Education: the only vaccine we have. (Halt and Begin to Reverse the Spread of HIV/AIDS).

A theatre troupe in Seshego township near Pietersburg, South Africa uses theatre to educate the public about HIV/AIDS. Phakama, which means "Rise, stand up", travels throughout the township, bringing its message to the local population and encouraging participation. This is one of the many ways AIDS education has diversified to reach a wider audience and help stop the epidemic spread of the disease. Other methods of prevention have been sought, because creating a vaccine or even providing treatment for a disease that is constantly mutating and becoming resistant to drugs may take many more years.

Finding alternative solutions has been a problem plaguing the medical community since HIV/AIDS was discovered. The United Nations Educational, Scientific and Cultural Organization has chosen to take a different approach in the fight against AIDS by using education, not medicine, to stop its spread. "UNESCO's strategy for HIV/AIDS preventive education" states that the impact of the disease on society could be reduced by battling complacency, advancing commitment and improving care. It has created a five-part strategy based on advocacy at all levels, customizing the message for various socio-economic groups, changing risk behaviour and vulnerability, caring for the infected and the affected, and coping with the institutional impact of AIDS on society.

The critical factor for a renewed and effective strategy for preventive education is massive, unfailing and unrelenting advocacy at all levels and support of political authorities at the highest national level, according to UNESCO.

To achieve this, audiences worldwide, starting with those most at risk, must be reached in culturally appropriate ways, and preventive education must be interconnected with the local way of life. Because of its interdisciplinary experience and worldwide mandate, UNESCO is suited to spread the message to a broad global audience.

Uneven distribution of knowledge is a main factor in the uneven distribution of infection rates worldwide. Comprehension and appreciation of prevention depend on many social factors, such as age, gender, education, economic conditions and religious beliefs.

The message must be tailored for different groups in order to enable them to understand and pass on the message. UNESCO believes that by using and disseminating information to help people understand what AIDS does to the body, it can reduce misconceptions and lessen vulnerability to the disease. However, it is important not to have negative campaigns as these often lead to stigmatization and discrimination. To reduce discrimination, UNESCO, in cooperation with the Joint United Nations Programme on HIV/AIDS (UNALDS), plans to promote inclusive and compassionate attitudes based on human rights towards the infected and the affected.

Only through communication of knowledge can risk behaviour be changed. AIDS can be prevented if children and young people learn how the virus spreads and do not participate in risky behaviour. No institutions have a greater ability to affect all aspects of a community than schools, as they can reach the age group between 10 and 25, where most new infections occur each year.

UNESCO believes that even younger children should learn about AIDS and how it can be contracted, as part of their primary education. However, schools alone cannot disseminate information about prevention because they do not reach many other groups at greater risk of contraction, such as soldiers and migrant and sex workers. The media must also spread the message of prevention and educate people about the disease. An example of using other sources to disseminate knowledge about AIDS can be seen in Phayao, Thailand, where health office staff regularly visit brothels to distribute condoms and explain safe sexual practices, in order to stop the spread of the disease in sex workers, 60 per cent of whom are infected.

Caring for both the infected and the affected has become more important, as AIDS has a greater effect on the population worldwide. The disease now infects over 40 million people and over 5 million more will be infected every year and will leave millions of children orphaned, making sustainable development in developing countries increasingly difficult because of the loss of human capital.

However, with better care, the social destruction caused by AIDS can be minimized. UNESCO argues that people with HIV can live productively for many years if they are given treatment, social support and better nutrition. However, international funding of treatments, investment in vaccine research and testing of medication in developing countries must be put into effect.

Coping with the impact of HIV/AIDS on society is the final part of the UNESCO education strategy. AIDS could undermine all health services, educational institutions and public services, making it increasingly difficult to maintain government and stability because of the loss of human capital. As UNESCO stated, the critical task is to protect the core functions of the key social, economic and political institutions from the onslaught of HIV/AIDS. By using education to prevent AIDS rather than relying on medicine to treat it, UNESCO has placed the responsibility on Governments, the education systems and people themselves. Only through commitment can this strategy be given the opportunity to save lives and lessen the impact of AIDS on society.

RELATED ARTICLE: 'A Generation or Orphans' The General Assembly Debates HIV/AIDS

Over 3 million deaths were estimated for 2001 and 14 million children have been orphaned by AIDS since the beginning of the epidemic. Sub-Saharan Africa, with 28.5 million infected people, is by far the region with the highest incidence of HIV/AIDS. In light of these figures, it is not surprising that the pandemic continues to be a topic of great concern among world leaders. Speaking at the general debate of the fifty-seventh session of the General Assembly, Member States of the United Nations clarified that the need to tackle the pandemic is extremely urgent.

The President of Botswana, Festus G. Mogae, said that the pandemic was the "most serious threat to economic and social progress in the world". Botswana has the highest HIV prevalence among pregnant women world-wide, at 44.9 per cent, as well as the highest overall rate for adults at 38.8 per cent. He said no one country has the resources to effectively battle the pandemic and a strategy that combines efforts is needed. He expressed his gratitude toward the United Nations and other partners, saying with the help of the international community, Botswana "will still be standing when the dust settles".

Foreign Minister Lilian E. Patel of Malawi called on transnational organizations, which "extract huge profits from business in poor countries", to increase their investment in HIV/AIDS prevention, saying that they have the moral responsibility to do so. International pharmaceutical corporations should "show more compassion" by expanding access to antiretroviral drugs and other life-sustaining medicines through meaningful price reductions and voluntary donations. He thanked those companies that had already taken steps in that direction.

Ambassador Martin Belinga Eboutou of Cameroon spoke of the seriousness of the HIV/AIDS pandemic in his country, where an estimated 860,000 adults (11.8 per cent of adults) were living with the virus. The country's first lady, Madame Chantal Biya, had organized a meeting of African first ladies to address the issue, to be held in the capital of Cameroon, Yaounde, in mid-November 2002.

Barnabas S. Dlamini, Prime Minister of Swaziland, told of efforts to fight the pandemic in his country, where 33.4 per cent of adults are infected. He said that the Government cannot afford the costly antiretroviral drugs and has also looked into its own cultural traditions for answers to the epidemic. They have resurrected "rites of chastity and respect for self"-values that have served many previous generations and are finding increasing acceptance in Swaziland.

Foreign Minister Timothy S. Harris of St. Kitts and Nevis spoke of the magnitude of the HIV/AIDS crisis in the Caribbean region, saying that it threatened to "devastate families and create a generation of orphans". The pandemic is also a hindrance to development, as citizens become less and less able to contribute to the country's economic activity and growth. Further, funds earmarked for other areas now have to be spent on the pandemic. He called on the donor community to realize the $10 billion required by the Global Fund for the fight against HIV/AIDS, tuberculosis and malaria.

Jonas Hagen

Scientists and multilateral donor organizations from all over the world, including representatives from fifteen African States, met on 3 and 4 June in Cape Town, South Africa, to define a plan of action for the next seven years. The meeting raised $233 million for the African AIDS Vaccine Programme. According to UNAIDS, a major obstacle for research in Africa remains the inadequacy of research infrastructures. Some of the funds will contribute to establishing regional facilities and strengthening local expertise.

Two thirds of all people living with HIV are in Africa. Vaccine research in the region currently receives only 1.6 per cent of the $2.5 billion spent on HIV research annually. Of the more than thirty HIV-vaccine trials conducted globally since 1987, only two have been carded out in Africa. Because certain strains of HIV present in the region differ from those found in other parts of the world, according to UNAIDS, current vaccine testing in Asia and the United States may not be appropriate for Africans.

Erika Reinhardt