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Desp ite moderate but noteworthy progress in rolling back the spread of HIV in several African countries, stigma and discrimination remain major barriers to reversing the AIDS epidemic, according to the United Nations' chief AIDS official, speaking here in the lead-up to World AIDS Day.

"There are encouraging signs that prevention efforts are bearing fruit among young people in Ethiopia and South Africa," said Dr Peter Piot, Executive Director of the Joint United Nations Programme on HIV/AIDS (UNAIDS). "HIV prevalence has dropped among young inner-city women in Addis Ababa and young pregnant women in South Africa. These are new, hopeful signs of progress against the epidemic." However, Dr Piot warned, such positive trends should not overshadow the severity of the epidemic.

"Discrimination and stigma continue to stand as barriers," Dr Piot said. "Stigma harms. It silences individuals and communities, saps their strength, increases their vulnerability, isolates people and deprives them of care of support. We must break down these barriers or the epidemic will have no chance of being pushed back."
A new report released last week by UNAIDS and the World Health Organization shows that 42 million people are living with HIV/AIDS worldwide, some 30 million of them in Africa. There were five million new HIV infections in 2002 and 3.1 million deaths. The report further revealed that for the first time half the people living with HIV/AIDS are women.

On a more optimistic note, the report, entitled "AIDS Epidemic Update, December 2002," also reveals that HIV prevalence for pregnant South African women under 20 fell from 21% in 1998 to 15.4% in 2001. In Addis Ababa, infection levels among women aged 15-24 attending antenatal clinics dropped from 24.2% in 1995 to 15.1% in 2001. Other encouraging trends include continued declines in Uganda and Zambia, while elsewhere in the world, sustained prevention efforts have helped prevalence level off in Cambodia and the Dominican Republic.

According to Dr Piot, these signs of hope show that leadership by governments and communities can and does help fight AIDS. "Leadership is nurtured in the institutions which decide the continent's future," Dr Piot said. "NEPAD, the New Partnership for Africa's Development, is an outstanding vehicle for strengthening the continent, and putting AIDS at the core of NEPAD's agenda will help intensify the fight against the epidemic." NEPAD is the programme of action for the redevelopment of the African continent and the framework that guides the UN's support to Africa.

The Executive Secretary of the Economic Commission for Africa (ECA), K. Y. Amoako, said AIDS is central to Africa's development. "We must now, as an urgent priority, raise the issues of HIV/AIDS and its governance, development, and peace and security implications to the top of the agenda, and identify specific policy measures that can be taken by governments, international organizations and civil society to respond to these multi-dimensional challenges."
Across Africa, leadership has been clearly recognized as crucial to fighting AIDS. The African Development Forum, organized by the ECA in Addis Ababa in 2000, focussed on AIDS in Africa as a leadership challenge. The Declaration issued at the Forum highlighted the importance of leadership not only by government but at all levels - community groups, youth, women, religious leaders, the private sector, and all other members of society.

Mr Amoako further highlighted the impact of AIDS on the continent's development and governance. HIV/AIDS is now undoubtedly a menace to political and social stability, he said. "It is threatening fragile security environments and increasing the vulnerability of already weak states. The current food security crisis in Southern Africa is also, to a significant degree, the consequence of the way in which HIV/AIDS has created vulnerability to famine in rural communities."

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