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15 A Ten-Point
AIDS Management Plan for the Government
1.´Determine 1. Find the extent of the problem
2.´Target
people especially at risk with further new campaigns
3. Get
an army of health educators on the road
4.
National training programme for all health care workers
5.´Provide
a network of specialist advisory teams
6.´Establish a network
of hostels
7. Recruit extra
community nursing staff
8.´Work in partnership
with the church
9.´Increase
spending on prevention in developing countries
10.´Research
into long-term relationships as well as vaccine/cure
How can I help
turn plans into action?
CHAPTERS:
Introduction 1
The Extent of the Nightmare 2
What's so Special about a Virus? 3
When Cells Start to Die 4
How People Become Infected 5
Questions People Ask 6
Condoms Are Unsafe 7
Moral Dilemas 8 Wrath or
Reaping? 9
Some Life and Death Issues 10
When Church Members Need Help 11
Others Need Help Too 12
Saving Lives 13 Needle
and Condom Distribution? 14
Special Issues in Poorer Nations 15
A Ten Point Plan for the Government 16
A Global Christian Challenge Appendix
B Appendix C
Appendix D
Note: This chapter of The Truth about AIDS by Dr
Patrick Dixon is the original text as published by Kingsway
in 1994 updated in 2002 and may be reproduced with acknowledgment.
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for Tear Fund)
People often ask what I think governments of various countries
should be doing next. Here are a number of different suggestions
which need to be adapted sensitively and carefully to the country
concerned.
1.´Determine
the extent of the problem
(return to index)
We need to get it right: governments do not have resources to squander
on problems that do not exist or are being exaggerated by those
with vested interests in increasing their own budgets. However,
we do not have time to adjust plans if the AIDS epidemic becomes
worse than estimated or changes its character in any way. For example,
has education reduced heterosexual spread but not affected drug
addicts? Are new HIV viruses spreading in different ways? After
all, as things stand, a person infected tomorrow will probably die.
You have possibly five to fifteen years to plan his or her terminal
care, but only today to prevent a death&Roman;.
All discarded blood samples from selected hospital laboratories
should have identifying markers removed and be sent to public health
laboratories for testing. Only the hospital of origin should be
stated. Results will give an indication of spread across the country
and will enable us to detect local increases. Hospitals giving cause
for concern should then be asked to send regular batches of blood
samples with age and sex recorded on each bottle, but no other information.
2.´Target
people especially at risk with further new campaigns
(return to index)
Education is most effective when targeted at those most at risk.
Young people also need to be targeted before they begin taking risks.
It is far easier to prevent risk-taking behaviour before it becomes
a life habit, than afterwards. Government campaigns are insufficient
without continued high-profile publicity for a prolonged period
afterwards. Education is easy. Changing behaviour is extremely difficult.
Smoking kills several hundreds of thousands each year, numbers which
dwarf the current AIDS problem, yet public health campaigns have
taken years to produce change. Sexual drives are stronger than the
power of nicotine or the needle. All educational literature should
be clearly marked with date of issue and leaflets should be promptly
withdrawn when out of date.
3.
Get an army of health educators on the road
(return to index)
The economics of health education are simple in many industrialised
nations: hospital costs for caring for one AIDS patient alone are
so high that a health educator only has to prevent one person a
year from developing AIDS to save the government or health insurance
companies his entire salary. If he or she succeeds in preventing
one person a month from becoming infected, the government or other
agencies make a fortune. (See
Chapter 12.) In poorer nations the economic arguments
are strongest when targeting those on whom the future of the country
most depends, and those likely to be at greatest risk.
The argument for prevention is overwhelming. From travelling
around to schools and colleges myself, I am convinced that an effective
communicator can save hundreds of lives a year.
One important factor has been left out of most school information
packs and is also missing from youth education: the personal factor.
Tell your own stories. When I go into a school or college everyone
is on the edge of their seats. Why? Because I know people personally
who have died of AIDS, people who are dying right now, and I often
see people who are dying of it. It is real, so prevention and encouraging
positive attitudes are easier.
4.
National training programme for all health care workers
(return to index)
Never has there been a new lethal disease that has spread so quickly
to affect so many millions of people. Consider cancer care or malaria:
cancer and malaria have been around for centuries. Even so, there
are acute training problems. Existing care teams are under strain
with conflicting demands from patients and from the need to train
more carers.
The explosion of AIDS cases in many countries and the rapidly-changing
appearance of the disease---with new treatments and research likely
to make most knowledge obsolete in a year or two---means that a
vast, crash-training programme needs to be established. If every
week terrorists blew up four civilian aircraft on domestic flights
killing 1,000 US citizens, a national state of emergency would be
declared. Why shouldn't governments treat the AIDS epidemic with
the same seriousness? After all, possibly the same number are doomed
every week or two in India, China and many African nations through
new HIV infections.
