World AIDS Day 1st of December
01/12/2010 09:00:00
Political leadership and the fight against HIV and AIDS
This week the dramatic change in the Pope’s stance on condoms demonstrates the enormous influence of political leadership in the fight against HIV and AIDS. The Pope now says that condoms can be used to prevent the transmission of HIV, albeit in ‘exceptional’ circumstances. This is a considerable shift from last year when the Pope said that AIDS “cannot be overcome through the distribution of condoms, which even aggravates the problems”; Influential African leaders, such as Jacob Zuma of South Africa, have also begun to use their considerable influence positively in the HIV response. In 2006 he infamously showed his lack of knowledge about HIV when he told a judge that he had showered after sex with a HIV-positive woman rather than use a condom. Yet, now just last year, he made a landmark speech that changed the attitude of his administration with dramatic positive changes in the way South Africa now addresses the pandemic.
Governance and HIV and AIDS was this year’s theme of the VSO-RAISA annual HIV and AIDS conference, funded by Irish Aid, held in Pretoria two weeks ago. MPs from six Southern African nations were addressed by influential leaders in the fight, such as Festus Mogae, former president of Botswana, Mrs. Tobeka Zuma, first lady of South Africa, Dr. Esau Chiviya, SADC Parliamentary Forum, and our own Fr. Michael Kelly, professor at the University of Zambia and honoured international guru on the virus.
On the first of December, World Aids Day, UNAIDS estimate that 33.3m people worldwide will live with HIV. 1.8m people die each year from AIDS and since the pandemic started in the 1980s, more than 60m people have been infected and nearly 30m have died. In 2009, around 370.000 children were born with HIV, bringing the total number of children under-15 with the virus to 2.5m.
HIV is not a democratic disease; anyone can become infected but it is your circumstances and your behaviours that make you more or less likely to become infected. The main mode of transmission of HIV is through sex and so HIV has had a particularly strong impact on those in the prime of their lives who are needed to drive the economy of their country. This is one important reason why we need strong leadership and good governance to fight HIV and AIDS. Fr. Michael Kelly, a personal hero of mine, has long since challenged the church’s thinking on condoms and other contraceptives and their role in preventing the spread of HIV. In his speech he challenged the assembled dignitaries to take leadership on key areas driving the epidemic across Southern Africa, the epicentre of the HIV and AIDS crisis. He challenged them to recognise the rights of men who have sex with men and to decriminalise homosexuality across the region. Homosexuals face enormous and violent discrimination in Southern Africa and, as a result, are forced underground. This means that they are less likely to be able to access HIV information and services and as clear evidence shows, leads to greater spread of HIV infection.
Fr. Kelly also gave many practical reasons why the trend in West Africa of criminalising the transmission of HIV is absurd - it discourages people from voluntary testing; stigmatises people with HIV as criminals; and undermines the relationship of trust with health care workers. He also spoke about women’s rights and the law; he pointed out that assembled politicians are allowing the law to discriminate against women, notably in the areas of personal law and property law. Women lose out on the right to divorce, inheritance of property and access to assets; which, upon the death of their male partner, means often they are left destitute and must find other ways to earn money to feed themselves and their children. This increased vulnerability only leads to a greater likelihood of HIV infection.
Great change is happening however and recent studies show that we are beginning to see a turn in the fight against HIV. The 2010 UNAIDS Global Report on HIV and AIDS has revealed that the total number of HIV-infected people was slightly down on 2008, and at least 56 countries have stabilised or achieved significant declines in rates of new infections. The report also found that new infections have reduced by nearly 20% in the past 10 years, and among young people in 15 of the most severely affected countries, rates have fallen by more than 25%, as the young adopt safer sexual practices.
Governance still remains a challenge, although here too we have seen progress. VSO has worked closely with six Southern African governments to address the status and needs of carers. Only 5% of HIV and AIDS budgets in the region are allocated to support HIV and AIDS carers, yet 80% of those infected are cared for by carers in their homes, and 92% of carers are women and girls. In the past year, VSO has worked with governments in Malawi and Namibia to pass through parliament a policy on providing support such as training, remuneration, materials and psycho-social counselling, to carers; similar polices are in different stages of completion in Zimbabwe, South Africa, Zambia and Mozambique. This is groundbreaking and a real step forward in recognising these unsung heroes, of which there are many. It is refreshing that we are now seeing increasing numbers of elected representatives and influential leaders stepping up to play their part in the HIV response and perhaps become new heroes.
Editor's notes
Malcolm Quigley is the Executive Director of VSO Ireland. Irish Aid, Ireland’s development programme, generously supports the VSO HIV and AIDS programme in Southern Africa.
This opinion peace was submitted to Irish National newspapers to mark World AIDS Day 2010 1st December.
