Care and support for people living with HIV/AIDS

What makes people vulnerable?“For many years, we have allowed the HIV virus to spread... [and now] we face the dangerthat half of our youth will not reach adulthood. Their education will be wasted. Theeconomy will shrink. There will be a large number of sick people whom the healthy willnot be able to maintain. Our dreams as a people will be shattered.”The end of the millennium allowed yet more African leaders to take a stand, and theydid. In Botswana, newly elected President Festus Mogae said his five-year term wouldbe devoted to fighting his country’s priority problems: high unemployment, poverty andthe spread of AIDS.There was significant activity in Kenya as well. After long opposition to condom use,President Daniel arap Moi radically reversed his position in his New Year’s address.“Anything that can be said or done to halt the progress of the disease must be said anddone,” he said. He was echoed in the United Republic of Tanzania by PresidentBenjamin Mkapa’s own millennium discourse. “We must openly declare war on thiskiller disease,” he said. “Let us not feel shy to talk about it and look for means to solvethe problem.”Even more recently, President Olusegun Obasanjo of Nigeria inaugurated the NationalAction Programme Committee on HIV/AIDS by saying: “We are determined not toallow our country to be overwhelmed by HIV/AIDS.” He will directly oversee the highlevelcommittee, which will be staffed by his deputy and the ministers of health, education,information, defence, culture, women’s affairs and youth development.Further evidence that AIDS, especially as it affects Africa, is now at the centre of theworld’s political agenda was its choice as the theme for the United Nations SecurityCouncil’s meeting in January 2000. The Chairman of that meeting, Vice-President AlGore of the United States, said that governments must consider the epidemic as athreat to peace and security on the continent. Kofi Annan, Secretary-General of theUnited Nations, told the Council that the “impact of AIDS is no less destructive thanthat of warfare itself, and by some measures, far worse.”In their speeches, then, more and more politicians are confronting the reality of AIDSand declaring their intention to do whatever it takes to reduce the spread and impactof the epidemic. As many African and world leaders realize, fine words are an importantstart but will not by themselves make any difference to the course of the epidemic.They must be followed up with budgets and with action.In many places, however, ordinary citizens are still reluctant to acknowledge the relevanceof AIDS to their own lives because of the shame and fear that surround thisfatal disease, and the discrimination directed at those affected. People with or suspectedof having HIV infection may be turned away by health care providers, deniedjobs and housing, refused insurance and entry to foreign countries, thrown out bytheir spouse or family, even murdered.39