part fuelled by networks of hardy and persistent activists.

Nonetheless, while there has been progress globally, sub-Saharan

Africa remains the epicentre of the disease, with 22 million of an

estimated 33 million Aids-infections worldwide. While the rest of the

world makes progress, the region strains not only to combat the

disease but also to contend with growing numbers of Aids orphans (75

percent of children that have lost parents to the disease live in the

region) and other knock-on effects, foremost among them decreased

economic productivity and social disintegration.

The battle against the epidemic remains fierce and formidable in the

region and will require a continuation of existing tactics as well as

access to prevention and contraception, investment in treatment and

other more generic strategies such as counselling and education.

A set of strategies aimed at tackling the psychological and cultural

factors that fuel the spread of the disease in the region is

necessary and equally important.

It remains permissible, and even commendable, for men to have

multiple sexual partners, despite the tremendous risk that this

presents. This and other similar perceptions shaped by cultural

beliefs substantially increase the likelihood of men engaging in

risky sexual behaviour by as much as three times, according to a

UNAIDS study in Botswana among other countries in the region.

Cultural and religious perceptions have also contributed to the

deafening silence on the uncomfortable social behaviour that

contributes to the spread of the disease. The role of commercial sex

workers and men who have sex with men in the spread of the disease

remain little-acknowledged issues that should be candidly discussed

and boldly tackled. More importantly, the lack of frank discussion,

research and policy on these taboo issues stifles the prospect of

developing comprehensive and relevant solutions to the epidemic.

Granted, changing entire cultures and deeply entrenched psychological

beliefs is a formidable and difficult task. However, sub-Saharan

Africa's political leaders have a critical role to play in shaping

the psychological beliefs that help sustain the epidemic. More

pointedly, these leaders have the ability – and the imperative - to

create policies that can forcefully re-shape those beliefs that

sustain the epidemic.

In several African countries, policies to protect and promote the

rights of groups vulnerable to the disease, including commercial sex

workers, do not exist. Yet, if meaningful headway is to be made in

the fight against Aids, vulnerable groups need the full protection of

the law and equal access rights to services and legal recourse should

they face discrimination. This is particularly critical to helping

boost the confidence of these 'at-risk' groups in seeking early

testing and prompt treatment. Granting these groups the right to

raise awareness of little-known aspects of the nature of Aids without

the fear of recrimination could also significantly alter how the

epidemic is understood, and perhaps help shape better-informed sexual

choices.

As the fight against Aids shows signs of progress globally, it is

critical for the sub-Saharan Africa - the region showing the least

progress - to build on current successes in increasing awareness and

access to treatment. And African leaders must face the crucial

challenge of confronting a regional fear of questioning uncomfortable

cultural beliefs. These leaders have the ultimate responsibility of

making laws to counter these cultural prejudices that have hitherto

helped sustain what has become an extremely formidable and costly

epidemic.

Katito is a researcher on the Governance and African Peer

Review Mechanism (APRM) programme at the South African Institute of

International Affairs based in Johannesburg.

----------------------------------------------------------------------

----------

allAfrica.com. All rights reserved. Distributed by

AllAfrica Global Media (allAfrica.com).

----------------------------------------------------------------------

----------