AIDS in the context of development

The first section of this paper considers AIDS in the context of widespread and worsening poverty. It identifies two strategies used by people to improve their income that exacerbate the spread of AIDS: firstly migration in search of work and secondly, poverty-driven commercial sex work.The second part of the paper looks at the factors that have caused further insecurity and poverty to large numbers of people making them more susceptible to disease and causing avoidence of HIV/AIDS to be less of a priority than simple survival. These factors include:debt crises and structural adjustment leading to economic recession, reduced employment and limited social service provisionwars and civil violence that have lead to displacement, weakened economies and the diversion of resources from health careThe third section looks at examples of community responses to the pandemic. The fourth section looks critically at three approaches on behalf of public health and donor agencies:integration of HIV/AIDS prevention and care with existing sectoral programmesmainstreaming of prevention and care into normal bureaucratic activitiesscaling up effective initiativesThe paper stresses the importance of understanding not only the content of sucessful programmes but process by which they have been developed. Key factors for sucess are:strengthening networks of social solidarity and broad based political actionimproving opportunities for a decent livelihoodrecognising and utilising the skills, resources and knowledge of all groups in societyRecommendations for future research include:analysing the global processes that drive the pandemic so HIV/AIDS can be integrated into international debates on development issues. HIV/AIDS likely to prove biggest obstacle to achiveing development objectivesidentifying the progress of the pandemic at a national and local level, who is affected and how to reduce vulnerability of certain groupsidentifying how certain social, political and institutional factors impact on responses to HIV/AIDSaddressing how community groups and NGOs are addressing the issue and how networks can be built for sharing experiences