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.