Putting the battle against AIDS epidemic back on track<\/p>\n
By Nona Pooroe Utomo<\/p>\n
JAKARTA (JP): More than a decade ago, the world discovered a
\nnew worldwide epidemic. Acquired Immune Deficiency Syndrome
\n(AIDS) shocked a public accustomed to biomedical triumph, and the
\nindustrialized world, shorn of its technological armor, was
\nforced to develop prevention and care strategies.<\/p>\n
In developing these, the industrial world had to listen and
\nlearn from the universally available wealth of human experience
\nand wisdom. These are qualities which exist in equal abundance in
\nall societies, in contrast to wealth or scientific
\ninfrastructure.<\/p>\n
The World Health Organization (WHO) developed a framework for
\na common action, a Global AIDS Strategy which was endorsed and
\nfollowed by most of the nations of the world, including
\nIndonesia.<\/p>\n
As the global scope and impact of AIDS became evident, a
\nremarkable period of solidarity started and a global AIDS
\nmovement was born.<\/p>\n
Early international AIDS conferences witnessed an exchange of
\nexperience carried out in a spirit of intellectual and social
\nequality rarely, if ever, seen before. Many of us felt, in
\njoining the world against AIDS at any level, in any place, within
\nany discipline or organization, that we belonged to something
\nlarger than a nation, an ethnic group or a profession.<\/p>\n
AIDS made people aware of global interdependence and
\nsolidarity, something tangible, real, visible and alive.<\/p>\n
But as new hope emerged with the news on the new combinations
\nof antiretroviral drugs that gave a solid ground for finding a
\ncure, we faced the decline of the global AIDS movement and
\ndecrease in solidarity.<\/p>\n
As the media started the spin that \"the cure is here\" at the
\nXI International AIDS Conference in Vancouver in July last year,
\nthe growing AIDS care gap, especially between the developed and
\ndeveloping world, became wider.<\/p>\n
So many people all over the world had no access to even the
\nsimple drugs they needed for their opportunistic infections, no
\nless to antiretroviral drugs.<\/p>\n
Nearly 22 million men, women and children now live with the
\nHuman Immunodeficiency Virus (HIV), and 8,100 more become
\ninfected every day. About 1,000 of them are children. Over 40
\npercent of adult infections are in women and this proportion is
\nstill rising.<\/p>\n
Losing solidarity<\/p>\n
Jonathan Mann from the Harvard School of Public Health, who is
\na former executive director of WHO's Global Program on AIDS,
\nconfronted the Vancouver conference with the message that the
\nworld had begun to lose solidarity.<\/p>\n
It was as if during that first period of global consciousness,
\nthe status quo of the world stood back briefly, gathering
\nstrength; they hovered over us, waiting for vengeance. There are
\nmany of these status quos, including the gap between the haves
\nand have nots, between scientists and activists, between men and
\nwomen and between infected and uninfected people. But beyond the
\ndetails, the essence, the common characteristic of all the
\nresurgent status quos, is that there are walls which separate and
\ndivide people.<\/p>\n
Ultimately, these status quo realities propose that we can
\nafford to forget about each other. It is now acceptable to think
\nand live in isolation; people in the rich countries can receive
\ntreatment with whatever the latest and best science can provide,
\nand the north has resume its limited, \"charity-based approach\" to
\ninternational assistance against AIDS. The biomedical research
\nestablishment can pursue its course with diminished attention to
\npressing societal needs. Officials can speak at the conferences
\nand elsewhere -- without fear of challenge or accountability --
\nas if they were activists rather than actually being responsible
\nfor policy and programs. And whoever we are, we can now feel
\nauthorized -- by the prevailing norms within the world of AIDS --
\nto go in our own way.<\/p>\n
Of all the status quos which divide us, the gap between the
\nrich and the poor is most pervasive and pernicious. Thus, the
\nbiomedical advances -- which we all desire so ardently -- have
\nwidened enormously the chasm between the rich and poor nations,
\nand between the rich and poor within nations. The injustice is
\nstark-- drugs are available to, at most, 10 percent of the
\nworld's people with HIV\/AIDS in industrialized countries. Yet
\nour problem is profoundly different from all the other health
\nconditions in which the same inequity of access to drugs and
\nother medical treatment between the \"haves\" and \"haves not\" has
\nbeen the tragic rule.<\/p>\n
For in AIDS, we all started in the same place, with the same
\nlack of treatment and with the same hopes, but the unfairness has
\narisen right before our eyes. So the injustice, and the
\nseparation it creates, is all the more acutely felt, more
\npersonal, direct and real.<\/p>\n
The global gap between richer and poorer has been intensified
\nby the shape and direction of the pandemic. During the period of
\ndiscovery, the dominant theme was global spread. Yet an ever-
\nincreasing proportion of the pandemic, today more than 90
\npercent, is in the developing world. As the epidemic matures, it
\nmoves along a clear and consistent pathway, which although
\ndifferent in its details within each society, nevertheless has a
\nsingle, vital, common feature. In each society, those people who
\nwere already marginalized, stigmatized, and discriminated against
\nbecome, over time, those at highest risk of HIV infection. The
\nepidemic is focusing upon those whose human rights and dignity
\nare least respected.<\/p>\n
As a result, at the strategic level, separatism and
\nfragmentation dominate where once was a coherent Global Strategy.
\nCurrently, instead of a strategy, we have a series of tactical
\napproaches.<\/p>\n
This loss of strategic focus is particularly evident and
\ntragic, because in theory, global learning has worked, and we
\nshould be able to apply what has been learned to generate more
\neffective action.<\/p>\n
We have strength yet for the sake of global future, we must do
\nmore than witness the seemingly inevitable decay of solidarity.
\nThe challenge is to create and recreate the conditions in which a
\ntruly global movement will become possible.<\/p>\n
To rebuild a capacity of global thinking and action, we need a
\nstrategic approach to restoring and reinforcing connectedness.
\nAnd this connectedness starts with the involvement of everyone,
\nthose who are working against HIV\/AIDS around the world,
\ngovernment, media, women and men -- every living individual.<\/p>\n
In moving forward, we must challenge , boldly and without
\ncompromise, the notion that the future is not the inevitable
\nconsequences of the past. The chains of pain and suffering we
\nhave inherited can be broken, and we can each contribute meaning
\nto the healing of the world.<\/p>",
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"sponsor": "Okusi Associates",
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