The statistics speak for themselves. In the UK, government action and effective education leading to behavioural change brought the epidemic under control relatively quickly - though at the cost of 14,000 lives so far.
Elsewhere it is a different story. With over 2 million deaths every year due to AIDS, an estimated 30 million people infected with HIV, and 40 million children losing one or both parents to the disease, the social impact in the worst affected nations is nothing short of devastating.
Africa
The heartland of the HIV/AIDS epidemic today is Africa south of the Sahara. Here it is believed 7% of people aged 15-49, totalling over 20 million are already infected. Almost 8 million children have been orphaned and in some areas only children and old people are left.
Uganda is one of the countries worst hit. In some urban areas a staggering one in three is HIV-positive. Here, as in most of the world, the main mode of transmission is heterosexual sex. Of particular concern are the rising infection rates in women, and consequently in children. In this mainly male-dominated society, women are often powerless to protect themselves, so, whereas in 1995 there were two HIV-positive men for every infected woman, by the year 2000 the ratio is expected to be six women for every five men. Cultural practices such as polygamy, wife inheritance and ritual circumcision with shared knives accelerate the transmission of the virus.
Nevertheless, Uganda is one of the success stories of the developing world. A highly successful national education campaign is credited with achieving the fall in the number of new HIV cases seen in Ugandan clinics now recorded for two years in succession. One UK-based Christian charity, ACET (AIDS Care Education and Training) has been at the forefront of this campaign, providing AIDS education for over 20,000 students and training over 1,000 community AIDS workers in one year alone.
But according to David Kabiswa, Director of ACET in Uganda, the efforts of the various charities involved would not alone have been sufficient to achieve what has been accomplished. The attitude and approach of the Uganda government has proved crucial. 'The President himself declared open policy on HIV and AIDS' says David. 'An AIDS Commission was set up in the President's Office, and there is an AIDS Officer in every Government ministry.' At the same time an effective surveillance system was established using data from blood banks, hospitals and clinics as well as from academic research and surveys.
Asia
Whilst Africa has borne the brunt for the last ten years, attention is increasingly shifting towards Asia, and to India in particular. With a population exceeding that of the whole African continent, and the early stages of an AIDS epidemic which threatens to be every bit as severe as Africa's, the prospects are bleak. By mid-1996 UNAIDS estimated that 2.5-5 million were already HIV-positive. By the year 2000, the number of HIV infections in India is likely to exceed the current total for the whole of Africa.
With the only effective treatments for HIV prohibitively expensive in the developing world, and with more resistant strains of the virus, effective education is the only hope for truncating the epidemic. But there is no sign as yet of the kind of government intervention which proved so crucial in Uganda.
One strategy for addressing the developing problems in countries like India is to develop successful existing campaigns in neighbouring countries into regional centres of excellence. In neighbouring Thailand for example, at the epicentre of the south-east Asian epidemic, organisations such as ACET have already embarked on education and information programmes in partnership with the Thai government and the European Commission.
Addressing the issue of prejudice is key to implementing a successful programme. Social stigma directed against those with the disease drives it underground, encouraging denial and the avoidance of HIV testing, preventing effective monitoring, and so keeping open the routes of infection.
Sadly, amongst churches in the West, attitudes to homosexual people and the perception of AIDS as mainly a homosexual disease have to some extent hindered a Christian response. A response of unconditional love and care is as appropriate towards those with HIV as towards any other medical condition. A non-judgmental approach, modelled by Christ himself towards the woman at the well and the woman caught in adultery, is the only one which has any hope of winning real trust, and of opening the door for real and positive influence on people's attitudes, lifestyles and behaviour.
With the support of governments and good financial backing, the experience gleaned in the first decade of the AIDS epidemic can be put to good use in areas such as Asia and eastern Europe, where it is still soon enough to make a difference.
