International inequities dent concept of common front against HIV

Unified international approach to AIDS only a fond memory

Is the idea of "one world, one hope," which was the theme for the XI International AIDS Conference in Vancouver, a call for global action or a romantic illusion destined to fade away and die?

Jonathan Mann of the Harvard School of Public Health said the framework for global action developed by the World Health Organization resulted in an international AIDS strategy that was endorsed and followed by most nations. As the world's first truly global health strategy, it was an event of fundamental importance.

Since then, something has happened to the unified effort. Fragmentation, separation and isolation have begun to dominate treatment and prevention efforts. One result, said Mann, is a loss of solidarity and the reappearance of status-quo realities.

Signs of the status quo, said Mann, include the gap between haves and have-nots, scientists and activists, infected and uninfected. "Ultimately, status-quo realities propose we can afford to forget about each other. People in rich countries can receive treatment with whatever the latest scientific achievement can provide. Societies in full possession of human rights can continue on in isolation from marginalized individuals at their doorsteps and in the streets.

"The gap between rich and poor means that the biomedical advances everyone desires have created an enormous chasm between rich and poor nations.

Despite this harsh reality, Mann said extraordinary creativity and personal commitment by many people remain undiminished, and today's challenge is to recreate conditions in which a truly global movement once again becomes possible. Humanitarianism will play a large role in this, he concluded. "Are not charity and humanitarianism based on the knowledge that we need each other and in some basic way are incomplete without each other?"

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| CMAJ December 15, 1996 (vol 155, no 12) |