World AIDS Day – Live and let live

A group of Kenyan women who are HIV-positive carry placards saying that the government is guilty of discrimination against AIDS patients, during the AIDS conference in Nairobi in September 2003. Demonstrators urged the government to reduce the price of antiretroviral drugs. Photo: AFP PHOTO SIMON MAINA.

HIV/ AIDS has devastated many countries where Oxfam Community Aid Abroad works. Sub- Saharan Africa, which includes 48 nations, has been hit the hardest. However the epidemic is now spreading in Asia, where two-thirds of the world's population lives. Poverty remains both a major driver and consequence of the HIV/AIDS epidemic.

The impact of HIV/AIDS is not confined to the communities we work with; it can also affect our field staff and partner organisations. This year, Oxfam Community Aid Abroad has developed a workplace policy to support staff in the field who may be infected or affected by HIV/AIDS. The policy ensures that staff have access to care and treatment, including AIDS medications.

This issue is close to my heart, because I am myself a person living with HIV/AIDS. I became HIV-positive in 1992, as a volunteer working in Zimbabwe's health services from 1990 to 1998. The epidemic has overwhelmed families and communities in Zimbabwe, and I miss the many friends and workmates who have died there of AIDS. There is also the enormous cost to the economy of HIV-related illness and deaths, such as lost productivity from absenteeism, lost skills, poor morale, and the increased costs from staff turnover. Imagine how you would be affected by the deaths of one in four of your relatives, friends or colleagues.

The desperate need for antiretroviral therapy

Global AIDS campaign 2002-2003 poster. Courtesy UNAIDS.

The World Health Organisation (WHO) views the failure to deliver antiretroviral medications as a global health emergency. The WHO and the Joint United Nations program on HIV/AIDS have renewed their commitment to providing antiretroviral therapy to three million people by the end of 2005 (the "3 by 5" target), but implementation is dependent on funding to increase training and strengthen health services, as well as supply drugs.

The Global Fund to Fight AIDS, Tuberculosis and Malaria was launched in 2002 to assist developing countries to scale up resources for the prevention, treatment, care and support of people living with these three diseases. The Global Fund is thus one of the key mechanisms to mobilise the funds necessary to achieve the "3 by 5" target. However, without massive contributions from rich countries, including Australia, the Global Fund will have little role to play in enabling the "3 by 5" target to be realised. Oxfam Community Aid Abroad is lobbying the Australian Government to contribute $108 million to the Global Fund by the end of 2004 – this is the proportion Australia should contribute in relation to its share of world Gross Domestic Product.

Creating an enabling environment

People who are infected or affected by HIV/AIDS do not have to inform their employers about their HIV status. Many countries, including Australia, have laws banning discrimination on the basis of HIV/AIDS, but few HIV-positive people disclose their HIV status at work. The secrecy and fear of being found out can be a terrible burden, so it is crucial that people have the support of their employer and colleagues. At Oxfam Community Aid Abroad, I chose to be open about my HIV status because I believe it's an important part of educating people about HIV/AIDS, to reduce stigma and discrimination, and to break community misconceptions and stereotypes about who gets HIV. As the HIV/AIDS Advisor, I am able to add my experience as a person living with HIV/AIDS to the advice and support I provide to our staff in responding to the epidemic, and also show how to live positively with the virus.

As an HIV-positive woman, I'm particularly concerned about how gender inequalities make women especially vulnerable to HIV infection and also deepen the impact of HIV/AIDS on women of all ages. Women often carry the burden of caring for family members infected by HIV/AIDS.

My work at Oxfam Community Aid Abroad is a good illustration of a principle known as 'GIPA', which means 'the Greater Involvement of People who are infected or affected by HIV/AIDS'. This principle was endorsed by 42 national governments at the 1994 Paris AIDS Summit. It aims to give a face and a voice to the epidemic, and enable people living with and affected by HIV/AIDS to use their experience at all levels in the response to HIV/AIDS, spanning from local to global. In practice though, stigma and discrimination remain great barriers to people's involvement in matters which affect their lives and to accessing HIV prevention and care.

'Live and let live' is the theme for the World AIDS Day Campaign in 2002-2003, with the focus on breaking down stigma and discrimination. While 2002's campaign focused on individuals, in 2003 organisations and companies will be targeted and asked to reflect on their own values concerning stigma and discrimination. It is important that the culture and practices of all organisations address the needs of HIV-positive employees, and employees who need to care for family. It is also vital that HIV-positive colleagues are able to continue to work, to provide for themselves and their families, and to live with dignity.

We must remember that HIV/AIDS is not just a health problem; it is a medical, social, cultural, economic, educational, developmental, political, moral and ethical concern. A viable and sustained response to HIV/AIDS demands community participation and change through collaboration by all sectors and levels of society, and especially partnerships with those infected and affected by the disease.

Support the Global Fund Campaign – visit www.oxfam.org.au/world/hiv to find out more