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Kamala Sarup: HIV/AIDS Contributes to Instability

HIV/AIDS Contributes to Instability

By Kamala Sarup

"Conflict destroys lives, opportunities and environments and may be one of the most significant obstacles to sustainable development as it can destroy in hours and days what has taken years and decades to develop", says the report, presented to an FAO committee meeting this week in Rome.

Even recently, Peter Piot, Executive Director of Joint UN Programme on HIV/AIDS said "He was optimistic that world leaders could still reach major milestones if HIV/AIDS finally received the same attention as other pressing concerns, such as global security. Those milestones included universal access to both treatment and prevention, getting the right funding to people on the ground, and treating the epidemic both as an emergency and a long-term threat.

He further said "It is clear now that HIV/AIDS will be for us for decades, that no quick fix will work. A long-term perspective would include both a focus on vaccines and a realization that the hundreds of thousands now requiring treatment for HIV/AIDS could turn into millions.

We need to substantially increase funding for prevention, testing, treatment, and care for HIV/AIDS orphans.

Even UN General Kofi Annan warned that the epidemic is accelerating on every continent and called for more money and leadership to halt its spread. The fight against AIDS may be the great challenge of our age. Only if we meet this challenge can we succeed in our other efforts to build a humane, healthy and equitable world." He said.

On Jun second, High-level officials from around the globe reviewd progress made towards goals in the struggle against HIV/AIDS set four years ago at an historic world meeting.

Those goals, adopted by the 2001 UN General Assembly special session on HIV/AIDS, focus on the rapid expansion of HIV prevention, care, treatment and impact alleviation by this year, 2005.

Nepal continues high Risk of HIV due to War

The Maoist war creates difficulties in setting up the necessary conditions to combat HIV/AIDS in Nepal. Health workers involved in HIV education have complained that due to the Maoist insurgency they are unable to spread the health message to the remote villages. In Western Nepal, people said the spread of HIV/AIDS was hastened by violence, lack of health services and drugs.

On the other side, Nepal is struggling to cope with the growing HIV/AIDS epidemic because we do not have the same access to the new and expensive drugs used in the western countries. In Nepal, HIV/AIDS positives have been deprived of CD-4 Cell Count facility, and also deprived of the widely available ARV drugs. Standard treatment with antiviral drugs is just too expensive for most people in Nepal. An effective HIV/AIDS vaccine is still a dream.

Though the life-prolonging drugs ARVs bring relief to the lives of people living with HIV/AIDS and increase their life expectancy, poor people have not been able to afford them and it is also beyond the government's budget capacity to provide the drugs to all HIV/AIDS patients for life. With the cost of counselling, social support and medical care, the figure is a lot higher. Drug companies in rich nations have often been accused of putting profits ahead of any commitment to combating an epidemic which is decimating populations in developing countries.

The cost of the medicine is high, so the local people do not have easy access to buy it. Even the check-up charge is costly because of the kit, which is very expensive. Nepal needed cheaper, generic drugs. In addition, throughout Nepal there are few doctors to treat AIDS patients. Price of ART had to be brought down to make it accessible for the poor.

Even recently The UN System in Nepal, in support with its 17 implementing partners, is all set to implement its GFATM-funded-projects in six districts of Nepal namely Acham, Banke, Chitwan, Doti, Jhapa and Rupandehi. In preparation for the activities, the implementing partners recently met and linkages with the technical resources within the UN System were established.

A key obstacle in overcoming the problem was refusal of the political leadership to accept the fact that the disease had gained a foothold in Nepal. Most policy-makers are hesitant to make the difficult policy decision to maximize government support to primary prevention programmes. In spite of such factors, less access to health delivery services, lack of sex education in school curriculum, sexuality issues as social taboos, and poor knowledge about condoms are also contributing to increase HIV/AIDS infection. Political commitment is lacking and ineffective implementation of plans; inadequate commitment and negligence in understanding the seriousness of the problem.

On the other side, For HIV to be addressed in situations of conflict may well require a psychological and political revolution. HIV/AIDS, moreover, can make it harder to bring conflict to an end. Law and order and governance have to be re-established quickly, regional and local administrations set up, schools and clinics opened.

It is highly essential to address the problem through consolidation of multi-sectoral and collaborative efforts. Capacity building of communities along with empowering women and girls is necessary. Medical treatment and psychological support to the victims are also essential factors that need immediate attention in the repatriation process. Nepal must try to slow new cases through preventive education and encouraging condom.

Even recently, China recognizes that even low overall HIV infection rates pose a serious threat in the long run. So, China has moved quickly to put in place anti-discrimination laws, to build a treatment programme for those already infected and to initiate prevention activities targeting injecting drug users and sex workers. Solutions are equally elusive, especially for long-term problems that cannot simply be swept away by a single policy change or introduction of an international law or convention.

Investing in health can reduce the risk of conflict as well as mitigating its impact. Health can help peace also in operational terms.


(Kamala Sarup is an editor of ).


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