“Abstinence is often not an option for poor women and girls who have no choice but to marry at an early age. Being faithful will not protect a woman whose partner is not faithful. And using condoms is not a decision that a woman can make by herself; it depends on a man.
Another promising approach is male circumcision. One new study found that it could significantly reduce the spread of HIV. This is exciting — and if male circumcision truly is effective, we should make it widely available.
But, like using condoms, circumcision is a procedure that depends on a man.
That isn’t good enough.
We need to put the power to prevent HIV in the hands of women.
We need tools that will allow women to protect themselves. This is true whether the woman is a faithful married mother of small children — or a sex worker trying to scrape out a living in a slum. No matter where she lives, who she is, or what she does — a woman should never need her partner’s permission to save her own life.” Bill Gates
Why aren’t we getting these life-saving tools to the people who need them?
There are many reasons — financial, logistical, political, social. But there is one reason I want to emphasize today, and that is stigma.
The simple fact is that HIV is transmitted through activities that society finds difficult to discuss — activities that are infused with stigma — and that stigma has made AIDS much harder to fight..
Stigma is cruel. It is also irrational.
Stigma makes it easier for political leaders to stand in the way of saving lives. In some countries with widespread AIDS epidemics, leaders have declared the distribution of condoms immoral, ineffective, or both. Some have argued that condoms do not protect against HIV, but in fact help spread it.
This is a serious obstacle to ending AIDS. In the fight against AIDS, condoms save lives. If you oppose the distribution of condoms, something is more important to you than saving lives.
This week there has been a lot of media talk surrounding the the 16th International HIV/AIDS 2006 conference going on in Toronto from the 13th thru the 18th. Major headliners such as Bill Clinton, Stephen Lewis, and the formidable power duo of Bill and Melinda Gates have lent their influential presence in order to raise awareness around the epidemic and to co-chair the event. Bill and Melinda gates have a foundation dedicated to bringing innovations in health to global communities, within that is the search for better preventative HIV measures.
One key message that emerged from Mr and Mrs. Gates has been preventative; the need to empower women by giving them access to sexual contraceptive devices. Currently the worse group affected by HIV/AIDS in Sub-Saharan Africa are women between the ages of 16 to 24. And marriage is not a sure protection against the disease, as many women protract the disease while in long-term commitments. Mrs. Gates also addressed the key issue of stigma, which was something I was told about during my spring trip to South Africa this past year. One of the greatest challenges and what is doing severe damage within communities already affected by the epidemic is the simultaneous but more silent attack of stigma. It is just as cruel, as Melinda points out, as the virulent disease and leaves people on their own to fight the physical and emotional trauma. I for one am glad Mrs Gates brought up this significant issue.
Bill Clinton criticized abstinence-only AIDS programs and call for a more realistic approach to the epidemic. As usual he created a little bit of controversy by telling the audience that politicans need to overcome their squeamishness and self-righteousness act. He also called on public-health officials to act on the evidence that male circumcision can help reduce the risk of HIV/AIDS transmission. He went on to critique pharmaceutical companies over the high cost of AIDS drugs for children and even demanded that politicians who pilfer AIDS dollars for their own personal gain be sentenced to jail. In what could be considered a culturally and religiously risky statement Clinton invoked God and announced to delegates that HIV/AIDS was a “gift from God” and humanity’s biggest test in modern times.
However the two main messages that seem to keep cropping up in the Canadian national papers are: keep it simple, and empower women. Part of the challenge for governments, well intentioned NGOs and volunteers is to ensure that the money and the resources are going to the right places. HIV/AIDS has many groups that lobby on its behalf but if the current HIV/AIDS stats are any indication, the epidemic shows no strains or signs of slowing down. Sometimes even hearing or reading the quotes of intelligent world leaders shows a gap between their culturally-biased good intentions and the people on the other side they are trying to help. How will Sub-Saharan Africa respond to a call to empower women? Will husbands and wives ambrace the initiative? And what about circumcision? Is this something African men are aware of and if so, are they interested in undergoing the surgery? And if neither party is interested in our “solutions” where do we go from here? And what are we going to do to address the destructive effects of social stigma?
While more solutions are being helpfully suggested by world leaders, it also inevitably raises more questions that need to be discussed and resolved, if we are to make real progress against this epidemic.
The Global Fund is active in 131 countries. It gets HIV drugs to more than half a million people. It provides access to testing and counseling to nearly 6 million people. It offers basic care to more than half a million orphans.
For each new person who got treatment for HIV, more than 10 people became infected.
Right now, nearly 40 million people are living with HIV.
The lowest price for first-line treatment drugs is about $130 per person per year; in many cases the cost is much higher. And the cost of personnel, lab work, and other expenses easily exceeds another $200 per person per year.
The annual cost of getting treatment to everyone in the world who is HIV positive would be more than $13 billion a year, every year.