Georgia Burford, HIV Strategy Manager, CAFOD
Progress on HIV since the MDGs has been remarkable, including the development of antiretroviral drugs, around 10 million people living with HIV now on lifesaving treatment and numbers of new infections halving within the last decade in 25 low to middle income countries. There has even been mention that we are nearing the end of AIDS. This progress has been down to the fact that HIV was given such high profile in the MDGs, with MDG 6 focussing specifically on this.
MDG 6: Combat HIV and AIDS, malaria and other diseases
Target A: Have halted by 2015 and begun to reverse the spread of HIV and AIDS
Target B: Achieve, by 2015, universal access to treatment for HIV and AIDS for all those who need it
Despite the magnificent gains made since 2000, MDG 6 targets are far from being met, much remains to be done. There is lifesaving treatment, which is reaching about a quarter of people living with HIV, and where people are supported to adhere to this, they can go on to live a long and healthy life. Yet, there are many challenges that still exist and in some countries fragile gains are being reversed.
The Compass 2015 Research project identifies HIV being a cause and effect of poverty and inequality. A woman in Zimbabwe explained the costs incurred in order to seek treatment through transport, purchasing medication and food required for a balanced diet to ensure the medication works.
In the case of HIV, there are often many intersecting factors making people living with and affected by HIV affected by poverty and injustice. The most significant of these being stigma and discrimination which exacerbates the injustices faced by people living and affected by HIV. The report gives an example where someone’s produce was not bought in the market because they were known to be living with HIV and with another beneficiary in Ethiopia their house was burned down by neighbours after discovering they were living with HIV. Such stigma and discrimination further marginalises people with HIV, and when this is combined with gender inequalities, gender based violence, lack of education and health services, migration and conflict, it is possible to see why HIV is common amongst the communities where CAFOD works.
One of the main findings in the Compass report is that changes in social norms, attitudes, policies and practices is the first step in addressing stigma and social exclusion. We must be mindful that whilst government attempts to address this in legislation and policies, this may not be conducive in practice.
We are not sure of what the post MDG goals will be, but we do know that HIV will not be one of them. It looks likely that HIV will be covered in a wider health goal. I would like to see more emphasis on vulnerable groups whose voices are not heard, be it gender, age, disability, or HIV status, such groups must be meaningfully involved and supported to participate in their communities, gain positions of power and are protected in whatever interventions are taking place.
Wherever HIV is located in the post MDG Framework, it is critical that the fragile gains made are safeguarded and that resourcing is maintained in order to make continual progress in addressing the HIV epidemic. More people than ever are now living with HIV, more demands are being made on service providers, more support is needed in addressing stigma and discrimination which affects ability of people to seek treatment, care and support.