An article by Gavin Strang in the Edinburgh Evening News
This Thursday evening, an Edinburgh audience will hear the UN Special Envoy for HIV/AIDS in Africa describe how a terrible epidemic is besieging a continent.
Presenting one of this season’s Edinburgh Lectures, Stephen Lewis will examine the links between AIDS, declining productivity and the growing famine in Southern Africa.
Africa’s AIDS crisis is Britain’s crisis too. We have a moral duty to act – we cannot stand by while millions of people die entirely preventable deaths. But it is also in our own self-interest to help combat AIDS worldwide.
The scale of the global epidemic is staggering. Forty two million people are living with HIV. Five million people get infected every year, including three quarters of a million babies born with HIV. Twenty five million people have died with AIDS, leaving 14 million orphans.
Cruelly, the crisis is at its worst in the developing world. In sub-Saharan Africa, life expectancy has plummeted from 62 to just 47 years – fifty years’ progress in raising life expectancy has been wiped out. Thirty million Africans are living with HIV, most of them women. In Botswana, Swaziland and Zimbabwe more than one in three adults are HIV positive. The epidemic in Asia threatens to becomes the world’s largest.
And hopes that the epidemic would level off have been confounded. A report published this July by the Joint UN Programme on AIDS (UNAIDS) showed that the AIDS epidemic is still at its early stages.
AIDS is having devastating effects on the very fabric of these countries, corroding economic growth and social and political stability.
AIDS removes economically active people, as it tends to hit individuals at their most productive ages, blighting already fragile economies. The disease is also greatly damaging the public sector. Death rates among health workers and police forces may be so high that lost workers cannot be replaced. In some countries, AIDS is already killing teachers faster than they can be trained.
At the same time, over fourteen million people – nearly three times the population of Scotland – are at risk of starvation in Southern Africa. And HIV/AIDS is greatly exacerbating the growing famine. Seven million agricultural workers have died with AIDS. As farm workers die, villages are losing up to half of their agricultural productivity due to AIDS.
In addition, HIV/AIDS threatens national and international security. As Bill Clinton told the International AIDS Conference this summer, HIV poses a threat ‘not simply to our health but to our economic well being and to our very security. A hundred million AIDS cases means more terror, more mercenaries, more war, destruction and the failure of fragile democracies.’
The tide can be turned. Some nations have brought the epidemic under control and are reducing infections. Uganda’s rate of infection is down from 20% in the early 1990s to about 5% now. Cambodia, Thailand and Senegal have been praised for their HIV prevention work . And Chine has shown some success in reducing HIV/AIDS in high risk groups and in improving openness.
But there is so much that needs to be done.
We need a massive expansion of work to prevent the spread of HIV. Fewer than one in five people at risk have access to preventive services. Education is a proven weapon against HIV – but a UN report says the vast majority of the world’s young people have no idea how HIV/AIDS is transmitted, or how to protect themselves.
We also need to greatly improve the lives of people with HIV, through care and support initiatives. In Africa, HIV treatment reaches just one in every thousand people whose lives it could save. And people with HIV the world over suffer terrible stigma and discrimination.
The good news is that there is more money spent on AIDS than ever before – six times more in developing countries than in 1998. The UK alone invested over £200m in HIV/AIDS programmes last year, supporting programmes in more than 40 countries, and has committed $200m to the Global Fund to fight AIDS TB and Malaria.
But the bad news is that that is nowhere near enough. UNAIDS estimates that AIDS spending in low and middle income countries needs to rise to $10bn per year by 2005- three times its current level.
The insanity of the global AIDS crisis is that it was entirely avoidable. We know what causes AIDS, and we know how to prevent it. The flip side of this coin is that we can stop the crisis from getting worse. This July an international group of experts put together a blueprint for action that would prevent 29 million new cases of HIV by the end of the decade -almost two thirds of the predicted new infections. There is a real opportunity to prevent tens of millions of personal tragedies and to avert further national catastrophes.
Our duty to work urgently to combat AIDS is not just altruistic. Self-interest also dictates that we act.
Firstly, as I have mentioned, the scale of the AIDS crisis represents a real threat to international stability – and has been formally recognised as a potential risk to security by the United Nations Security Council.
Secondly, AIDS is wiping out decades of investment from Britain and other countries to help people in developing countries, undermining all the work that has been done to help those nations reduce poverty and conflict and improve education and health.
Thirdly, as new HIV diagnoses in the UK reach record levels, the global AIDS crisis is reflected in our own HIV epidemic. Nearly three quarters of new diagnoses in the UK of heterosexually transmitted HIV – 1926 people in 2001 – are among people who are from Africa or who lived there for many years. Nearly half of the people newly diagnosed with heterosexually transmitted HIV in Scotland in the last year were exposed to the virus in Africa.
AIDS is a human tragedy and an international emergency. We know how to prevent it. We must act to do so.
Gavin Strang is MP for Edinburgh East and Musselburgh, and was the architect of the AIDS (Control) Act 1987.