HIV/AIDS in Africa: Shifting the Horizons of Development
By Lennart Båge
For many in the developed world, the HIV/AIDS crisis has receded as an active concern. The spotlight of international attention has shifted away from the devastating effects of the epidemic on Africa to other crises.
There is also a sense that the situation is somehow under control, given the increasing availability of funds to combat HIV/AIDS and wider access to antiretroviral drugs.
That is certainly not the case. HIV/AIDS remains a huge problem in Africa. The crisis persists, deepens and resists easy solutions.
The disease is not only a serious obstacle to development efforts but is shifting the horizons of development. The epidemic has decimated an entire generation of young adults; born after independence, they represented the hopes, savings and investments of their peoples.
It leaves communities and societies struggling to survive. If they are left without support, the Millennium Development Goals will only be idle talk, and strategies to reduce poverty will be equally empty frameworks.
Epidemics are not only about how people die, but are also about how people live. In sub-Saharan Africa alone, HIV/AIDS has caused 17 million deaths. More than 25 million people are living with the disease, powerless to keep their families from sinking deeper into poverty.
In 2001, about 11 million orphaned by the epidemic in sub-Saharan Africa struggled to grow to adulthood.
The rapid spread and persistence of the disease mirrors the social conditions that make Africas poor vulnerable to HIV/AIDS. Economic- and gender-related factors increase the probability of behaviour that puts people at risk of contracting the HIV virus.
Lack of access to education and communication means that people cannot gain an understanding of HIV/AIDS and the dangers it poses. A low level of public services leaves families and communities without support in confronting the crisis.
Poor people in rural areas, particularly women, are the largest and weakest segment of Africas population. They have fewer economic opportunities and limited access to education, information and public services such as health care.
As a result, these people are the hardest hit by HIV/AIDS and their families and communities become even poorer and more vulnerable. They exhaust their already meagre resources in caring for the sick and are permanently weakened by the loss of their most active family members.
The HIV/AIDS crisis is so severe in Africa because it exploits the weak points in society, most of which are linked to poverty. Rich regions do not experience the epidemic in the same proportion as Africa. Because the disease is rooted in the weaknesses of society, combating it is not only a medical or public health issue.
Although specialized and intensive campaigns are necessary, they are not enough to meet the challenge; it is essential to respond to the social and economic weaknesses that HIV/AIDS exploits.
We know that limited rural economic opportunities, gender problems and the material weakness of rural communities lie at the heart of the epidemic. We also know that we cannot succeed in changing the dynamics of the epidemic until the impact of these factors is reduced.
Dealing with HIV/AIDS as a disease may be a scientific challenge, but dealing with the social and economic factors that favour its spread is not an impossible task.
The issues and solutions involved in dealing with the poverty underlying the HIV/AIDS epidemic are as well known as those involved in dealing with malaria and water-borne diseases—the other deadly diseases in Africa that are driven by socio-economic forces.
It is imperative to understand these facts about HIV/AIDS and mobilize Governments, the United Nations system and donors to focus on combating Africas social crises as an essential complement to activities that specifically address the disease.
In fact, there has been a dramatic decrease, in per capita terms, of national and external resources devoted to helping Africas rural poor build better lives.
Moreover, much assistance has failed to develop the continents strengths. Public expenditure has been the focus of assistance, yet in rural Africa, households and communities primarily take care of themselves.
The public sector does have a key role to play, but no less important is the role of families and communities. Progammes focusing specifically on HIV/AIDS must reach out to strengthen the capacity of families and communities.
Rural development must also be strengthened and focused on the heart of the problem: poor men and women need the opportunities and capacities to build better and safer lives, rooted in enduring social and economic change.
Lennart Båge has been President of the International Fund for Agricultural Development (IFAD) since February 2001.
He came to IFAD with nearly 25 years of experience in international development, and a longstanding and active involvement in the UN system and multilateral finance institutions. He served in Swedens Ministry of Foreign Affairs as head of the Department of International Development Co-operation (SIDA).
Lennart Båge er en af de i dag få nordiske FN-chefer. IFAD har specialiseret sig i at hjælpe u-landenes fattige bønder og har siden sin stiftelse haft Danmarks bevågenhed.
Kilde: UN Cronicle Feature Service, New York
