Magazine article UN Chronicle

Far More Than a Health Issue

Magazine article UN Chronicle

Far More Than a Health Issue

Article excerpt

Ten years ago, a handful of health professionals and leaders like Elhadj Sy asked, prodded and cajoled Governments and ministers to pay attention to a disease called HIV/AIDS (human immunodeficiency virus/acquired immune deficiency syndrome).

"HIV/AIDS was impacting development", said Mr. Sy, the Joint United Nations Programme on HIV/AIDS (UNAIDS) Representative in New York and whose work on the disease began in the eighties. "But there were many people, many government officials who didn't think so. One minister of health told me 'we can discuss malaria but not this AIDS of yours."'

Ten years later, as the number of global infections hit 36.1 million, the HIV/AIDS battle is gaining momentum. On three occasions in 2000, the United Nations Security Council discussed HIV/AIDS. The story of HIV/AIDS when addressed as a health problem offers vastly different endings compared to when it is addressed as a human security threat.

Take the example of Senegal. In 1986, when the first six cases of HIV/AIDS were reported, the Government responded immediately and created a national AIDS programme. By 1987, blood transfusions were systematically scanned in ten regions of the country. By 1992, awareness of the disease had become part of primary school curriculums. Soccer games included messages about HIV/AIDS on stadium banners and on t-shirts of players. Young people mobilized to fight the disease, "even though they had never seen a person living with AIDS", recalled Mr. Sy. The Government incorporated HIV/AIDS across development policies, and today Senegal boasts one of the lowest HIV/AIDS rates in Africa--1.77 per cent.

In Brazil, President Fernando Cardoso, in a 1996 Presidential Decree, recommitted providing universal access to HIV/AIDS antiviral therapies under his country's public health care system. "The health authorities in Brazil determined that the cost of the spread of AIDS in Brazil would be extremely high", said Ambassador Gelson Fonseca, Jr., Brazil's Permanent Representative to the United Nations. "They determined it was better to spend money on prevention, because it will save money in the long run." By 2001, Brazil's national AIDS policy decreased the numbers of HIV/AIDS-related deaths by 50 per cent and of hospitalizations by 75 per cent.

In 1992, when the Uganda AIDS Commission began coordinating their national HIV/AIDS strategy, the Government faced a 14 per cent infection rate. By December 2000, the rate decreased to 8.3 percent.

And the list goes on. When top leaders pay attention, changes can happen.

Look at the United Nations. "Even in 1998, AIDS was still very much seen as a health disease to be dealt with in a health forum, not as a social development problem", said David Lawson, a Liaison Officer for UNAIDS in New York. But today, beyond the seven co-sponsoring bodies of UNAIDS--the UN Children's Fund, the UN Development Programme, the UN Population Fund, the UN Educational, Scientific and Cultural Organization, the UN Office for Drug Control and Crime Prevention, the World Health Organization and the World Bank--every UN body addresses HTV/AIDS.

When the United States first pushed to have HIV/AIDS discussed in the Security Council, many nations protested for procedural reasons. "They felt that the Security Council was not the appropriate venue for social and economic issues", said Mr. Lawson. But the United States persisted. "Unless we act effectively and decisively now HIV/AIDS might be the worst pandemic we have ever seen", said former United States Vice-President Al Gore, who presided over the Council's first meeting on HIV/AIDS. "Absolutely the United States should address HIV/AIDS as a national security issue", he said in a recent interview with the Chroncile. "AIDS is a security issue, just as the environment is a security issue."

Two results emerged from the Council's first meeting in January 2000 on the "impact of AIDS on peace and security in Africa". …

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