UNAIDS: The First 10 Years

The challengesThe challenges:need to tackle the major ‘drivers’ of the epidemic261“We live in aworld that mustbe changed tosurvive”.The epidemic will be halted only if AIDS is placed firmly in mainstream developmentwork. Major drivers of the epidemic such as poverty, inequality—especially of women inmost societies—and stigma have to be tackled.Jim Yong Kim, former Director of WHO’s HIV/AIDS Department, and Paul Farmer,both co-founders of Partners in Health, a non-profit organization working forinternational health and social justice, have written 28 : ‘... poverty is far and away thegreatest barrier to comply with ART [antiretroviral therapy] … far and away the greatestbarrier to the scale-up of treatment and prevention programmes. Our experience in Haitiand Rwanda has shown us that it is possible to remove many of the social and economicbarriers to adherence but only with what are sometimes termed “wrap-around services”:food supplements for the hungry, help with transportation to clinics, child care andhousing … Coordination among initiatives such as PEPFAR, the GF [Global Fund] andWFP [World Food Programme] can help in the short term; fair-trade agreements andsupport of African farmers will help in the long run’.A major challengeto combating theepidemic is povertyand the conditions inwhich people live – inBrazilian favelas, forexampleUNAIDS/J.Maillard‘AIDS flourishes in poor societies because illiteracy and penury make people vulnerable;success against the virus depends partly on broader progress’. As President Paul Kagameof Rwanda told the Washington Post, ‘there’s no use in giving someone antiretroviraldrugs if he has no food’ 29 .Achmat put it very simply when addressing a conference: “We live in a world that mustbe changed to survive” 30 .28Kim JY, Farmer P (2007). ‘AIDS in 2007 – moving towards one world, one hope?’ New England Journal ofMedicine, 355.29Interview (2007). ‘Another $10 billion. The world has only begun to wake up to the AIDS challenge’.Washington Post, 2 June.30Achmat Z (2007). Make Truth Powerful: Leadership in Science, Prevention and the Treatment of HIV/AIDS.Address at the Microbicides 2007 conference, Cape Town, 26 April.