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Time to Act on HIV/AIDS
Failure to act to stem the HIV/AIDS epidemic risks endangering hard-won development gains.

The significant economic and social progress achieved by some of the world's star developing countries over the past few decades could be jeopardized unless they increase their efforts to combat the HIV/AIDS epidemic, a senior World Bank official warns.

Speaking ahead of the XV International AIDS Conference in Bangkok, Thailand, Callisto Madavo, the World Bank's regional vice-president for Africa - the area hardest hit by the HIV/AIDS epidemic - says he is concerned some key Asian and Eastern European countries are not doing enough to combat the epidemic.

The consequences of high HIV/AIDS infection rates on economic development - and therefore poverty reduction - are severe, he says. "What we are seeing, in Africa anyway, through our modeling and so on, is that the per capita growth in some of these economies is being reduced by one to two percent each year." Over time, there is a huge difference between growth without a HIV/AIDS epidemic and with an epidemic.

Awareness Is Rising Faster Than Treatment

Madavo says the degree of awareness of the dangers posed by the HIV/AIDS epidemic is much higher than ever before. Progress is being made in obtaining the funding to fight the epidemic and in prevention efforts.

Through the Multi-Country HIV/AIDS Program (MAP), the Bank has made $1 billion available to in Africa for prevention, care, and treatment programs. Significant funding has also been pledged by the United States Government, the Global Fund to Fight AIDS, TB and Malaria, and through organizations such as as the Gates and Clinton foundations.

He emphasizes, however, the need to step up attention to treatment.

"We have a unique opportunity. Five years ago…the cost of drugs was a significant deterrent in terms of the ability to treat those who are already infected. With the cost of them coming down now, we have a real window and the question is, are we going to use it?"

The key now is to ensure the funding is used in the most effective manner. This could be done by substantially strengthening the implementation capacity of countries themselves. A prime example is the African Multi-Country AIDS Program (MAP), which taps into the capacity of community-based organizations such as non-governmental or faith-based organizations. In addition, donors need to do a better job of co-ordinating and harmonizing their efforts.

Need for Renewed Commitment

Under the theme of Access for All, conference organizers are seeking to further intensify global efforts to halt the epidemic's advance. Leaders will be asked for a renewed commitment to take concrete steps to turn back the spread of HIV/AIDS.

More than 15,000 delegates from 160 countries are expected at the conference from July 11-16. It will bring together distinguished researchers, community leaders and policy specialists to discuss five streams: basic science; clinical research, treatment and care; epidemiology and prevention; social and economic issues; policy and program implementation.

The conference is convened every two years by the International AIDS Society (IAS), and this year is being hosted locally by the Thai Ministry of Public Health. Madavo says it is fitting that this year's conference should be in Bangkok because the Thai Government had been one of the first in the world to mount an aggressive campaign against HIV/AIDS. "In Africa we learned early lessons from Thailand. We looked to Thailand for some of the initial thinking."

World Bank experts will be participating extensively in the conference through an extensive range of seminars. Other major backers of this year's conference are the Global Network of People Living with HIV, the International Community of Women Living with HIV/AIDS, the International Council of AIDS Services Organizations, the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the Thai NGO Coalition of AIDS.

Madavo said the World Bank had, as an institution, came late to the HIV/AIDS fight. "But once we have got into it, I'm very proud of our track record so far in Africa, in the Caribbean, the beginning that we have made in India, and so on.

"We are an institution whose vision is development, and an institution that knows that development is about people. You can't have development in places where people are suffering and dying. Where systems are being undermined from a capacity point of view because teachers are dying, nurses are dying, doctors are dying and so forth."

The Bank's Work on HIV/AIDS

In the past few years, the Bank has committed a total of about US$1.7 billion through grants, loans and credits for programs to fight HIV/AIDS.

In addition to the $1 billion allocated to 28 countries in Africa through the Multi-Country HIV/AIDS Program (MAP), the Bank has made available US$ 155 million to the Caribbean to fight HIV/AIDS.

For the poorest countries, World Bank support for HIV/AIDS projects can be up to 100% grant financed.

In April 2004, the Bank entered into a partnership with the Global Fund, UNICEF, and the Clinton Foundation to make it possible for developing countries to purchase high-quality AIDS medicines at low prices. The drug agreements could save from US$ 150 to US$ 400 per patient per year while the diagnostics agreements will result in savings of up to 80%.

To encourage countries to use Bank funding for treatment, the US$ 60 million Treatment Acceleration Project (TAP) was approved in June 2004. The TAP's grants to Burkina Faso, Ghana and Mozambique will test public sector/civil society partnerships to scale up treatment.

( July 7,2004)

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