Tackling the 'ugly sisters'

Sunday is World Aids Day. What started as an outbreak has become an epidemic threatening 40million people worldwide, claiming 8,000 lives every day. Yet Aids, after the initial shock subsided, has fallen woefully from the world agenda. In response - and in an almost unprecedented move in the charity world - the Stop Aids Campaign, a coalition of 22 charities, has come together to speak with one voice calling for action, awareness and a new government response.

Cause and effect

Around 95 per cent of HIV and Aids sufferers live in the developing world. While medicines allow UK sufferers to live with Aids, the huge majority are condemned to die, receiving just ten per cent of worldwide resources. In Africa - with 30million HIV sufferers - Aids and hunger are called the 'ugly sisters', parasitically thriving off each other; poverty begetting Aids and Aids - by taking out key workers within the family - begetting poverty. Yet, in countries such as Zambia, where a fifth of adults are HIV-positive, the government is forced to spend 30 per cent more on repaying debt to the West than on national health.

Why do poverty and Aids go hand in hand? 'It's so many different factors,' explains Dr Sunanda Ray, an Aids information worker with the VSO in Southern Africa. 'It's lack of education and awareness; it's desperate mothers turning to sex tourism to pay their children's school fees; it's not enough condoms to go around and a culture in which women are maledependent and unable to insist on protection. It's STD clinics, which make patients pay for services. And it's the indignity: people would rather continue undiagnosed and infected than face the stigma and wrath of their community.'

Slowly, education is spreading - although, without networks of radio, newspapers and TV, it's at a village-byvillage pace. Meanwhile, Voluntary Testing Centres stand empty. Hospital shelves are

barer still. 'Medicines? There's nothing,' say Dr Ray. 'In South Africa, hospitals barely have paracetamol, so the best health workers can offer is words and support.'

In Cambodia, Buddhist monks working in clinics can fend off some of the more docile bugs - such as diarrhoea and skin disorders - but nothing more. In Ethiopia, aid workers hand out vitamin tablets to boost the immune system but these stimulate hunger, so often end up discarded. Sickness and death are inescapable facts of life. If you or a family member aren't HIVpositive, then you'll be covering for someone at work who is - and weekends will be a maudlin round of funeral duties. Without some kind of governmental welfare system - to protect from famine, flood or Aids - it's an opportunistic free-for-all. In the words of a sex-worker from Botswana: 'It's the lesser of two evils. I'd rather die of Aids than hunger.'

Facing the challenge

Is Aids one of the biggest challenges facing humanity? Unequivocally, yes. Is it insurmountable? 'No,' says Paul Bates of the Stop Aids Campaign. 'Stop Aids is about reengaging the British public and policy-makers, letting them know there's something they can do - whether it's wearing a ribbon or writing to local MPs.' With its lobbying arm, Stop Aids mounts a three-pronged attack - 'More aid, less debt, access to treatment'. Aid from resource-rich countries will allow the developing world to loosen the stranglehold of Aids and poverty. Debt cancellation will free up billions of dollars for health care. And treatment access - lobbying drug companies to allow the developing world to produce and distribute cheap drugs - will spearhead an assault on Aids when coupled with support, advocacy and solidarity from abroad.

Poverty robs people of a future and Aids provides a final, brutal full-stop. 'Living in the West, we tend to forget that thinking about the future is a privilege of the middle classes,' says Dr Ray. 'We can look years ahead but, in the developing world, day-to-day survival keeps you totally in the present.' Action today means designs on a future. And Stop Aids believes that should be a right, not a privilege.

HOW TO HELP

For involvement and details, visit www.stopaidscampaign.org.uk The Terrence Higgins Trust at www.tht.org.uk or Tel: 0845 1221 200 Body&Soul at www.bodyandsoul.demon.co.uk or Tel: 020 7373 7678.