APPENDIX 3
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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