Approaching the Epidemic
Many efforts are underway to address the AIDS epidemic in Africa at many different levels—international, national, and local. Effective approaches must address both prevention and treatment in order to stop the spread of HIV and improve the lives of people already living with HIV/AIDS.
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How do International Initiatives approach AIDS?
There are many international initiatives intended to address AIDS and each uses a slightly different strategy—some focus on providing medication to HIV-positive individuals, while others emphasize education. Some examples include:
- The World Health Organization (WHO) “3 X 5” Initiative. By working with nongovernmental organizations (NGOs) and national governments, WHO hoped to deliver ARV medication to 3 million people in developing and transitional countries by 2005. By the end of 2005, however, only 1.3 million people were receiving treatment. Although the WHO achieved just 40% of its intended target, it was successful in establishing needed healthcare infrastructure that will facilitate delivery of treatment in the future.
- The Global Fund to Fight AIDS, Tuberculosis, and Malaria. Founded in 2002, this private initiative raises funds from governments, organizations, businesses and individuals around the world. It distributes the money in the form of grants, with the most money allocated to AIDS. So far, The Global Fund has raised $5.5 billion and distributed money to 132 countries. It has been praised for its innovative model in which grant proposals are evaluated through an independent review panel that only funds technically sound projects with the greatest chances of success.
- The President’s Emergency Plan for AIDS Relief. PEPFAR is President George Bush’s five-year, $15 billion global initiative to combat the AIDS epidemic. The Emergency Plan is the largest commitment ever by any nation for an international health initiative dedicated to a single disease. Primary beneficiaries include: Botswana, Cote d'Ivoire, Ethiopia, Guyana, Haiti, Kenya, Mozambique, Namibia, Nigeria, Rwanda, South Africa, Tanzania, Uganda and Zambia.
- World AIDS Day. The purpose of World AIDS Day (December 1st) is to raise both funds and awareness about AIDS to educate the public and fight prejudice. December 1st has been celebrated as World AIDS Day since 1988. On this day, communities, organizations and governments around the globe organize rallies, marches and educational events to raise awareness about the AIDS epidemic. Each year one slogan is chosen (formerly by UNAIDS; by the World AIDS Campaign since 2005) highlighting a specific aspect of the AIDS pandemic.
- 2005: Stop AIDS. Keep the Promise.
- 2004: Have You Heard Me Today? Women, Girls, HIV and AIDS
- 2003: Live and Let Live: Stigma and Discrimination
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How do national governments approach AIDS?
Experts agree that government involvement is a key component of a successful AIDS intervention program. But again, there is no single strategy for how governments get involved. A government’s strategy depends on:
- The scale of the pandemic in that country,
- The available funds, and
- Willingness to talk openly about the issue.
In 2004, UNAIDS adopted the "Three Ones" principles to help national governments improve their responses to AIDS:
- One agreed AIDS action framework that provides the basis for coordinating the work of all partners
- One national AIDS coordinating authority, with a broad-based multisectoral mandate
- One agreed country-level monitoring and evaluation system
By encouraging nations to articulate clear national AIDS policies, create specific agencies responsible for implementing the policies, and monitor the HIV/AIDS work being done within the country, the “Three Ones” principles have helped governments around the world to begin to build better more efficient responses to the AIDS crises within their countries.
In recent years, both Uganda and Botswana have demonstrated effective national responses to the AIDS epidemic. Uganda's prevalence rate has fallen from 15 percent in the early 1990's to 6.7 percent in 2005. At the end of 2005, Botswana was providing treatment to 54,000- over 50 percent- of its HIV positive citizens. These "success stories", along with other effective nationwide responses, include:
- A dedicated government
- Funding from external donors, and
- Cooperation with local institutions, churches, and private sector organizations
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How do local efforts approach AIDS?
Local efforts are often highly specific to the communities in which they are implemented, so they are not especially uniform. Some examples include:
- AIDS Empowerment and Treatment International: AIDSETI is a network created and managed by people living with HIV/AIDS throughout the world. The international network includes 26 community-based associations of people living with HIV/AIDS in Africa and the Caribbean. Their main goal is to expand access to treatment in resource-poor countries.
- Treatment Action Campaign- South Africa: TAC is an organization based in South Africa that advocates for treatment of HIV-positive individuals and campaigns to prevent new HIV infections. Among their many successful efforts, TAC is responsible for nationwide programs to prevent mother-to-child transmission and provide antiretroviral treatment to those in need.
- AIDS Support Organization- Uganda: TASO is a grass-roots group originally founded in 1987 by 16 individuals personally affected by AIDS. The TASO model of comprehensive community-based care and support is now mimicked by many local programs throughout the world.
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What are the advantages of local/community-based approaches?
There are several advantages to community-based approaches. These local efforts:
- Encourage those affected by the epidemic (HIV-positive people as well as family and friends) to acknowledge AIDS and seek care and support.
- Encourage entire communities to accept the existence of AIDS, avoid stigmatization and discrimination, and begin to address the problem.
- Educate individuals in the community about the effects of AIDS as well as modes of transmission.
- Put a human face on the suffering and devastation AIDS causes.
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