UNAIDS Report Says HIV/AIDS Thwarts Sustainable Development Goals

Efforts to achieve sustainable development goals in developing nations will be "meaningless" unless HIV/AIDS is "brought under control," UNAIDS Executive Director Peter Piot said during yesterday's session of the World Summit on Sustainable Development in Johannesburg, South Africa, the AP/Philadelphia Inquirer reports. A UNAIDS report released yesterday documents how the HIV/AIDS pandemic is reducing life expectancies, "devastating" families and "destroying" economies in the developing world (Nessman, AP/Philadelphia Inquirer, 8/30). "Here our message is very simple: in many parts of the world you can forget about sustainable development if this AIDS epidemic is not brought under control," Piot said. He noted that many developing nations are experiencing a "major crisis of human resources" because the epidemic is killing people in the most productive periods of their lives. HIV/AIDS is depleting the ranks of laborers, teachers, health care providers and farmers in many nations, and the disease strains existing labor resources because people who are not infected with the virus must care for an increasing number of dependents. Piot said that strong political leadership, greater access to treatment and anti-poverty efforts must be implemented to fight HIV/AIDS (Kotch, Reuters, 8/29). "Prevention works. Treatment and care save lives. The world knows what it takes to set effective responses in place everywhere they are needed," he said (Agence France-Presse, 8/29). Piot criticized the summit for "addressing AIDS only as an afterthought," adding, "It's striking to me that most of the discussions are on trade issues, and those are important ... but maybe AIDS is considered too soft" (AP/Richmond Times-Dispatch, 8/30). He also expressed concern that the New Partnership for Africa's Development -- a "recovery plan" for the continent -- "shows similar ambivalence" about HIV/AIDS. "When I look at that document, AIDS is just not there. (African leaders) still see AIDS as separate, as something for the minister of health to deal with, not fundamental to Africa's survival," Piot said (McGreal, Guardian, 8/30).

Report Findings
The report, titled "HIV/AIDS, Human Resources and Sustainable Development," outlined how the HIV/AIDS pandemic is affecting several development areas, including:

• Health systems: HIV/AIDS is straining governments' health budgets and countries' health systems. The epidemic has led to a shortage of hospital beds, which means that many people with HIV are not treated until the later stages of illness. In addition, growing HIV incidence among health care workers has reduced providers' productivity and boosted recruitment and training costs. The strain on health care systems raises the overall cost of providing basic health care, the report states. The report concludes that broadening antiretroviral treatment access will help people with HIV remain healthy and productive.
  
• Household structure: HIV/AIDS is killing many "family breadwinners" and forcing households to spend available resources on care, funerals and "sustaining a bare minimum of standard of living," the report states, adding that income in AIDS-affected households can be less than 50% of that of a household not affected by AIDS. "The transition from relative well-being to extreme poverty can be quite rapid in AIDS-affected households," the report states.
  
• Food availability: The food crisis in southern Africa is growing worse as an increasing number of farmers become infected with HIV. Several efforts could help fight HIV/AIDS among farmers, including the development of AIDS-awareness programs that target rural communities; the introduction of programs that can help sustain female-run households; the provision of HIV education to farmers and agricultural workers; the support of home- and community-based care in rural areas; and fostering fairer access to global markets for developing and middle-income countries.
  
• Labor: HIV/AIDS has decreased labor supply and skills, increased business costs and disrupted production and productivity, the report states. Providing HIV prevention programs in the workplace and providing treatment and care to workers "makes good business and developmental sense," the report states.
  

Funding, Political Will Needed to Fight AIDS
The report offers a number of recommendations for fighting HIV/AIDS and boosting sustainable development. Broadening prevention and treatment efforts, integrating HIV/AIDS into wider development strategies, enacting measures to protect women and young people and "[r]eviving" the public sector are several ways countries can fight AIDS, according to the report. The report notes that such efforts require commitment from political leaders, community mobilization and the involvement of people living with HIV/AIDS. In addition, greater funding is needed to make substantial reforms. The report states that a "sustained increase" of 50% annually in total funding for international HIV/AIDS programs must be achieved. While the report states that this sum is "modest," it says that international funding must increase "exponentially" to boost HIV/AIDS funding to the necessary levels. In particular, the Global Fund to Fight AIDS, Tuberculosis and Malaria requires "sustained support" and a good deal of "additional and new" funding ("HIV/AIDS, human resources and sustainable development," UNAIDS, August 2002).

Kaisernetwork.org's HealthCast will feature webcasts of some sessions at the summit. Daily Report readers will be alerted when the video is available online.