HIV and AIDS

Over 33.2 million people worldwide are living with HIV and AIDS, half of them are women. Nearly all live in poor countries and are unable to get the treatment and care they need. Every day, over 68,000 persons are infected with HIV, with young people especially at risk. 420,000 children under the age of 15 years were infected with HIV in 2007 and half of all new infections occur among 15 to 24 year olds.

Young women are particularly affected and infected. They are 2 to 6 times as likely to be infected as young men, and often responsible for caring for the orphaned and sick in their communities. Confronting the AIDS pandemic today requires we address the needs of women and girls. For Mary Robinson, former UN High Commissioner for Human Rights and honorary president of Oxfam, this means three things: money, laws and seats at the table.' Women must have a direct and equal say in designing programs and in determining treatment and prevention.

HIV and AIDS and the poverty cycle

HIV and AIDS have a huge impact on poverty because they affect millions of adult women and men whose work drives their countries' economies and services, and who care for the young and the old. While HIV and AIDS push more and more families into poverty, poverty makes them more vulnerable to infections. Global food price increases are further exacerbating these problems as food insecurity increases the risk of HIV transmission and, simultaneously, the agricultural sectors suffer from a decreasing labour force. For Oxfam's mission to overcome poverty and suffering to succeed, it is vital that these cycles of poverty are broken.

How can alleviating poverty make people less vulnerable to HIV and AIDS? If people are well nourished, they are less likely to fall sick; children can go to school if they are not forced to care for sick relatives, or become orphans; if women are not made destitute by being widowed and having their property seized, they are less likely to have to consider resorting to sex in exchange for food, shelter, or money, thereby increasing their risk of infection; and if men do not have to migrate to find work, the chance of the virus spreading further will be reduced.

For Oxfam's mission to overcome poverty and suffering to succeed, it is vital that the cycle of cause and effect that link HIV and AIDS and poverty is broken. This is why tackling the pandemic and its effects is a high priority for Oxfam.

Oxfam's strategy and learning

As the pandemic grows and changes, we need to keep checking that our approach is the right one. We need to be learning all the time from our own experience and from that of others - to ensure that our responses are appropriate and timely. In order to do this, we have established a Global Centre of Learning for HIV and AIDS, based in Pretoria, in South Africa, at the epicentre of the world's most severely hit region. The Global Centre of Learning is also leading on developing Oxfam's HIV and AIDS program.

Changes we want to see, and what we think our contribution can be:

I) Communities affected by conflict and natural disaster controlling the spread and impact of the epidemic

• Oxfam can contribute by addressing HIV and AIDS in disaster situations through better information, better access to treatment and care, and helping affected people recover from economic impacts of emergencies.

II) Marginalised people will not be at greater risk or vulnerability to HIV and AIDS

• Oxfam can contribute by working with vulnerable people such as the very poor, women, orphans and vulnerable children, commercial sex workers, injecting drug users, and men who have sex with men, to help ensure that they have a voice and are empowered to protect themselves and reduce the impact of the epidemic on their lives.

III) Prevention and treatment programmes are integrated and universally accessible

• Depending on the level of need in each country, and the extent to which the epidemic has taken hold there, Oxfam will develop two kinds of programs: those designed to increase awareness about HIV and AIDS and to change the behaviours that put people at risk of infection (such programs are being implemented in Nicaragua and South Africa), and programs providing care and support to those affected by HIV and AIDS.
• The experience we gain from working closely with communities and community leaders allows us to develop advocacy messages and campaigns at local, national, regional, and global levels to press for more services, and the funds to run them, to be made available to the communities that most need them.

IV) Communities are Supported to Survive and Recover from the Impacts of the Epidemic

• Oxfam's programs will focus on supporting households and communities heavily affected by HIV and AIDS, both to reduce the impact of the epidemic on poverty, but also to lessen the impact of poverty on the spread of the epidemic. Our programs will also assist in rebuilding the ability of communities to support themselves, while recognising that, in the short run, many communities have been so badly damaged that they cannot support themselves without assistance for some time to come.

  This work will include household level support, such as home-based, empowerment of women and other marginalized groups, support of health systems, education systems, welfare systems, and other initiatives aimed at rebuilding communities affected by the epidemic.

• Oxfam will also work to develop innovative programing that assists communities to manage the long-term implications of an epidemic that will affect numerous generations to come.