Fight Against HIV/AIDS
A Call For Action

By Jhabindra Bhandari

IN RECENT years, Acquired Immune Deficiency Syndrome (AIDS) which is caused by Human Immunodeficiency Virus (HIV) has been a matter of grave concern as the spread of HIV/AIDS is still growing. The problem is seriously on rise particularly in poor developing countries of the world. No doubt, it will be one of the greatest threats to sustainable human development.

Challenges

More importantly, millions of people will have to lose their lives due to HIV/AIDS. Since the AIDS epidemic began some 20 years back, 25 million people have died and more than 40 million are living with HIV and AIDS. In 2001 alone, over 5 million people were infected with the deadly disease worldwide. Particularly children, young women and adults are most vulnerable in the developing countries. Thus, the increasing problem of HIV/AIDS will have adverse negative impacts on socio-economic development of the developing countries.

Though HIV/AIDS came late in Asia, the situation is now rapidly changing. In Asia and the Pacific, over 7 million people are estimated to be living with the killer disease. Despite a number of prevention efforts, the cases of HIV/AIDS in Nepal is rapidly increasing. Even though National Centre for AIDS and STD Control (NCASC) reports that the cases of HIV/AIDS have reached a little more than 2000, the reality is far worse. It is estimated that the HIV cases have reached at least 35,000.

The efforts of the government and NGOs in particular in the fight against HIV/AIDS are very crucial. Largely, NGOs’ awareness raising programmes like street drama and training activities are increasingly popular in different communities where people’s participation is gradually increasing to address a wide range of issues related to HIV/AIDS. Still, such programmes are yet to reach in very remote parts of the country.

The NCASC has a lead responsibility to co-ordinate and facilitate a wide range of activities related to HIV/AIDS prevention and care throughout the country. Equally, it is the crucial role of the NCASC to support and facilitate NGOs working in the field of HIV/AIDS to yield maximum impacts. In order to meet the growing needs and challenges of prevention and care, the country has to spend a huge amount of resources in the years to come.

The 14th Asian Red Cross and Red Crescent Regional Task Force on HIV/AIDS and South Aisa Regional Meetings and a joint workshop were recently held in Kathmandu. " This was a major landmark to support global communication campaign to reduce stigma and discrimination associated with HIV/AIDS. With the greater involvement of the people living with HIV/AIDS, there are emerging needs to undertake advocacy for human rights, dignity of those affected, and social solidarity."

Reducing household vulnerability to HIV/AIDS and other infectious diseases is one of the important objectives of Global Programme 2002- 2005 of International Federation of Red Cross and Red Crescent Societies. The pupose of this important initiative is to create an environment in which HIV/AIDS and factors that make people more vulnerable are shared openly so that their vulnerability is greatly reduced.

It is equally important to note that local beliefs and perceptions about modes of transmission and about the people living with HIV/AIDS affect the ways in which households and communities respond to the epidemic. In some communities where community interventions like awareness raising programmes are effectively launched, households and families respond to HIV/AIDS with courage, determination and support. Therefore, community education in HIV/AIDS is key to prevention and care.

In order to accomplish this, community-based HIV/AIDS strategies must address stigmatisation and discrimination, prevention, and access to support, care and treatment. In a country like ours where problems of girl trafficking and drug abuse among youth are on rise, youth peer education is one of the most important strategies in prevention and care. Largely, this takes a holistic approach to empower and educate youth on the risk of HIV/AIDS.

Every year, as reports indicate, a large number of girls is trafficked to the Indian and other cities. As soon as they are infected with HIV/AIDS, they are forcefully returned home with serious health problems. They are neither accepted in the families nor have they positive response from health care providers. On the other hand, seasonal migration of youth for economic opportunities in other cities or abroad also increases the vulnerability to HIV/AIDS. Similarly, majority of drug injecting youth are mostly infected with HIV/AIDS.

Undertaking advocacy to policy makers, planners and other stakeholders is very urgent for local response. Sadly, very few District AIDS Co-ordination Committees (DACCs) in all District Development Committees (DDCs) of the country are active, though their role is very crucial in co-ordinating, facilitating and networking local stakeholders to initiate multi-sectoral interventions in the communities for prevention and care.

