The World of The AIDS Generation

Kampala, Uganda. Rebecca has been living with AIDS since 1992. That was the year her husband died after many months of illness. He never told her what was wrong with him. But it was not until 2001 that Rebecca found she had the first symptoms of the disease. Since then, it has been one long uphill struggle to find money to pay for her medicines.

Yet another battle she has to wage to buy the antiretroviral drugs prescribed for her. Access to care is not easy in a country where income per head is usually no more than an annual US$250. And so Rebecca survives as best she can with help from her family or a British NGO... Rebecca's story is all too familiar.

People in developing countries pay a heavy tribute to one of the most devastating epidemics in the history of mankind. For lack of care, but mainly for lack of money. Today, AIDS rarely makes media headlines.

And yet statistics are sky high in the poorer countries particularly, but also in richer countries where the benefits brought about by combination therapy are largely offset by slacker observance of elementary precautions.

Figures on the increase across the board

In 2004, the AIDS epidemic killed over three million people worldwide; that represents approximately six deaths every minute. Forty million people are HN positive. According to the 2004 UNAIDS Report on the Global AIDS Epidemic, "Over the past two years, the number of people living with HIV has risen in every region of the world.

The steepest increases occurred in East Asia, China in particular, with a 50% rise. The 40% increase in Eastern Europe and CentralAsia in 2004 in that period is mainly due to Ukraine's expanding epidemic and the rapidly growing number of people living with HNin the Russian Federation." Sub-Saharan Africa, however, is still far and away the worst affected region, with 25 million people living with HIV, representing over two thirds of the world's victims... of which some three-quarters (76%) are infected women.

The relative stability observed in the region over the past two years (+7.4%) should not be allowed to conceal a true and particularly devastating situation: the number of people infected with the virus is equivalent to the number of AIDS-related deaths.

This represents over a million people affected every year. On the other side of the Atlantic, the Caribbean continues to be the second worst-affected region in the world. In five countries of the archipelago, HIV prevalence figures rise over 2% and the disease is about to become the principal cause of adult death in the 15 to 44 age group.

From one continent to another these figures reveal a situation which can only be described as desperately out of control, and all the more so because the repercussions of the disease are not solely confined to health. In the poorest countries, the disaster is also measured in economic terms.

Women and children are the first victims

AIDS spells disaster for rural economies and aggravates the food shortages that affect their inhabitants. Farmers become too sick to work the fields and those who are still in good health are obliged to neglect their farms - or even sell them - to look after members of their family. Another factor is important: the role of women.

In developing countries, they produce 60 to 80% of food-crops. More frequently affected than men by HIV, they cannot continue to carry out this vital function. In some countries, they even lose the right to cultivate their land after the death of their husbands.

As a consequence, children and adults suffering from malnutrition find it increasingly difficult to fight the infections affecting them. On the industrial front, the picture is hardly brighter.

To give but one example, South Africa, with over 20% of its people contaminated, loses 5% of its workers and 1% of its GDP annually, due to repeated absences from work, lack of qualifications and the cost of healthcare. "Out of our 2,300 employees, between 20 and 30 die from AIDS every year," Frederic de Rougemont, CEO of Lafarge South Africa, told the French magazine "Le Point" recently. "It is first and foremost a human tragedy, but it is also a sad loss of know-how for the company."

A glimmer at the end of the tunnel

Despite this sombre picture, there are a number of reasons to believe that we may be over the worst. In 2000, at the G8 meeting in Okinawa (Japan), the richest countries decided to intensify the battle against the three major diseases afflicting the Third World.

The decision to launch a global fund to fight AIDS, TB and malaria was accompanied by an endowment of several billion dollars. An intensification of research to discover a vaccine against the HIV virus; making treatment available for 700,000 patients; active prevention policies in countries such as Uganda and Thailand - forces are indeed uniting. In parallel, the pharmaceutical industry's involvement has made it possible to reduce by 80% the cost of antiretroviral drugs for the sick in poor countries.

The aim is to make therapy available to the greatest number of people. Another positive note is that some large countries seem to be emerging from denial of the reality of the disease. China, which had been criticised for its failure to take timely action, made an official commitment in the latter part of 2004 to fight the scourge that could contaminate five million of its nationals by 2010.

The Indian Government has announced that it will make greater efforts to inform and organise prevention, particularly for young people and in rural areas. Better late than never.

Industrialists are also getting organised. To counter labour shortages, nearly 200 international groups (including BP, Coca-Cola, Renault, Siemens and sanofi-aventis) have joined forces within the Global Business Coalition on HIV/AIDS (GBC).

They are all engaged in the same project: launching corporate plans to fight the disease. Prevention, raising awareness, screening and free healthcare for employees and close relatives are all significant steps on the way to harmonising economic logic with ethics, humanity and solidarity. Examples to be followed enthusiastically .