Report on the Global HIV/AIDS epidemic

Report on the global HIV/AIDS epidemic - June 2000

Advancing other social goals such as education, empowerment of women and
human rights protection are important for reducing overall societal vulnerability to
infection, as well as critical in their own right. At the same time, planners need to
bear in mind that development projects such as the construction of a major highway
or the creation of free-trade zones may exacerbate the epidemic by promoting rapid
urbanization, splitting families and depriving individuals of familiar social support
systems. These negative effects need to be anticipated and actively countered.
Common features of effective national responses
Analysis of effective programmes shows that a number of features characterize the
responses of communities and countries which have already managed to stabilize or
reverse their epidemic trends. This is not to say that there is one ideal expanded
response or universal blueprint, but some basic, common principles of effective
response can be identified. It is important for each country to find locally relevant
pathways to a response that are likely to include most, if not all, of the elements
summarized below.
Successful national responses have generally comprised the following features:
1. Political will and leadership
Political will expresses the national commitment and provides overall leadership to
the nation in response to AIDS. Effective responses are characterized by political
commitment from community leadership up to a country's highest political level.
Such commitment leads to high-profile advocacy and helps bring in all the sectors
and players, along with the necessary human and financial resources. It is also critical for making the hard political choices often involved in adopting intervention
methods that really work - such as making sex work safer - and can lead to helpful
policy changes and supportive legislation.
Ultimately, the success of a programme is determined by the dedication and efforts
of the change agents who are closest to its level of impact. They, however, need to
be constantly motivated, supervised and supported by the political leadership.
2. Societal openness and determination to fight against stigma
To be effective, programmes need to make HIV visible and the factors leading to its
spread, discussible. Programmes need to make people aware of the existence of
HIV and how it is spread, without stigmatizing the behaviours that lead to its transmission. They also need to facilitate discussion about an individual or community's
own vulnerability, and how to reduce it. This involves dissipating fear and prejudice
against people who are already living with HIV or AIDS.

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