Year
after year, AIDS statistics hit us like a sledgehammer, a forceful
reminder of the uphill struggle against one of the worst afflictions
of humanity. Since the epidemic began, some 65 million people
have been infected, 25 million of whom have died. The chilling
death count continues at a rate of 8,000 a day.
While it is true that antiretroviral treatment has brought hope,
this alone is not enough to vanquish the condition. The epidemic
has profoundly weakened or even decimated many poor communities,
particularly in Africa. This has shaken the very foundations
of society, with life expectancy plummeting to below 40 years
in many African countries.
HIV and AIDS places an unimaginably heavy burden on the poorest
families: from the extra costs of treatment to lost jobs and
livelihoods, disrupted family life, orphans, and funeral costs.
Behind the figures lie myriad personal and family tragedies.
What is needed to restore communities and to prevent others
from shattering? What can be done to effectively meet the Millennium
Development Goal to reverse the deadly progress of HIV and AIDS,
and halve the rate of spread of the virus by 2015? After twenty
years’ experience and hundreds of conferences and seminars,
it is time to move beyond the endlessly repeated statistics,
and to face the AIDS challenge head-on with effective specific
solutions. We know what must be done to prevent further infection,
expand care, treatment, and support, and reduce stigma and discrimination.
These are inter-related objectives. Effective prevention requires
the development of life skills, and good information and social
mobilization which will counter the stigma and discrimination
that hampers access to treatment. In turn, effective treatment
and care eases stigma and boosts prevention through, for example,
motivating people to accept voluntary counselling and testing
to learn about their HIV status and thus get help to look after
themselves better and to protect others.
People living with HIV and their families are a central focus
as their interaction within society contributes towards and
reflects the success of our collective efforts. In contrast,
discrimination and exclusion fuels further spread of the epidemic
and deprives society of the productive contribution of people
living with HIV.
There is no doubt that focused action is essential. This must
be directed at communities because it is only there that the
epidemic will be halted. For the International Federation of
Red Cross and Red Crescent Societies, communities are at the
heart of our practical and humanitarian mission. But community
action depends on the perseverance of individuals coming together
for a common cause, people who make the extra effort to include
the marginalized and vulnerable who would otherwise be left
out.
Any action that aims to achieve concrete, practical results
at the community level needs one resource that is all too often
forgotten: someone who is willing and able to walk the last
mile. With millions of committed volunteers working in 185 National
Societies around the world, the International Federation of
Red Cross and Red Crescent Societies is the world’s largest
humanitarian organization, capable of the necessary large-scale
mobilization, if resourced to do so.
A priority target is women and girls. In the context of an increasingly
feminized epidemic, gender inequalities have a direct bearing
on personal and social vulnerability to HIV. Women have a greater
biological vulnerability to the virus but the main problem is
their relative powerlessness. Women often have fewer rights
and resources to call upon. They are frequently forced into
early sexual activity, are unable to insist on protecting themselves,
and may suffer sexual violence and exploitation, including being
forced to barter sexual favours for their own survival or that
of their families.
The big picture is clear: we will not make a dent in the HIV
epidemic unless we get really serious about tackling the vulnerability
of women and girls. That is not all. For the fight against HIV
and AIDS to succeed, it is also essential to address other vulnerable
populations, such as the growing numbers of migrants and prisoners.
To deliver the greatest impact for vulnerable people, a Global
Red Cross Red Crescent HIV and AIDS Alliance is launched on
this World AIDS Day in order to do more, and do better. This
will help to advocate for and enable universal access to prevention,
care, treatment and support, and will result in at minimum a
doubling of direct participants and beneficiaries in Red Cross
Red Crescent HIV and AIDS initiatives in low and middle income
countries.
The Global Alliance works through regional initiatives –
such as the recently launched US$300 million Red Cross programme
for ten southern Africa countries which have the highest HIV
prevalence rates in the world. Over the next five years, the
Red Cross will convey prevention messages to approximately 50
million people, provide care for 250,000 people living with
HIV/AIDS and provide support to 460,000 vulnerable children,
particularly orphans, across southern Africa. Similar scaled-up
programmes will be promoted by the International Federation
of Red Cross and Red Crescent in Asia, the Pacific, the Caribbean
and Latin America.
This calls for a “joined-up” effort – to act
together at all levels, from the local to the global and from
the human to the political. It is time to do away with scattered,
small-scale efforts for a more effective, integrated response.
It is time to walk the last mile to make the difference.
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Dr
Mukesh Kapila, Special Representative of the Secretary
General for HIV
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