Northern governments and international institutions boast of the resources they have committed to prevention and education campaigns worldwide. The reality is that, in country after country, explicit information about HIV transmission has been prevented by censorship.
Governments as diverse as Vietnam, Indonesia and Zambia say that condom promotion offends national morals, and which will prioritise equality, rather than accepting the spread of death.
Many women have no choice but to accept the traditional authority of their husband. When the number of children is a sign of wealth for a man, and social recognition for a woman, how many will use condoms?
Other women are alone with their children. 29% of Latin American and Caribbean families are single parent, compared to 26% that all resources should be devoted to promotion of abstinence, monogamy and family values.
Effective AIDS education includes solidarity with people with HIV. It also requires the widest possible distribution of empowering sex-positive messages Unfortunately, religious influence over government and NGO programmes often prevent or hinder this. [KD] * of families in the rich developed countries (OECD). 21% of African families are single parent, and 14% of Asian families. These are the poorest families, with the highest rates of child labour and prostitution, and the lowest participation rates in the education system. Not surprisingly, this is where AlDS hits hardest, and most frequently.
In some countries, most men have sex with prostitutes as well as with their wives.
Mumbai (Bombay) has at least 200,000 prostitutes, servicing a male population of about six million. The city's HIV+ population increases by 60% every year.
This terrible concentration does however carry the seeds of a solution. In India and elsewhere, it is the prostitutes of the "pleasure districts" who are leading the campaign to popularise the use of condoms. The country's family planning policies are of little use here — 44% of Indian couples use contraception, but in 7 out of 10 cases, the contraception used is the sterilisation of the wife. Only about five percent of men say they use condoms "regularly"
The international organisations that encourage third world governments to educate their populations about AIDS simultaneously force those governments to cut their education and health budgets. UNICEF estimates that total third world spending on education fell 35% between 1980 and 1995. The proportion of girls attending school fell by 7% world-wide.
The latest anti-viral drugs are less available in Spain or Italy than in France or Belgium. In Africa, they are completely unavailable. One in ten of the Ivory Coast's 12.5 million citizens has HIV. In 1994, the
AIDS Failure of international programmes In 1994, the World Health Organisation estimated that 10 million new HIV infections could be averted by the year 2000, if global spending on STD and HIV prevention were increased 10-15 times, to US$1.5-2.9 billion per year.
UNAIDS, whose objective is to coordinate the efforts of six UN agencies in combating AIDS, was launched one year ago.' With continuing conflict between the various bodies, lack of commitment by national governments, and without the promised funding, it has been able to channel only minimal resources to HIV programs in the poorest countries, barely able to assemble infrastructure for its own offices, staff and consultants.
Within bilateral aid packages, a very small percentage actually provides resources for care or prevention at a community level in the most needy countries. For most donor countries, 90% of aid money is spent at home, purchasing testing kits or advice on training, needs assessments, planning or evaluation from profiteering pharmaceutical or development consultancy corporations. At the increasingly large and expensive international Aids conferences, those on the circuit of "technical advisers" grow ever richer, while the rhetoric grows more hollow, and the inaction by governments more criminal.
The recent success of anti-retroviral combination therapies among many people with HIV in the imperialist nations throws into stark relief the al26 International Viewpoint most complete lack of access to any but the simplest treatments for symptoms or common opportunistic infections for people with HIV in the Third World. The lives of people with HIV are being squeezed out in a vice. On one side are the very opulent profits of the major drug companies, (Glaxo-Wellcome, Ciba-Geigy, Roche, Abbott, etc.), and on the other, the enforcement of debt repayments and the structural adjustment plans.
Precisely at the point at which HIV emerged as a large scale epidemic in Sub-Saharan African nations, governments were implementing - as demanded by the IMF — major cuts to public health spending, and dismantling primary health care services. In Zambia per capita annual expenditure on health fell in the 1980s from US$23 to $5 Where only user-pays or private health care exists, AIDS victims will only present themselves at a very late stage of the disease, and after the main bread-winner dies, families affected by HIV will be unable to access any care.
While there has been some progress, hopes for effective, cheap and available vaginal viricides, female condoms, and vaccines are a long way from being fulfilled. KD]* 1. The lasting products of the former Global Program on AIDS. under the malevolent and slow bureaucracy of the WHO, were national Medium Term Plans, expensivelv written by government officers, short-term consultants and UN representatives. In most cases, hardly any of the positive interventions outlined have been implemented, and often the budget allocations never appeared.
country imported exactly 600 doses of AZT, the main anti-viral treatment. Even the basic pain relief drugs, and treatments for the most common secondary infections are unavailable.
Over the last 20 years, the International Monetary Fund has forced most third world countries to cut their health spending UNICEF estimates that total third world health spending fell 50% in the 1980s. Among the programmes cut in many countries are facilities for diagnosing and treating sexually transmitted diseases. The result is more genital lesions, which make more people more vulnerable to HIV.
Only a minority of the African population can afford medication, all of which is imported. At most hospitals, patients buy
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AIDS