Care and support for people living with HIV/AIDS

Report on the global HIV/AIDS epidemic – June 2000Advancing other social goals such as education, empowerment of women andhuman rights protection are important for reducing overall societal vulnerability toinfection, as well as critical in their own right. At the same time, planners need tobear in mind that development projects such as the construction of a major highwayor the creation of free-trade zones may exacerbate the epidemic by promoting rapidurbanization, splitting families and depriving individuals of familiar social supportsystems. These negative effects need to be anticipated and actively countered.Common features of effective national responsesAnalysis of effective programmes shows that a number of features characterize theresponses of communities and countries which have already managed to stabilize orreverse their epidemic trends. This is not to say that there is one ideal expandedresponse or universal blueprint, but some basic, common principles of effectiveresponse can be identified. It is important for each country to find locally relevantpathways to a response that are likely to include most, if not all, of the elementssummarized below.Successful national responses have generally comprised the following features:1. Political will and leadershipPolitical will expresses the national commitment and provides overall leadership tothe nation in response to AIDS. Effective responses are characterized by politicalcommitment from community leadership up to a country’s highest political level.Such commitment leads to high-profile advocacy and helps bring in all the sectorsand players, along with the necessary human and financial resources. It is also criticalfor making the hard political choices often involved in adopting interventionmethods that really work – such as making sex work safer – and can lead to helpfulpolicy changes and supportive legislation.Ultimately, the success of a programme is determined by the dedication and effortsof the change agents who are closest to its level of impact. They, however, need tobe constantly motivated, supervised and supported by the political leadership.2. Societal openness and determination to fight against stigmaTo be effective, programmes need to make HIV visible and the factors leading to itsspread, discussible. Programmes need to make people aware of the existence ofHIV and how it is spread, without stigmatizing the behaviours that lead to its transmission.They also need to facilitate discussion about an individual or community’sown vulnerability, and how to reduce it. This involves dissipating fear and prejudiceagainst people who are already living with HIV or AIDS.108