You may think Aids is too complicated and too persistent for us to solve – it’s been 44 odd years since it was supposedly discovered. You may have a dozen other issues clamouring for your attention – Ebola, the erratic rains, dismal tourism season, Boko Haram, world peace, just to name a few – and the day has only just begun.
But Aids is still worthy of our attention, resources, and effort – now, more than ever before. The troubling fact is that Aids continues to attack young adults as they make their way into the world and start their own families. Aids is devastating household incomes and national economies, propelling the perpetual cycle of poverty.
But there is hope. We should be heartened by the recent statistics from UNAIDS that tell a promising story – 5 million people on treatment and a 25 per cent drop in new infections across the worst-affected countries since 2001. We should be motivated by the progress that Aids has quite unintentionally moved forward, rather than the destruction it has left in its wake.
Because despite the chaos Aids has wrought, it has also resulted in remarkable human compassion and ingenuity. When religious leaders and moral crusaders declared it to be “God’s judgment”, brave and unlikely champions such as Princess Diana and Ryan White emerged to challenge the prejudices and taboos that lived in the hearts of millions. And when epidemics claimed the lives of millions of nurses, teachers, miners, and soldiers, an army of ordinary people proved to be much stronger, building networks, raising funds, and opening their hearts to the sick and their homes to the orphaned.
In 2001, the Global Fund – the most ambitious response to a global catastrophe since the Marshall Plan – was established to fight Aids, TB, and malaria. And in 2003, US president George Bush launched the President’s Emergency Plan for Aids Relief – PEPFAR – the largest international health initiative ever directed at a single disease. What has this incredible and unprecedented convergence of love, compassion, money, political will, and science given us?
For one thing, it has shattered the belief that poor countries are unable to manage complicated medical treatment. When PEPFAR was announced, only 500,000 Africans had access to HIV treatment, now 5.2 million people are on life-saving medicines. In Botswana, where 39 per cent of the population was infected with HIV in 2002 and life expectancy was under 40 years, Aids treatment has now reached more than 80 per cent of patients and saved that country from the brink of extinction.
For another, the innovation and ingenuity that has enabled millions to live longer lives has benefited so many more. The Global Fund has increased resources for more than just Aids: 35 per cent of its funding strengthens health systems that reach all patients, not just those with HIV. Since the Global Fund there is a real goal to eradicate malaria and usher in the first new TB drugs since the 1970s. The Aids epidemic has created an architecture to improve global health. It has given new impetus to improving primary education for a generation of Aids orphans. It has sharpened focus on gender equality and reinvigorated efforts to end maternal mortality. It has challenged stigmas and double standards that persisted long before the disease appeared.
But a lot of work remains to be done. The challenges of getting 10 million patients the treatment they still need and filling a funding shortfall of US$10 billion in the midst of a widespread economic crisis is undaunting. We should recognise the need for business expertise and leadership, good government policies, and engaging affected communities. Barriers continue to exist to building up the capacity of health care systems, training enough health care workers, and eradicating dangerous stigmas that keep many people from knowing their status and obtaining the medicines that could save their lives.
Yet, on this World Aids Day, we should reflect on the positives that a disease that once made us feel helpless can make us feel hopeful – and even proud. These achievements should restore our faith in compassion. But most of all, we should have a renewed sense that not only is this battle worth fighting, it is one we can win. And in many ways, it’s the very thing that could save us all.
It is also encouraging to note that UNAIDS has reopened its offices in The Gambia. The closure of the MRC GUM unit at Fajara years ago has been an incalculable loss to the fight against the disease and the closure of the UNAIDS office a year or so ago dealt another body blow to the efforts to keep the disease in check in the country. Therefore, the reopening of the office represents a very propitious turn of events as the fight against AIDS is far from over.
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