Millions of people around the world are suffering from a terrible pandemic HIV/AIDS. Sub-Saharan Africa is by far the worst affected region with more than 30 million people infected. Four southern Africa countries: Botswana, Lesotho, Swaziland, and Zimbabwe have a HIV/AIDS prevalence exceeding 40 per cent. Eritrea is lucky because the magnitude of this disease is small with about 2.7 per cent.
AIDS has orphaned more than 13 million children in Africa. The lucky ones have relatives taking them but frequently, most orphans are left to care for themselves and their siblings. In spite of lack of skills and training these children often work long hours to grow food or earn a meagre income, but lack the skills and training to succeed. Furthermore, they risk having their family lands taken away, dropping out of school and becoming destitute.
More than 55 percent of the people infected with HIV/AIDS in Africa are women. For physiological and social reasons, women and girls are particularly susceptible to the sexual transmission of HIV/AIDS. Often bound by cultural traditions where women hold lower social standings than men, women cannot control their husbands’ sexual behavior of their husbands, and have no voice in contraceptive choices. As regards the condition of the disease in Eritrea, the degree of awareness compared to the level of the disease in other countries in Africa is better. The government and the NGOs are active in informing the public about this disease. However, whatever is being done is still not enough as long as the disease continues to spread.
Several factors put Africa in danger of experiencing a rapid spread if effective prevention and control measures are not scaled up and expanded throughout the continent. These risk factors include: unsafe sex; migration and mobility; Injecting Drug Use (IDU), low status of women and widespread stigma.
In majority of the African countries, sexual transmission is responsible for 84 percent of reported AIDS cases. HIV-prevalence rates are highest among sex workers and their clients. About 70 percent of commercial sex workers do not use condoms as their customers are opposed to this. Migration for work for extended periods of time takes migrants away from the social environment provided by their families and community. This places them outside the usual normative constraints hence increasing their likelihood to engage in risky behavior. Studies indicate that many drug users are switching from inhaling to injecting drugs. This phenomenon is more popular in many states of Africa, and injecting drug users show sharp increases in HIV prevalence. About 30 per cent of IDUs is done with used needles or syringes. Of those who cleaned needles and syringes, only three percent use an effective method such as alcohol, bleach, or boiling water. Infection rates have been on the increase among women and infants in countries like South Africa, Botswana, Ethiopia and Swaziland. As in many other countries, unequal power relations and the low status of women, as expressed by limited access to human, financial, and economic assets, weakens the ability of women to protect themselves and negotiate safer sex, thereby increasing vulnerability. Only when women are truly empowered, economically and socially, can their health conditions improve. Different strategies are required for both rural, urban settings, and literate, illiterate parts of society. Improving HIV/AIDS education, healthcare, and services for women in Africa is part and parcel of the essential strategy the UN programmes need to employ to achieve sustainable development, and Millennium Development Goals. Stigma towards people infected with HIV/AIDS is widespread. The misconception that AIDS only affects homosexuals, sex workers, and injecting drug users strengthens and perpetuates existing discrimination. The most affected groups are often marginalized and have little or no access to legal protection of their basic human rights. Addressing the issue of human rights violations and creating an enabling environment that increases knowledge and encourages behavior change are thus extremely important to the fight against AIDS. In anti HIV/AIDS campaigns in Africa, many countries do not exhibit pictures of victims. People who are living with the disease do not come out to the public. If they are not able to come out, a lot of people will not understand the dangers of the disease.
In June 2006, the United Nations General Assembly Special Session (UNGASS) noted that, "we are facing an unprecedented human catastrophe". However, they were unable to commit and lay concrete targets to halt the disease's spread in the world, particularly in Africa. It is surprising to note that the boldness of the specific time-bound commitments of the U.N. Declaration on HIV/AIDS reflect an unwillingness to admit the realities of the pandemic.
Other groups most vulnerable to the pandemic include, youth, older people, transgender, people living in poverty, prisoners, migrant laborers, orphans, people in conflict and post-conflict situations, indigenous peoples, refugees and internally displaced persons, as well as HIV/AIDS outreach workers.
Barring a late-stage recognition of the feminization of the epidemic, these groups remain without frameworks addressing their specific needs, or targets through which real change can be made. Examples include: provision of clean needles and condoms, substitution therapy for drug users, unstigmatised access to services and treatment, and prevention outreach programmes. Breakthrough negotiations on the final day of the U.N. session saw the ratification of the rights of women to protection and provision of health care and services by 2015. These exclude specifics on the rights of girls married in childhood under 18. The problem for all this terrible suffering is lack of information about the consequence of the disease.
Under pressure from the United States, African leaders allowed a progressive deal made in Abuja, Nigeria, in May 2006 to be sidelined at the U.N. It had endorsed ambitious targets towards universal access to treatment by 2010. It included programmes designed to prevent transmission to newborns for 80 per cent of mothers, basic services for 80 per cent of orphans and vulnerable children, access to antiretroviral treatment for 80 per cent of those in need, access to voluntary testing and condoms for 80 per cent of target populations, and access to AIDS medicines for all those with tuberculosis.
No such commitments exist in the U.N. declaration. Instead, it uses broad-brush statements recognizing the importance of universal access to prevention, treatment, care and support programmes, and drawing up targets by 2008.
U.S.-based groups such as the Global AIDS alliance have berated their government for weakening language on HIV prevention, low-cost drugs, trade agreements and targets and funding for prevention and treatment. However, since 2001, the U.S. administration has preferred to commit most of its HIV spending via the President's Emergency Fund for AIDS Relief (PEPFAR), through which it can enforce abstinence-only programmes and forbid the use of cheap generic life-saving medicines that are not approved by the Federal Drugs Administration.
The adopted declaration estimated that $23 billion a year will be needed by 2010 to fund AIDS programmes. Despite the fact that this is nearly triple the $8.3 billion spent in 2005, U.N. members did not commit themselves to a fundraising timetable. Besides, the Global Fund to Fight AIDS, TB, and malaria set up in response to the 2001 declaration, is already facing a funding shortfall of over $90 million for this year and $1.2 billion for next year.
The 2006 declaration has done little to provide a funding outlook or targets upon which African countries including Eritrea will be able to base interventions for vulnerable populations and treatment rollout in the final stage of its programme. Governments, NGOs and other Activists fear continued stigmatization, lack of treatment and resource provision and increased infection rates in the continent.
The 2006 declaration will not be seen as a milestone in the fight against HIV. At a potential turning point, it has not provided standards for mitigation of the disease in the African continent. At best it rubber stamps the 2001 declaration and acknowledges the scale of the issue. At worst it has missed an unparalleled opportunity to ensure gains in the fight against the pandemic. The HIV/AIDS is one fatal disease, which human beings can choose to keep away from, and it is easier to avoid than a common cold. It needs moral and financial support. Everyone should fight against this pandemic with a slogan: "spread the message not the virus."