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.

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