From poverty to power - Oxfam-Québec

FROM POVERTY TO POWEREveryone has a heartbreaking story to tell. Virtually every countryin East and Southern Africa is a nation of mourners. 58CITIZENS AND STATES AGAINST AIDSBecause there is no vaccine for HIV or cure for AIDS, and becauseHIV spreads through sexual contact, this health shock cannot beeffectively mitigated by state action alone. In this way AIDS is notunlike diseases spread by poor hygiene. Stopping it requires changesin people’s behaviour. The state must take the lead but all of societyneeds to become engaged: women to demand their rights; men toresist social pressures to have unsafe sex; groups of people living withHIV to organise systems of self-help and demand services fromgovernments; all to understand how HIV is spread and how it can beprevented. Active, empowered citizens are an essential part ofstemming the spread of HIV and AIDS and reducing the devastationit wreaks: their ‘agency’ cannot be neglected.The pandemic has thrown up some inspiring examples of grassrootsactivism. The experience of perhaps the best known, SouthAfrica’s Treatment Action Campaign, is discussed in the case study onpage 242. In the Ukraine, what went on to become an award-winningmovement began when seven HIV-positive activists met in 1999 andset up the All Ukraine Network of People Living with HIV and AIDS.Its combination of self-help, public education, and high-level lobbyinghas helped to get HIV and AIDS designated as national health carepriorities, trebled the national budget for treatment, and persuadedthe government to cancel the results of what are delicately called‘non-transparent tenders’ for purchases of ARV drugs. The Networkhas helped to inspire similar exercises across the countries of theformer Soviet Union.In parallel with citizen action, governments both North and Southmust deliver protection, whether in the shape of properly funded,effective health services and prevention programmes or trade rulesthat facilitate (rather than obstruct) the provision of affordablemedicines. The pharmaceutical industry, for its part, must understandthat access to medicines is a fundamental human right,enshrined in international law, and that this places a particular234