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Commentary

More aid will not prevent more AIDS
Philip Stevens, Bangkok Post, 6-5-06

Stevens, the author of last week's Spotlight article, argues that more aid for AIDS programs may make international donors feel good, but is unlikely to do much to stem the rising tide of the disease.

Last week's UN Special Session on Aids in New York called for spending on fighting Aids to be increased from $8.2 billion (313 billion baht) a year to $22 billion (840 billion baht) by 2010, a target resisted by the US which fears it will be blamed if shortfalls occur.

The idea that Aids in Africa and other poor countries can only be reversed with large sums of aid money is certainly politically attractive. Politicians get a warm, fuzzy feeling when they sign large cheques that show they are helping the needy.

But showering the Aids plague with cash will do nothing without real reforms. While extra funding is certainly needed for prevention and treatment programmes, no amount of money will address the root cause of the crisis— political and economic oppression.

Aids is so tenacious not because of the cost of medicines or a lack of aid. The reason Aids has taken such a hold in Africa and parts of Asia is because these regions suffer from government oppression that stifles prosperity, keeping their people in poverty and therefore ill health.

Leading public health experts are unanimous that prevention is of paramount importance to combat Aids. But political oppression has made it difficult to spread that message.

Until recently, President Mbeki refused to acknowledge that South Africa even had an Aids problem, a factor that helped it spread rapidly there. Some religiously conservative Islamic, African and Latin American governments at the UNAids conference are reluctant to admit that drug users and prostitutes exist within their countries, meaning that prevention messages do not reach these highly vulnerable groups.

By contrast, the government of Thailand acknowledged Aids as a problem early and encouraged discussion and education, bringing infection rates down rapidly.

Yet recently the Thai government cracked down on intravenous drug addicts and police have been accused of killing more than 2,000 in 2003 while thousands more were imprisoned. The consequence: drugs were driven further underground and open discussion of the need to use sterile needles was made impossible. As a result, HIV infection rates are now soaring among drug users.

Economic oppression is an even more powerful vector of all disease.

When governments restrict the ability of people to start up businesses and exchange goods freely under the rule of law, poverty and hopelessness are guaranteed. People flee from the countryside looking for work, to be greeted with urban slums and unemployment.

Rent controls, oppressive planning restrictions and lack of land title mean there is a woeful undersupply of suitable housing. It is also impossible for people to use their houses as security against loans.

Poverty leads desperate parents to sell their children into the sex trade. For poor women with few employment opportunities, prostitution is one of the few options available. Drug abuse is rife. In the poverty of the favelas in Brazil and the shanty towns of Africa and India, HIV finds fertile ground.



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