Introduction
1. In 1999 war claimed 269,000 lives throughout the
world; homicide and violence a further 527,000.[1]
The figures are shocking and whilst easy to write almost impossible
to register or imagine. Nevertheless we take them seriously. Murders
are reported and worried over. Wars and conflicts fill our newspapers
and television screens. However, in 1999, 2.8 million people
worldwide died with AIDS. — more than three times the combined
deaths from war, murder and violence. The catastrophe of HIV/AIDS
must be the priority for action by the international community.
2. The situation continues to worsen. We begin with
the stark and most up-to-date statistics on the HIV/AIDS epidemic:
Global summary of the HIV/AIDS epidemic,
December 2000
|
| People newly infected with HIV in 2000
| Total
Adults
Women
Children <15 years
| 5.3 million
4.7 million
2.2 million
600 000
|
|
| Number of people living with HIV/AIDS
| Total
Adults
Women
Children <15 years
| 36.1 million
34.7 million
16.4 million
1.4 million
|
|
| AIDS deaths in 2000 | Total
Adults
Women
Children <15 years
| 3 million
2.5 million
1.3 million
500 000
|
|
Total number of AIDS deaths
since the beginning of the epidemic
| Total
Adults
Women
Children <15 years
| 21.8 million
17.5 million
9 million
4.3 million
|
|
Source: UNAIDS: Aids epidemic update, December
2000
3. We have called this inquiry 'HIV/AIDS —
the impact on social and economic development'. Since the emergence
of HIV/AIDS in the 1980s and the resulting health promotion messages
in much of the developed world, the majority of people in the
richer countries have known about HIV/AIDS as an issue of personal
and public health. But what is now apparent, and it is at last
coming to the attention of the international community, is that
HIV/AIDS raises acutely not only questions of health but also
questions of development. The developed world spends annually
about US$50 billion in development assistance to poor countries.
DFID has increased its planned annual expenditure to nearly £3
billion for 2000/1. The rapid spread of HIV/AIDS, particularly
in sub-Saharan Africa, and the consequences for life expectancy,
education, the agriculture and business sectors, have threatened
the long-term effectiveness and sustainability of such expenditure.
Responsible development programmes must as a matter of urgency
take account of the effects of HIV/AIDS when planning all aspects
of their policy and implementation. Not to do so is to risk wasting
public funds on projects then rapidly undermined by HIV/AIDS,
whilst neglecting to address what has become one of the greatest
challenges facing the world's poor.
4. Much has been written on HIV/AIDS. There are also
numerous conferences and seminars dedicated to a consideration
of how to fight the epidemic. We do not intend in this Report
to cover all the ground or to repeat unnecessarily information
readily available elsewhere. We would in particular refer those
interested in a broad survey of HIV/AIDS-related matters to the
work produced by UNAIDS. There will be issues, considered by many
to be important, which we only touch on briefly in this Report
or omit altogether. Our aim here is simply to draw from the evidence
received those points raised which we feel need to be brought
to the attention of the Department for International Development
(DFID) and of the wider development community. We trust our conclusions
and recommendations will assist all those involved in combatting
the epidemic.
5. We begin this Report with a consideration of the
impact of HIV/AIDS on social and economic development. The second
section considers selected issues of prevention and care, raised
during the inquiry, which we consider deserve further or fresh
consideration. The third section examines the responses and responsibilities
of governments and donors, including DFID, faced with the epidemic,
in particular the funding of effective interventions.
1 WHO 2000 Report Annex Table 3 Back
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