AIDS/HIV -- When the State Fails: NGOs in Grassroots AIDS Care

Abstract

In the past quarter century HIV/AIDS has intensified poverty and suffering world wide more so in underdeveloped countries and poor neighborhoods of cities within industrial nations. UNAIDS and WHO estimate that 40-60 million people are living with the disease worldwide. The poorest nations in Africa and the Caribbean in which HIV/AIDS have spread most rapidly also live under political social and economic insecurity. For example Haiti has experienced a brief civil war and a hurricane disaster in 2004; however AIDS is the leading cause of death for adults accounting for 5.9% of deaths and 20% of deaths among adult women. Many of the poorest African countries have also suffered concomitantly from civil wars and high HIV/AIDS prevalence. In the 1980s when Uganda had a civil war this country was the epicenter of the pandemic world-wide with an adult HIV prevalence of 30%. Liberia ended her civil war in 2003 and currently records an HIV prevalence of 8.2%. Sierra Leone also had a civil war which ended officially in 2002 with HIV/AIDS prevalence among the army of 46% and a rise in prevalence among the general population. Finally Rwanda emerged from civil war genocide and mass dislocation in the 1990s and records 11.2% of adult prevalence. The economic crises from poor countries arose from "weak agricultural growth a decline in industrial output poor export production high debt and deteriorating social indicators and institutions." Botswana with 35% prevalence and South Africa with 25% prevalence though relatively more prosperous continue to be weighed down by the legacy of apartheid in the form of a high migrant labor system and disruption of family life. (excerpt)