From Poverty to Power Green, Oxfam 2008 - weman

FROM POVERTY TO POWERof the Black Death, such health shocks frequently take the form of newdiseases that lay waste to entire populations.The latest of these is AIDS, which initially seemed to be buckingthe trend, attacking health in the rich countries. But soon the basiclink between poor health and inequality reasserted itself, as thehuman immunodeficiency virus (HIV) spread rapidly across theworld, affecting poor and vulnerable people, particularly in sub-Saharan Africa and particularly women. Other new diseases, such asavian influenza or severe acute respiratory syndrome (SARS), many ofthem ‘zoonotic’ (originating in animals, then passing to humans) alsothreaten to trigger an HIV-style pandemic, while long-standingmaladies such as tuberculosis, malaria, bilharzia, Chaga’s disease, andsleeping sickness continue to take an enormous toll on individuals,families, and societies.In societies where HIV prevalence is high, every aspect ofthe struggle against poverty and inequality, from production toorganisation to daily relations, has been transformed by HIV andAIDS. Taking action now can prevent millions of deaths in the future,as the example of Brazil shows (see page 235). Given that there is notyet a medical cure for AIDS (although there is treatment that stopsshort of a cure), reducing poor people’s vulnerability involves lookingat the social and economic context of their lives to find out whatmakes them vulnerable, and taking steps to remedy these sources ofrisk. ‘It’s not the disease that kills, but the lack of other resources –poverty, dirty water, food’, says a nurse at an HIV centre in SouthAfrica. 52The stigma attached to HIV and AIDS makes the disease far harderto bear. When people living with AIDS in northern Thailand weresurveyed, researchers expected them to say that access to antiretroviraldrugs (ARVs) was their main worry but, instead, ending discriminationagainst HIV-positive people was their number one concern.The first cases of HIV and AIDS were discovered in 1981 in theUSA, the Democratic Republic of the Congo, and East Africa. By 1985cases were reported in every region of the world. In 25 years thedisease has spread to virtually every country, with 65 million peopleinfected with HIV and 25 million deaths from AIDS. In 2005, therewere 38.6 million people worldwide living with HIV and AIDS:232