The new wave of cheaper antiretroviral drugs will not stem the global HIV pandemic unless they are used in tandem with urgent measures to alleviate poverty, stated an agency of the churches in the UK and Ireland in a recent report released to mark World Aids Day 2004. The report, entitled, If Not Now, When? HIV, Drugs and Prevention, expressed UK-based Christian Aids concerns regarding the HIV pandemic making mention of two misleading ideas presently being circulated, as well as the crucial role over poverty.
We are concerned that there are currently two contradictory and confusing messages regarding the HIV pandemic, Christian Aid stated in a recent news release.
According to the agency, the first message is that the situation is so far gone in some parts of the world as to be hopeless, while the second is that with the introduction of antiretroviral drugs (ARV), HIV can be controlled.
Both these ideas are misleading, said Dr. Rachel Baggaley, head of Christian Aids HIV Unit. There is good news and in certain areas we have seen significant progress. The introduction of cheaper antiretrovirals is a positive move, but we must realize that it is not the sole answer to this crisis.
The dangerously spiraling HIV rates will only be brought under control if there is a committed, multi-pronged attack on the crisis nowincluding drug provision, prevention and community care. Countries must also be freed from the burdens of debt and unfair trade rules, Baggaley added.
Christian Aid stated that the role of community-based organizations, for example, must be enhanced; in many countries they are the only organizations which provide support and counseling to people living with HIV.
With the introduction of antiretroviral drugs, they are assuming an ever greater importance, the agency said. Without community-based careers to help people take ARVs regularly, they risk developing resistance to their drug treatment.
Baggley added, These community organizations must be supported so that the needs and priorities of people living with HIV are met. These groups are also indispensable since they put pressure on governments to ensure a steady supply of affordable drugs.
She also spoke of the role of poverty in the epidemic.
Poverty is one of the key drivers of this epidemic, Baggaley said. Unless we tackle issues of trade, debt and the lack of trained health care workers, we cannot begin to win the battle. Providing drugs without taking account of these issues will not work in the long-term.
As stated in the If Not Now, When? report, the crucial role that poverty plays in the epidemic must be acknowledged and that all HIV policies must incorporate the eradication of poverty.
Christian Aid added that the overwhelming debts owed by poor countries to wealthy nations make it impossible for some of the countries hardest-hit by HIV to cope.
Currently, Zambia has one million HIV-positive people but spends 30% more on servicing its debt than on health. Kenya, which spends $12.92 (USD) per capital on debt repayments, only spends $0.76 (USD) per capital on HIV/AIDS.
Christian Aid supports the initiative of the World Health Organization to get three million people on ARVs by 2005, known as 3 by 5, but the agency says, Unless the rich countries commit the money necessary this target will remain an unattainable objective.
By the end of 2004 only 440,000 people will have received ARVs.
The UN agency for HIV/AIDS, UNAIDS, calculates that $20 billion (USD) each year is needed by 2007 for prevention and care in low and middle-income countries. To date global spending on HIV is a paltry $4.7 billion (USD) annually.