Lack of political will and the subordination of women are major barriers to tackling AIDS

Denial, myths, complacency, lack of political will and the subordination of women are major obstacles in the fight against HIV and AIDS. And with no cure or vaccine in sight, scaling up prevention is of paramount importance, according to Professor Lars Kallings, a leading expert in the global fight against the world’s first modern pandemic.

Writing in March’s Journal of Internal Medicine Professor Kallings says that: “Trust in modern science is so great that people don’t like to consider the thought that it may not be possible to find a simple medical way to eradicate the virus. As a result, not enough attention is given to the social and economic aspects of HIV and AIDS and the fight against discrimination – factors that are vital if we are to respond to this epidemic.”

Professor Kallings says that the subordination of young girls and women, and the contempt they are shown in many countries, is the major cause of the epidemic.

“Many women are not able to say no to unwanted sex or ask their husbands to use condoms or be faithful” he says. “Stigmatisation of women is another major issue, with many not daring to be tested or treated in case they are thrown out by their families, beaten or even killed.”

Professor Kallings is eminently well qualified to comment. Currently the UN Secretary-General’s Special Envoy for AIDS in Eastern Europe and Central Asia, a post he has held since 2003, he was also the founding President of the International AIDS Society in 1988 and its Secretary-General from 1994 to 2002.

His paper provides a detailed and often controversial analysis of the last 25 years, highlighting political and religious barriers and conspiracy theories, together with key medical advances.

“Money is no longer the main obstacle to treating the virus, as the cost has dramatically fallen in recent years” he says. “However, by 2010 a massive 42 billion US dollars will need to be spent to meet the goal of universal access to prevention, treatment and care and strengthen national healthcare systems.

“But even if it is made available, funding does not always reach the people who need it, because rulers in many countries are more interested in nursing their own power base and private fortune than the wellbeing of their people.

“The main problems lie with a lack of political will to influence attitudes, implement prevention and provide care, together with a lack of healthcare infrastructure, including the drain of trained health-care workers from developing countries to the West.”