Cracking down on the HIV/AIDS crisis: can global targets work?

Globally, 40 million people live with HIV/AIDS; 5 million people were infected with HIV in 2001. Millennium Development Goal (MDG) 6 to halt and reverse the spread of the disease is critical to other aspects of human development. However, this goal must consider how the disease develops in different regional and national contexts.

The figures for HIV/AIDS, especially with regard to sub-Saharan Africa, are depressing. About 70 percent of the global total of people living with HIV/AIDS and those infected in 2001 live in the region. Sub-Saharan Africa also has an adult prevalence rate of 8.4 percent, compared to 1.2 percent globally.

The United Nations MDG to halt and reverse the spread of HIV/AIDS replaces a more specific target of a 25 percent reduction in global HIV infection rates by 2010. However, research from the University of Sussex in the UK stresses that a single global target may not take account of different patterns and future projections of HIV/AIDS prevalence in places such as Africa and Asia. The potential effect of the epidemic on other MDGs is equally worrying.

The research finds that:

• HIV/AIDS has a significant effect on the other MDGs: parts of Africa are seeing a reversal of a long-term mortality decline, and the poorest household economies are being devastated (though it is more difficult to calculate effects on a national level).
• The epidemic may follow a different path in Asia than in Africa. But even with the current low prevalence in Asia, there is potential for rapid growth of HIV/AIDS (due to migration and the commercial sex sector in densely-populated regions) and significant losses among the large populations (especially India and China).
• New infections are declining in some parts of the world, and success stories such as Uganda and Thailand show that government-backed campaigns can work.
• The goal of halting and reversing the epidemic’s spread is realistic but is not equally relevant to countries with different prevalence patterns.
• Global targets for HIV/AIDS either do not go far enough (in countries with extremely high prevalence rates) or are irrelevant (in countries experiencing the first stages of the epidemic).
• The global targets will probably not be met, because: the epidemic is recent in significant populations such as in Asia; there is a lack of political commitment and money.

Despite some successes, HIV/AIDS continues to spread and is affecting prospects for achieving other MDGs, notably in sub-Saharan Africa. The key to addressing HIV/AIDS lies in:

• political commitment to the crisis
• mobilising financial resources
• regional rather than global targets
• a clear focus on existing patterns of prevalence, particularly in China and India.

Given the wide-ranging effects of HIV/AIDS, it is imperative that a strong commitment is made to address the epidemic. A global strategy to reverse spread therefore needs to be focused on regional targets and changing patterns of prevalence.

Source(s):
‘The global challenge of HIV/AIDS’ by Ronald Skeldon in Richard Black and Howard White (eds.), Targeting Development: Critical Perspectives on the Millennium Development Goals, London: Routledge, 2004

id21 Research Highlight: 3 May 2005

Further Information:
Ronald Skeldon
Department of Geography
University of Sussex
Brighton BN1 9SJ
England

Tel: +44 (0) 1273606755
Contact the contributor: R.Skeldon@sussex.ac.uk

University of Sussex, UK

Other related links:
'Refugee women and HIV/AIDS: what role for relief organisations?'

'Dispelling myths of HIV/AIDS among conflict-affected and displaced populations'

'The impact of HIV/AIDS on rural livelihoods'

'How can the real scale of the HIV/AIDS pandemic be measured?'

See id21 links on HIV?AIDS

Information on MDG 6 from the World Bank