Are we ready?
WAR AGAINST AIDS: When Acquired Immune Deficiency Syndrome (AIDS)
first made headlines in 1980, few could have foreseen the terrible
shadow, which the deceptive mnemonic of AIDS is now set to cast over
generations to come.
Although the HIV retrovirus is an opportunistic infection with no
will or agenda of its own, we talk of the 'war' against AIDS as if it
were some otherworldly invader. In truth, the war is with our own very
human qualities of ignorance, fear and prejudice.
Although the disease is a global issue, a pandemic as opposed to an
epidemic since the fight to control it extends well beyond the borders
of any given country or continent, the personal matter of sexual
behaviour is critical. In fact, social mores about sexual behaviour are
the 'minefields' of this 'war'.
Close to 6 million people are infected with HIV/AIDS in South Asia.
More than 90 percent of them live in India. Social factors like
widespread poverty and inequality increase the region's vulnerability to
Sri Lanka detected the first AIDS victim in 1987. Gradually this
number has increased to around 800. We have been able to maintain a
low-prevalent status through the effective control measures undertaken
by the Health Ministry, supported by all other relevant sectors
including NGOs and UN agencies.
Yet, as the President said in his message for the World AIDS Day, the
challenge for the future would be to further maintain the low-prevalent
status in the presence of all the ingredients in Sri Lanka to end up in
an epidemic, if we do not get together in our prevention efforts.
While all HIV testing and treatment is principally covered by the
Government, the primary objective is to negotiate these 'minefields' in
order to inform those who are most at risk of infection. The Government
has to work closely with non-governmental organisations (NGOs) on
education and awareness campaigns.
The prime need in this "war" is for a comprehensive programme of
education directed for young people.
This is clear. The topics may cover the teaching of delaying sexual
activity, how to say "no" to sexual advances, the correct way to use a
condom, the risk of AIDS, how to discuss condom use with a sexual
partner, and the importance of not having premarital sex.
But before we venture into a sensitive project of that nature, I
believe we should do a study to assess the perceptions of our parent
population regarding the appropriate approach of teaching various
AIDS-related topics to higher grade students.
We should understand that in a country where religions play an
important role in the lives of most of the people, particularly in the
rural sector, support for sex education at school can be minimal. In
fact, educating young people about becoming infected through sexual
contact can even be controversial.
Therefore it is absolutely necessary that school systems should
obtain broad community participation to ensure that school health
education policies are locally determined and are consistent with each
community's social and religious values.
I believe education about AIDS may be most appropriate when carried
out within a more comprehensive school health education program that
establishes a foundation for understanding the relationships between
personal behaviour and health.
For example, education about AIDS may be more effective when students
at suitable ages are more knowledgeable about sexually transmitted
diseases, drug abuse, and community health. It may also have greater
impact when they have opportunities to develop such qualities as
decision making and communication skills, resistance to persuasion, and
a sense of self-esteem.
Although information about the biology of the AIDS virus, the signs
and symptoms of AIDS, and the social and economic costs of the epidemic
might be of interest, such information is not the essential knowledge
that students must acquire in order to prevent becoming infected with
Similarly, a single film, lecture, or school assembly about AIDS will
not be sufficient to assure that students develop the complex
understanding and skills they will need to avoid becoming infected.
At the same time, we should not forget that thousands of children
living and/or working on the streets are in danger of being exploited
for sex, and there is a clear need for concerned agencies to offer
counselling, advice and protection from the hazards of infection.
Above all, these children need to be sheltered from the dangers of
life on the street: they need the safety and security of home and a
place in society.
While HIV/AIDS is clearly a health problem, the world has come to
realize it is also a development problem that threatens human welfare,
socio-economic advances, productivity, social cohesion, and even
national security. If there is any fight against HIV/AIDS, it is not
with the retrovirus.
The real fight is to educate, inform and counsel against the lack of
knowledge and discrimination which puts communities and individuals the
world over at risk.