Report on the Global HIV/AIDS epidemic

Care and support for people living with HIV/AIDS

only 12% did so. It emerged that while some people understood the concept of a
revolving loan, others perceived it as a grant that did not have to be repaid.
The scheme soon collapsed.
Avenues for tackling the economic impact of the epidemic range from loans or
grants to individuals with HIV, at one end, to complex societal measures for averting
and alleviating the epidemic's impact on agriculture, the educational system and the
private sector, for example (see pages 26-36). Alleviation measures may be directed
at a well-defined problem, such as the increase in orphans, or may be more general
in nature. In some cases the project's beneficiaries may be restricted to people living with HIV or AIDS.
There is no perfect or universally applicable solution. For example, restricting grants
to people affected by AIDS may help channel severely limited resources to where
they are badly needed, but it can also have negative consequences. Organizations
bringing support to AIDS orphans learned early on that it was better to target all
orphans as a group so that the project would not create resentment among those
excluded or attach an AIDS stigma to specific children.
Micro-credit, also known as micro-finance, is an effective poverty-alleviation instrument promoted by the United Nations Development Programme (UNDP). These
group lending schemes grant small loans to individuals who want to start up a small
business and who seem likely to be able to repay. Communities with HIV-positive
people generally meet the criteria for these schemes, including the presence of
many poor people, the existence of market opportunities and infrastructure facilities,
high population density, approval of local authorities, and the ability to build trust in
the community. Experience has already shown that the schemes can work very successfully in high HIV-prevalence areas of Africa. In Malawi and Uganda, for example,
the Foundation for International Community Assistance (FINCA) has achieved 100%
recovery of its loans.
While some micro-finance organizations are closing their eyes to the AIDS epidemic
or even excluding sick members, some are helping their clients to accumulate savings by serving as a bank or banking intermediary, assisting them to carry on their
business when they fall ill, and providing survivors with advice on inheritance and
legal protection. Some have even joined the front-line fight against the epidemic. For
instance, FINCA in Uganda is working with organizations such as TASO to promote
condoms and educate its clients about safer sex, while the Zimbabwe Opportunities
Industrialization Centre (ZOIC), operating in small towns and rural communities
affected by the epidemic, is organizing community-based orphan care programmes. These practical examples of an integrated response to AIDS illustrate
why it can be artificial to make a distinction between prevention, care, support and
impact alleviation.
UNDP estimates that micro-finance at present covers only 1% of the potential market, affording great potential for expansion. It has been suggested that proxy indicators of possible HIV spread - such as military conflict and population migration -

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