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OVERVIEW OF HIV/AIDS EPIDEMIC |
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| The
Status and Trends of HIV/AIDS/STI epidemics in Asia and the
Pacific - 2001, Report by MAP |
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| HIV/AIDS is a complex epidemic to comprehend
or respond. But ways of communicating the complexities in a
lucid way need to be found. |
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| "The hallmark of great science is that it reduces complexity
into simplicity"-- Bruce Stillman, Director: Cold Spring
Harbor (molecular biology) Laboratory, N. Y. |
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| The understanding of the epidemic requires examination from
multiple perspectives. |
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| Similarly a response to the epidemic also needs all sectors
of society to work together, often going beyond the boundaries
of their individual sectors. |
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| The complex response also needs to be programmed in a way
that it permits easy and effective implementation. |
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| Thus the HIV epidemic presents challenges in
many dimensions - the answers to many questions continue to
evolve. |
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| The Cause |
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| Human Immune deficiency virus has been established
as the cause of HIV/AIDS. The origin
of this virus is not firmly established but there are indications
it evolved from a similar virus, which infects monkeys. The
first case of AIDS was reported in 1981 in US. Analysis of literature
has pushed the claims of first case report as far as back as
1930.
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| The Spread |
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| HIV spreads through sexual route, blood route and from pregnant
woman to the infant. The sexual route is the dominant route
that fuels the furious spread of the epidemic. |
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| The Dilemma |
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| The behaviours associated with HIV transmission
(like multipartner sex and injecting drug use) are often not
socially approved behaviours. This places major hurdles in developing
programmes for prevention. For example though use of condoms
in sex ensures an effective prevention strategy, the promotion
of condoms remains a major challenge for many countries. |
| Thus the key behaviours that put people at risk are often
outside the legal and ethical framework of communities. This
leads to silence that envelopes issues that need to be discussed
openly. |
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| The Speed |
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| 20 years back AIDS was an unknown entity - BUT now |
- 36.1 million people in the world are living with HIV/AIDS.
- Of this 34.7 million are adults and women.
- Children constitute about one and half million.
- HIV/AIDS has so far claimed 21.8 million lives.
- Children account for 4.3 million deaths |
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| The Despair |
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| AIDS has created 13.2 million orphans worldwide. |
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| Individuals, communities and countries have been pushed into
intense despair by HIV/AIDS. The trauma that the diagnosis of
HIV brings to the person and family has no parallels. Communities
have suffered because of stigma and social isolation. Countries
have seen massive shifts in mortality patterns with HIV inexorably
climbing to the top position of major causes of death. |
| AIDS emerged about 20 years back. At that time it was not
possible to conceive the devastation that the disease would
cause in many parts of the world. In some parts of the world
large sections of the adult population have been wiped out.
This has led to profound changes like households lead by grandparents
and even children. |
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| Reversing Development |
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| "The epidemic is more effective than war in destabilizing
countries:" Mr. James D. Wolfensohn, President, World Bank." |
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| In worst affected places HIV/AIDS has already eroded developmental
achievements. Epidemiological projections of early 90s have
proved to be underestimates. A current projection says that
in Africa, life expectancy will fall to 30 to 40 years by 2010.
This would take us back by a century or more. |
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| The virus travels selectively through the tracts of poverty
and powerlessness. The already marginalized groups with poor
access to information and services become more marginalized. |
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| The Hope |
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| More understanding of the epidemic and better designed programmes
have started giving results. |
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| There are also major reasons for hope. Carefully planned and
implemented initiatives have shown to be successful in lowering
the HIV infection rates. Advances in care have extended lifespan
of people living with HIV. More effective drugs and falling
drug prices are bringing hope to more and more people. Uganda
and Thailand have shown how each country can have tailor effective
programmes in collaboration with other countries. |
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| Thus HIV/AIDS epidemic presents a picture of despair
and hope. |
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| Towards a New Vision |
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| The response to HIV needs convergence of countries and communities.
Barriers in cultures and religions need to be sensitively handled.
Political systems, judiciary and the administrative systems
need to collaborate. Disciplines like social sciences, medical
sciences, management and a host of others need to find ways
of working together. |
| This epidemic holds the threat of untold misery
and the promise of new ways of living with tolerance, compassion,
understanding and caring for others. We can make the choice |
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