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“The only thing necessary for these diseases to the triumph is for good people and governments to do nothing.”


HIV/AIDS on top of Poverty: what needs to be one?


Extreme poverty, which is associated not only with underdeveloped infrastracture of health, but also similarly primitive other sectors of development, is the main reason why we have uncontrolled spread of HIV/AIDS and its devastating complications( incredible suffering, loss of lives and other resources, worsening of risk of famine, etc). The world community is reluctantly accepting this central issue (way far from rediculing it just a couple years ago).

The developed countries have been able to control the HIV/AIDS epidemic in their own countries by mobilizing huge amounts of resources and by organizing and reorganizing their responses continually, although the beginning story was not all that to be proud of( Saving lives had been put secondary to political stance and games in much of the earlier days of the epidemic atleast in the U.S. ). They have used a multidicsiplinary approach . The relative success,which is far less enjoyed by poor communities in rich countries, was effected by:

-utilizing the expertise of medical and mental health professionals,public health workers, scientists, activists, artists, social workers, affected communities and their leaders as well as other people from various walks of life.

-continuing education for care providers and patients, research and development

-drugs for prevention and treatment of opportunistic infections, and others directed against the HIV virus itself

-care and support facilities


One sometimes sees writings where anti-retroviral treatment is presented as the innitial and main component of care in poor countries. This is wrong even if the medications were absolutely free.  Because of the extreme scarsity of resources and lack of experience in comprehensive medical management of HIV/AIDS , much more participation, networking, organization and partnerships are needed than even required in rich countries. We need extensive education, documentation, and regulation of anti-HIV/AIDS work. There is an urgent need to organize anti-HIV/AIDS teams that include the people affected , health workers,government and non-government agencies,economists, social scientists, communty leaders, volunteers, activists,other concerned individuals and groups, and intensify the work not only in the cities and big towns, but also in every village in rural areas. The main players should be the affected communities themselves. Others can and should help in e! very way including in capacity building. We have to support the existing community based organizations dealing with HIV/AIDS, school clubs, work place associations and the like, with any small resources at our disposal both in the country and immigrants living elsewhere. We urgently need to structure and restructure care units for intensification of HIV prevention, opportunistic infections prevention and treatment,work to minimize mother to child transmission and ways and means of continual education for care givers and patients. These will pave the way for more comprehensive management including appropriate anti-HIV treatment in a wider scope.

In Ethiopia, we have traditions and experiences that can help in this struggle for survival. Ekub,local financial groups, idir, community association for burial and other expenses, religious associations, rural and town kebele associations, history of massive mobilizations for Development Through Co-operation Campaign and Literacy Campaign, have all thaught us what is possible for mass mobilization.


The real long-term solution and guaranty to survival is decreasing the vulnerability to natural and other disasters through real work for sustainable development. This requires a lot of effort. In the short-term, the survival of entire communities hangs in the balance on our willingness and motivation. Acting now for comprehensive management may help a little in the race against the formidable enemy: time.

Ashenafi Waktola