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HIV and AIDS
Background: HIV and AIDS
It is over 25 years since a disease started spreading across the globe whose name has become synonymous with untold human suffering: AIDS.
Today more than 33 million people are estimated to be carrying HIV, the virus which triggers the immune deficiency syndrome. Most of the people concerned live in developing countries. The number is especially high in sub-Saharan Africa, where in some countries more than a fifth of the adult population is infected. The pandemic is a threat to the existence of entire societies. It is not only a disaster in human terms, but in economic terms too. The fight against AIDS is an important task and one of the greatest challenges facing international and German development policy.
Women: a high-risk group
In 2007 some 2.5 million people became infected with the human immunodeficiency virus (HIV). The poor in particular have a high risk of infection – and women.
In the initial phase of the pandemic, AIDS was regarded essentially as a disease threatening homosexual males. Today, women account for around half of all HIV cases. In fact, in sub-Saharan Africa, the number of infected women is substantially higher than the number of infected men: in 2007, women accounted for 61 per cent of infections. Among young people, the number of women affected by the disease is disproportionately high.
Women's high risk of HIV infection is in part due to biological factors: for women, unprotected sexual intercourse with an infected male is statistically twice as dangerous as unprotected sex for men with an infected female.
Additionally, women's risk of infection in many countries is heightened by their social status, poverty and powerlessness. If a woman wishes to protect herself against HIV infection, she is ultimately dependent on the man's support, for condoms offer the most effective protection against the virus. But girls and women are often unable to determine for themselves whether, when and how they have sex.
Causes of the spread of the pathogen
The spread of HIV and AIDS is caused by a wide variety of factors. Poverty, economic dependence, low social status and a low standard of education are all conducive to the spread of the disease. Poorer sectors of the population and people living in rural areas are difficult to reach with prevention programmes. Hence they have a higher risk of infection than urban dwellers. The more well-to-do population groups in the cities are usually quicker to make use of prevention and counselling services.
Discrimination against women, violence, drug and alcohol abuse, prostitution, flight, displacement and cultural uprooting all increase the risk of infection. It is feared that HIV will continue to spread, in particular amongst women and girls, young people and poorer population groups.
Outlook
One of the goals declared by the international community at the UN Millennium Summit aims to halt and begin to reverse the spread of HIV and AIDS by the year 2015. The German government subscribes to this international goal. The fight against AIDS is a priority area of German development cooperation.
As long as immunisation is not an option and as long as AIDS can only be treated but not cured, prevention will remain the most important instrument on hand to fight this disease. However, this instrument must be embedded in overarching, national strategies comprising preventive measures, treatment, care and counselling services. Germany, together with its international partners, is heavily involved in this sector. The examples of Uganda, Thailand and Brazil show that these efforts are not futile. Awareness-raising campaigns – combined, in Brazil's case, with therapy offered free of charge – have enabled these countries to achieve dramatic reductions in infection rates.
Permanent AIDS control can only succeed as part of an all-round strategy. Only if progress is made towards reducing poverty, strengthening human rights, improving people's education and making health-care systems more effective can the AIDS pandemic be contained in the long term.