Capacity building of DAACs, DDCs, local NGOs and Village Development Committees (VDCs) in participatory planning and management of HIV/AIDS is extremely necessary. In some of the districts, it is encouraging to note that the DDCs and VDCs are allocating resources for community mobilisation in the fight against HIV/AIDS. At the village level, training and orientation programmes to elected representatives, school teachers, students, NGO activists and community health volunteers have been very effective in reducing household vulnerability to HIV/AIDS.

With a view to have better planning and response to this problem, participatory operational research is necessary in the area of health seeking behaviour, knowledge and attitude of communities regarding people living with HIV/AIDS. This really helps to formulate appropriate policies and strategies in order to work in communities where social stigma and discrimination associated with HIV/AIDS is highly prevalent.

Solution

More importantly, HIV/AIDS is not only a health problem, but also a social problem. It requires multisectoral response to cope with the emerging challenge of HIV/AIDS. Apart from strong political will and commitment, partnership with national and international NGOs, people living with HIV/AIDS and civil society will be an innovative strategy for global response and hence reduce the growing burden of HIV/AIDS significantly.

Promoting Agriculture Sector

By Krishna Chandra Bhattrai

THE main aim of agricultural development programme has always been how to promote broad based economic growth with social justice so as to address the deep rooted problem of poverty, unemployment and underemployment in the rural areas. However, we are still facing food shortage and economic deficit despite several decades of development efforts initiated so far.

Reality

Even at this semi-industrialisation stage about 90 per cent of the population still live in the rural areas depending directly or indirectly on agriculture. Food is the major item of consumption and about 75 per cent of the income is spent on it. Agriculture as the main occupation is mostly unproductive. Farming is dependent heavily upon the cyclical monsoon. Good and timely rainfall helps raising agricultural productivity. But it would be increased by providing adequate irrigation facilities. However the existing facilities are far below the potential. Land will not be ready for sowing operations till it is ploughed with traditional wooden plough. It is carried on in an old fashion with obsolete and out dated method of production. As a result the production is precariously low.

During the one and half decades, the use of modern agricultural technology in some of the Terai districts has greatly increased agricultural productivity. Modern technology may also come in a big way in developing agricultural sector at a reduced cost and with moderate labour. Tractors, threshers, harvest on combines, pumpset technology may be cited in this regard. Improved method of farming, better quality seeds, fertilizers, pesticides and improved tools and implements have resulted in considerable increase in farm productivity. But to adopt new technology would certainly involve purchase of new equipments, machinery and other new inputs.

While rich farmers are in a position to adopt these modern technologies a vast majority of farmers may not afford it owing to the lack of adequate financial resources, together with the lack of access due to unequal distribution of these technology in different regions of the country. On the other hand the traditional sector of the economy has not created adequate income and employment opportunities.

In respect of agricultural products, production is seasonal while consumption is throughout the year. These products are stored to make them available the year round. We have not been able to provide marketing and storage facilities to all producers. Marketing rather than storage is a great problem for poor farmers. Given the chronic debt burden and poverty small and marginal farmers are always forced to sell their products immediately after the harvest when food price is normally low and purchase again later at high price.

In the absence of sound marketing facilities the farmers have to depend upon local traders and travelling traders for the sale of their farm products. In most small villages, farmers sell their production to the moneylenders from whom they have usually taken loans. An average farmer is so poor and indepted that he can not afford to await till such time when he will be able to sell the product at higher price. In order to meet his commitments and pay his debt he is forced to sell the products immediately after the harvest is produced. Like other industries it also requires government loans to raise production. Short term and medium term loans are granted by the government for meeting current agricultural needs. Such loans are payable mostly after the harvest. There is no positive agriculture price policy to provide and incentive to producers.

Prospects

The experience of government participation in supplying credit and other facilities to the farmer has not been sound. In case of small and marginal farmers, due to lack of access to market system, lack of resources and incentives to modernize their production method, transformation of subsistence farming has become complex business. It requires carefully designed approaches, strategies and long term planning with vision for successful development of agricultural growth that ultimately leads to poverty alleviation.While such vision is well reflected in our agricultural perspective plan, the proper implementation of this plan has remained far from satisfactory.