Select Committee on International Development Written Evidence


Memorandum submitted by The Panos Institute

  In response to the Press Notice No 19 of Session 1999-2000, dated 6 April 2000, there are two specific comments that the AIDS Programme of the Panos Institute would like to make regarding the response to the effects of HIV/AIDS on developing countries.

  The first is that Panos believes it is critical to involve the media in any response to the epidemic. The media should be involved, not as mouthpieces for "official" messages, whether from governments, donors or indigenous non-governmental organisations, but as a key tool in promoting awareness of the issues and debate around the response to the issues.

  We suggest there is little prospect of improving public health in most developing countries without a major increase in the quality and quantity of informed public debate. HIV/AIDS provides the most obvious example of the link between inclusive and informed public debate and effective action on the ground. In countries such as Uganda and Thailand a combination of political leadership, a preparedness to discuss issues of sex and sexuality openly, a vibrant and plural media and a thriving civil society have greatly facilitated the creation of an environment conducive to the reduction in HIV incidence.

  Effective health strategies must be locally owned and evolve in environments that enable individuals to make appropriate decisions. In democratic societies, such ownership and environments emerge from public dialogue and debate. Associations with sex, sexuality, death, prejudice, poverty and gender make HIV/AIDS intensely controversial. Local ownership of strategies designed to address such issues requires that they be debated on the basis of solid information and the inclusion of the voices of those with most at stake, most often the poor and marginalised. Ensuring a strong, independent, informed and able media is critical to this process.

  There is also a major requirement for greater political leadership. The fact that not a single head of state attended the 1999 International Conference on AIDS in Africa is indicative of the lack of political commitment within the continent to this epidemic. We would argue that an informed pluralistic media has a major role to play in fostering such commitment. The media also has a key role in critiquing contentious government responses to health issues (such as the recent "AIDS tax" imposed by the Zimbabwean Government).

  The second point that we would like to make is recognition of the fundamental role of men in the epidemic. As we pointed out in our 1999 publication AIDS and Men, an analysis of the epidemic that has been welcomed by UNAIDS and adapted as background to this year's World AIDS Campaign, it is men's behaviour and men's reluctance to protect themselves and their partners that lie at the heart of the epidemic, and the reluctance of men in positions of leadership (political or religious) to address controversial issues which has frequently hampered an effective response to the disease. Any effective response, therefore, must address the issue of gender, recognising that men and women are affected differently by the epidemic, affect it differently and must be approached differently, at every level of society, from appeals to safer sex behaviour, though workplace issues and community responses to national policy.

  As one of the first organisations to bring to international public attention the severity of the implications of the AIDS pandemic (Panos Dossier No 1: Aids and the Third World, 1986), and an organisation which continues to be widely recognised as an authority on the social causes and consequences of the disease in the developing world, we argue that in the absence of a vaccine, substantial reduction in HIV/AIDS is unlikely to happen without these two issues being clearly addressed in each affected country.

Martin Foreman
Director, AIDS Programme
The Panos Institute
May 2000

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