IN the last 12 months a new phrase has come to dominate discussions about HIV and AIDS - ‘the tide is turning’. There is now a strong body of evidence to support the idea that the worst of the epidemic is behind us. Worldwide, the number of AIDS-related deaths has fallen by 25% in the last six years, from 2.3 million in 2005 to 1.7 million in 2011.
We are also seeing a significant fall in infection rates. A recent study by UNAIDS found that new HIV infections across 25 low- and middle-income countries dropped by more than 50% in the last two years.
Developments like improved access to testing, more widespread use of condoms, better sex and health education and male circumcision are making a real difference. The most significant factor, however, has been increased access to anti-retroviral drugs. In recent years these drugs have become more affordable and accessible for millions of people in the developing world. In the last two years, access to treatment has increased by 63%. Today, UN AIDS estimated that more than 2.3 million people in Sub-Saharan Africa have access to HIV treatment.
These incredible gains have laid the foundations for the end of AIDS, but that goal is a long way away, and there are still enormous challenges to overcome. There is also the risk of complacency. For the first time in decades we are seeing major cuts to funding for HIV and AIDS programme as governments feel pressure to cut spending on overseas aid. Last year saw a reduction in funding by the Global Fund to fight AIDS, TB and malaria, which sets a dangerous example to other donors.
There is also a human side to the fight against HIV that is at risk of being neglected. HIV has left many communities in low income countries hollowed out, often with grandparents left to care for people living with the virus. We often see grandparents caring for their orphaned grandchildren without any support, and children living alone. Other children, often girls, are forced to drop out of school to care for relatives who are affected by the virus and fend for their siblings.
According to UN AIDS, 80% of care for people living with HIV and AIDS takes place in the home. Often this work is done by family members, and too often it falls exclusively to women and girls. These community care providers are usually not paid for their work, and they receive little support from the public health system.
They run the risk of impoverishing themselves because their time is monopolised by their caring duties. In the long run, the fact that children are staying home from school to care for relatives living with HIV and AIDS will have a negative effect on their future ability to support themselves.
Our focus now should be on caring for these carers – providing support for them so that they can give their time to care for family members without compromising their ability to support themselves and their households. This means drawing attention to the work of community care providers until they receive recognition and remuneration for their work from local and national health systems, and working with carers to develop income generating activities. It also means challenging traditional gender roles by encouraging men and boys to share the burden of providing care.
World AIDS Day: Dec 1
While the tide is turning, we should be careful to remember the impact that HIV and AIDS continues to have in the world’s poorest communities, and redouble our efforts to ensure that the families and wider communities of people living with HIV and AIDS have the support they need to provide care while also providing a livelihood for themselves.
VSO Ireland is the world’s largest independent development organisation that works through volunteers. Thanks to the generous support of their donors, they are currently recruiting qualified, experienced teachers, doctors, other health professionals, and people with experience in IT and business, to work in 33 countries in Africa and Asia.
- World Aids Day is Saturday December 1. Malcolm Quigley is the executive director of VSO Ireland.