5.´Provide
a network of specialist advisory teams
(return to index)
Governments should fund teams to advise and support health care
workers in the community and various hospitals in high-incidence
areas. One aim would be to channel the latest information and techniques
on treatment from research centres to those in the field. Such workers
can have a remit to cover other illnesses as well, particularly
in poorer nations.
6.´Establish
a network of hostels
(return to index)
Some governments need to slash through miles of red tape to allow
the swift establishment of safe housing for AIDS patients who have
nowhere to go, nowhere to live. It is not unusual for a recently
diagnosed person with AIDS to come back home to find his bags outside
the door and that his partner has changed the locks.
7.
Recruit extra community nursing staff
(return to index)
People with AIDS are heavy users of nursing resources. Health teams
need additional resources for community nursing that are increased
in line with their numbers of people with AIDS.
8.´Work
in partnership with the church
(return to index)
The church is the largest non-government organisation in many nations
and perhaps globally. It represents a massive untapped resource.
In many countries the church has a long history of care provision,
particularly so in developing nations. Governments should actively
seek partnership programmes. The church represents not only an effective
resource organisation, but also a powerful influence for behaviour
change. The essential government task is to provide overall strategy,
leadership and co-ordination. We all need to work together. The
problem is too great in many countries for governments or secular
agencies to solve on their own. Faith-based organisations have a
vital role to play, especially in behaviour change.
9.´Increase
spending by wealthy nations on prevention in developing countries -
and pass on funding to NGOs (return
to index)
In an age when a traveller from the UK can be in Botswana more
quickly than it takes to drive from the North of the UK to the South,
wealthiest nations must recognise the need to invest in international
prevention efforts, even as a matter of self-interest. The AIDS
epidemic must not rage ahead unchecked. It is a scandal that
the UK government spends more on AIDS, with a tiny domestic problem,
than the entire UN agencies for their global programmes on AIDS.
No wonder the world epidemic is out of control.
Part of the deal is for developing countries to work hard ensuring
that every dollar of aid goes swiftly and openly to projects delivering
practical services to people who need them. Too often red-tape
and secrecy have created a climate that encourages corruption and
other bad practices. In many countries there are unspent aid
funds sitting in accounts because of disagreements about where the
money should go. Delays cost lives.
Governments should give major priority to funding non-government
agencies (NGOs) since they are often much better placed to deliver
services quickly in a relevant and efficient way.
Getting spending sorted out will encourage donors, who want to
see rapid action and real results.
10.´Research
into long-term relationships as well as vaccine/cure
(return to index)
In addition to these points, governments and international agencies
need to fund further major research into vaccines, cures and better
ways to prevent spread. Incentives need to be provided to encourage
drug companies to direct their vast research operations towards
vaccines. A comprehensive study of marriage is greatly overdue:
what makes a happy marriage , how to choose the right partner and
how to prevent breakdown. Results can then be fed into schools'
education
How
can I help turn plans into action?
(return to index)
The future is in your hands. You can write, phone, or otherwise
make your views known to those in local or national government,
to health planners and to church leaders. You can make sure copies
of this book (produced without profit) get to the right people.
You may feel that your contribution is small and not worth much,
but thousands of others are doing the same. Together we can help
turn the tide and build a better place for those who come after
us. We are too late to prevent a disaster, but not too late to prevent
an even bigger one.
Petitions are useless in comparison to individual letters, so get
others to write too. Write to your Member of Parliament or other
appropriate government official. Even if not read, your letter will
be counted as yet another part of a big vote on the issue. Write
to TV producers who have made AIDS programmes. Commend them for
good content and criticise the bad. Remember that in the past, thirty
letters after a programme have been enough to influence the producers.
Write to your local legislators asking them what provisions they
are making for those with AIDS. If you are dissatisfied with the
reply, say so, and send copies of the correspondence to your newspaper.
Having looked at how the government can respond, we now need to
return to our overall Christian vision for responding to AIDS. Is
there more needed than just prevention and cure? Is there anything
more we need do? Is the church in danger of just becoming an expert
provider of AIDS programmes almost identical in many ways to government
ones? Are we in danger of losing our way?
1.´Determine
1.The extent of the problem
2.´Target
people especially at risk with further new campaigns
3. Get
an army of health educators on the road
4.
National training programme for all health care workers
5.´Provide
a network of specialist advisory teams
6.´Establish a network
of hostels
7. Recruit extra
community nursing staff
8.´Work in partnership
with the church
9.´Increase
spending on prevention in developing countries
10.´Research
into long-term relationships as well as vaccine/cure
How can I help
turn plans into action?
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