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In spite of recent advances in treatment and care available in most developed countries, the HIV/AIDS pandemic continues to spread throughout the developing world.
Structural inequalities continue to fuel the epidemic in all societies, and HIV infection has increasingly been concentrated in the poorest, most marginalized sectors of society in all countries. The relationship between HIV/AIDS and social and economic development has therefore become a central point in policy discussions about the most effective responses to the epidemic.
Important progress has been made in recent United Nations initiatives. Maintaining long-term commitment to initiatives such as the Global Fund to Fight AIDS, Tuberculosis and Malaria is especially important in the wake of September 11 and ensuing events, which threaten to redirect necessary resources to seemingly more urgent security concerns.
AS THE HIV/AIDS EPIDEMIC enters its third decade, much of the sense of urgency that accompanied discussions of AIDS only 10 or 15 years ago seems to be disappearing.1 Thanks to the development of new antiretroviral treatments capable of transforming HIV infection into a chronic but manageable health condition, mortality rates due to AIDS have fallen throughout the industrialized or "developed" world, and even in some of the more privileged "developing" countries.2
The worst types of discrimination and human rights violations against people living with HIV and AIDS (or suspected to be at risk for HIV infection), which occurred regularly during the early years of the epidemic, seem to have declined as well. Legal systems and official structures have been pushed to respond to the epidemic by reaffirming the basic rights of all human beings, independent of serostatus. And both governmental and civil society organizations in countries around the world have gradually mobilized resources and developed programs to overcome what once was described as "AIDS exceptionalism,"3 increasingly mainstreaming programmatic responses to the epidemic at international, national, and local levels. Indeed, as we have turned the page on the past century and entered the new millennium, and as we head into the third decade of the HIV/AIDS epidemic, the progress made in responding to AIDS over the past decade seems to give reason for guarded optimism.
STRUCTURAL INEQUALITIES
When we turn our gaze beyond our own borders to focus on the HIV/AIDS pandemic in the most resource-poor...