June (Web-only) 2006

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Good news is rare in the battle against HIV/AIDS. So when the U.N. released its 2006 report on Tuesday, most expected more of the grim statistics we have heard since the disease first surfaced 25 years ago.

But the 2006 report seems to signal a maturation of both the disease and the response to it. While the actual numbers of new infections and deaths are continuing to climb, the percentages are declining, signaling what Paul De Lay, director of evaluation at UNAIDS, called a "global slowing,"

That's about as good as it gets when talking about a disease that afflicts nearly 40 million people worldwide, with 4.1 million newly infected last year alone.

In addition, the report seemed particularly inclusive of the various groups fighting the disease, praising the President's Emergency Program for Aids Relief (PEPFAR) initiative from the Bush administration, and specifically citing churches and faith-based groups for being "among the first to deliver treatment and care."

That's in stark contrast to most international AIDS meetings, which had criticized the U.S. approach as "cultural imperialism" and worse, and openly dismissed religious groups that supported abstinence education.

In a press conference, De Lay went so far as to say that the loss of PEPFAR funds to the global effort would be "disastrous" and would result in withdrawing treatment to thousands who would certainly die without it. He was careful to praise the U.S. for playing a "major role" in making progress against HIV/AIDS.

One of the most positive points of the report was the decline of infections among young people in several African countries specifically tied to a delay in the onset of sexual activity.

Ken Casey, who heads the HIV/AIDS HOPE Initiative for World Vision International, said, "It does not take a great leap in logic to believe this is related to abstinence education. It is clear that education about abstinence does have an impact, especially with young people."

In a press conference last week, the International Women's Health Coalition criticized the Bush administration's emphasis on funding abstinence programs, saying "there is no evidence that these programs work" and, instead, asking for more comprehensive sex education and reproductive health services.

But in a telephone interview, Beth Fredrick, executive vice president of the organization, clarified that the group "does not object to abstinence education per se. We just believe it is impractical. When it does work, `God bless it."'

Sadly, the youngest people living with HIV/AIDS are the children who primarily contract the disease from infected mothers. What is especially tragic about the growing numbers is that mother-to-child transmission can be greatly reduced.

"We know how to dramatically reduce transmission of HIV from mother to child at a modest cost," said Charles MacCormack, president and CEO of Save the Children U.S., one of seven organizations requesting more funds specifically to help HIV positive children.

But pregnant women often do not know they are infected until they give birth to a sick child, and the percentage of women living with HIV is rising at an alarming rate — one of the most disturbing findings in the report.

Women in developing countries are most often infected by an unfaithful spouse or by being married to an older man who is already infected. Sexual violence and coercion is also a risk factor for women in poor countries who are offered food or school fees in return for sex.

The U.N. report calls for tougher laws to protect women, but many also believe that justice must happen at the local level where cultural practices often hurt women.

"Every intervention possible is necessary to protect women," says Kay Warren, executive director of the HIV/AIDS Initiative at Saddleback Church in California, and wife of pastor Rick Warren. "We must teach men and women to respect one another and view sex as a gift from God, not a commodity. Churches can and should play a major role in this effort."

While the 2006 UNAIDS Report stops short of endorsing specific approaches and methodologies, it does encourage the involvement of churches and faith based groups, noting that one in five groups currently working in AIDS programming is faith-based. It also encourages the growth in the "untapped potential" of faith communities to respond to the pandemic.

The report notes that strategies must be developed for long-term prevention, treatment and care. Perhaps the first step is the inclusiveness reflected in this report and the sense that anyone who is fighting the disease is on the same side.

Dale Hanson Bourke is the author of The Skeptic's Guide to the Global AIDS Crisis.

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