The HIV/AIDS epidemic has been a gathering force for nearly a quarter century, and it continues to be a major global challenge. AIDS finds its victims in both rich and poor countries. There is no region of the world where HIV/AIDS is not a potentially serious threat to the population.
Sub-Saharan Africa has so far borne the brunt of the AIDS devastation, and the region continues to experience high rates of infection. About 3 million people in the region were newly infected with the virus in 2004. Countries in Eastern Europe and Asia now have the fastest-growing rates of HIV infection in the world, and the populous countries of China, India and Indonesia are of particular concern. In some more developed countries, there are signs of a resurgence of risky sex between men.
HIV/AIDS was already recognized as a global threat to health and development in 1994, when the Programme of Action of the International Conference on Population and Development1 was adopted. The epidemic was closely interlinked with the Conference’s central concerns of population and development. The Programme of Action recommended a range of actions aimed at preventing HIV infection and providing support for individuals and families coping with the disease. Five years later, in 1999, with the HIV/AIDS epidemic continuing to worsen, the key actions for the further implementation of the Programme of Action of the International Conference on Population and Development (General Assembly resolution S-21/2, annex), adopted at the twenty-first special session of the Assembly, included additional recommendations for combating the epidemic.
The urgency of the AIDS crisis was conveyed in the Declaration of Commitment on HIV/AIDS, adopted by the General Assembly at its twenty sixth special session in June 2001 (Assembly resolution S-26/2, annex). Overcoming the AIDS epidemic has proved to be a challenge with respect to the achievement of the eight Millennium Development Goals, which were agreed upon by 147 heads of State and government at the United Nations in 2000. Not only is halting the spread of HIV/AIDS one of the goals, but success or failure in meeting this goal will profoundly affect the ability to reach most of the other goals. A high-level plenary meeting in 2005 will review progress towards these goals and fulfilment of all the commitments contained in the United Nations Millennium Declaration (see Assembly resolution 55/2).
Globally, the highest HIV prevalence rates are found in poor countries, but within regions such as Africa, it is not necessarily the poorest countries that have the highest prevalence rates. Nevertheless, poverty increases vulnerability to HIV/AIDS and exacerbates the devastation of the epidemic. Poverty deprives individuals of the means to cope with HIV/AIDS. The poor often lack the knowledge and awareness that would enable them to protect themselves from the virus, and, once infected, they are less able to gain access to care and life-prolonging treatment.
The international community has responded to the challenge of AIDS with an unprecedented level of financial resources, but it is still less than half of that is needed to effectively conquer AIDS (UNAIDS, 2004a). The Global Fund to Fight AIDS, Tuberculosis and Malaria, which was established in 2002 as a partnership among Governments, civil society and the private sector, had by June 2004 approved 314 grants in 128 countries totalling US$ 3 billion, most of which was directed towards AIDS programmes. Funding alone, however, will not stop the epidemic from infecting new victims in new countries and regions. Preventing new cases of HIV/AIDS depends on changing the behaviour of all those at risk of contracting the disease. As the Secretary General of the United Nations said in his statement of 20 July 2001 to the Conference of G-8 heads of State, the first priority is “to ensure that people everywhere particularly the young — know what to do to avoid infection”.
Contents
Preface
Explanatory notes
Introduction
I. Population, HIV/AIDS and poverty: an overview
II. Determinants of HIV/AIDS
III. Mortality, population growth and orphanhood
IV. Fertility and sexual behaviour
V. Geographical mobility
VI. HIV/AIDS, development and poverty
VII. Government views and policies
VIII. Prevention, treatment and care
IX. Conclusions
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