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The Pink Paper

HIV Life

The real face of One World, One Hope

Edward King on the developing world

ACCORDING TO a recent Parliamentary answer, the UK Government’s contribution to HIV and AIDS support programmes for the developing world will be about �10 million this year – essentially at a standstill for the third year in a row.

“Official external assistance” from developed to poor countries is evaporating, according to Dr Peter Piot, Executive Director of UNAIDS (the United Nations and World Health Organisation’s joint AIDS programme). His agency’s annual budget is only about �40 million.

Piot was speaking on the eve of the International Conference on AIDS earlier this month. The conference slogan ‘One World, One Hope’ is also to be the theme of World AIDS Day in December. Both are designed to draw attention to the continuing impact of AIDS in the developing world.

But in practice, the conference disproved its own slogan. For Western countries, the mood was indeed optimistic, buoyed by promising studies of expensive new drugs. But these hold little hope for poorer countries. As Piot pointed out, most people with HIV in the developing world “lack any access to even basic pain-relieving drugs or treatment for their opportunistic infections”.

Some American activists argued that drug companies should drop their prices so that drugs like AZT and protease inhibitors become more affordable. That’s missing the point. The medical back-up required to use these drugs safely and effectively means that they will never be realistic options for most of the developing world.

There’s no shortage of shocking statistics about the impact of AIDS in parts of Africa and Asia:

Investment in HIV prevention initiatives and vaccine research offers the only real hope for controlling these HIV epidemics. Education campaigns have slowed the spread of HIV significantly in Uganda and Thailand. New approaches to prevention, such as the anti-HIV gels being developed to prevent sexual transmission, could also have an important future role to play.

Ultimately, though, it is a vaccine against HIV that will have the greatest impact. At a conference debate, Dr Edward Mbidde from Uganda argued that even a vaccine that was only partially effective should be made available as quickly as possible, as it could still potentially save hundreds of thousands of lives.

If the early promise of the new AIDS drugs bears fruit, it will simply re-emphasise the gulf between the plight of people with HIV in developed and developing countries. If the ‘One World, One Hope’ slogan has any meaning, it is that, in Piot’s words, “Unless we have products that can bring the global epidemic down to safer levels, everyone everywhere will continue to be at unacceptable risk”.

Originally published in The Pink Paper issue 440, 26th July 1996.