Pat Macaulay became Chief Executive of ACET (AIDS Care Education and Training) in 1995 after working for 18 years in NHS financial management and six years in the private sector. She visited Uganda and Thailand on behalf of ACET in 1996 and 1997
For further information about ACET please contact Bruce Townsend on 0181-780 0400
Elsewhere it is a different story. With over 2 million deaths every year due to AIDS, an estimated 30 million people infected with HIV, and 40 million children losing one or both parents to the disease, the social impact in the worst affected nations is nothing short of devastating.
Africa
The heartland of the HIV/AIDS epidemic today is Africa south of the Sahara. Here it is believed 7% of people aged 15-49, totalling over 20 million are already infected. Almost 8 million children have been orphaned and in some areas only children and old people are left.
Uganda is one of the countries worst hit. In some urban areas a staggering one in three is HIV-positive. Here, as in most of the world, the main mode of transmission is heterosexual sex. Of particular concern are the rising infection rates in women, and consequently in children. In this mainly male-dominated society, women are often powerless to protect themselves, so, whereas in 1995 there were two HIV-positive men for every infected woman, by the year 2000 the ratio is expected to be six women for every five men. Cultural practices such as polygamy, wife inheritance and ritual circumcision with shared knives accelerate the transmission of the virus.
Nevertheless, Uganda is one of the success stories of the developing world. A highly successful national education campaign is credited with achieving the fall in the number of new HIV cases seen in Ugandan clinics now recorded for two years in succession. One UK-based Christian charity, ACET (AIDS Care Education and Training) has been at the forefront of this campaign, providing AIDS education for over 20,000 students and training over 1,000 community AIDS workers in one year alone.
But according to David Kabiswa, Director of ACET in Uganda, the efforts of the various charities involved would not alone have been sufficient to achieve what has been accomplished. The attitude and approach of the Uganda government has proved crucial. 'The President himself declared open policy on HIV and AIDS' says David. 'An AIDS Commission was set up in the President's Office, and there is an AIDS Officer in every Government ministry.' At the same time an effective surveillance system was established using data from blood banks, hospitals and clinics as well as from academic research and surveys.
Asia
Whilst Africa has borne the brunt for the last ten years, attention is increasingly shifting towards Asia, and to India in particular. With a population exceeding that of the whole African continent, and the early stages of an AIDS epidemic which threatens to be every bit as severe as Africa's, the prospects are bleak. By mid-1996 UNAIDS estimated that 2.5-5 million were already HIV-positive. By the year 2000, the number of HIV infections in India is likely to exceed the current total for the whole of Africa.
With the only effective treatments for HIV prohibitively expensive in the developing world, and with more resistant strains of the virus, effective education is the only hope for truncating the epidemic. But there is no sign as yet of the kind of government intervention which proved so crucial in Uganda.
One strategy for addressing the developing problems in countries like India is to develop successful existing campaigns in neighbouring countries into regional centres of excellence. In neighbouring Thailand for example, at the epicentre of the south-east Asian epidemic, organisations such as ACET have already embarked on education and information programmes in partnership with the Thai government and the European Commission.
Addressing the issue of prejudice is key to implementing a successful programme. Social stigma directed against those with the disease drives it underground, encouraging denial and the avoidance of HIV testing, preventing effective monitoring, and so keeping open the routes of infection.
Sadly, amongst churches in the West, attitudes to homosexual people and the perception of AIDS as mainly a homosexual disease have to some extent hindered a Christian response. A response of unconditional love and care is as appropriate towards those with HIV as towards any other medical condition. A non-judgmental approach, modelled by Christ himself towards the woman at the well and the woman caught in adultery, is the only one which has any hope of winning real trust, and of opening the door for real and positive influence on people's attitudes, lifestyles and behaviour.
With the support of governments and good financial backing, the experience gleaned in the first decade of the AIDS epidemic can be put to good use in areas such as Asia and eastern Europe, where it is still soon enough to make a difference.
Pat Macaulay became Chief Executive of ACET (AIDS Care Education and Training) in 1995 after working for 18 years in NHS financial management and six years in the private sector. She visited Uganda and Thailand on behalf of ACET in 1996 and 1997
For further information about ACET please contact Bruce Townsend on 0181-780 0400
