We now recognize it as a development issue. Desperately needed are expansions of credit programs, labor-saving technologies and help for those left behind, including orphans and the elderly. Another tool is courage - namely, courage to fight social stigma and acknowledge the disease in public. AIDS carries a burden of guilt and blame unlike any other disease. Too often HIV victims hide their fatal illness, justifiably fearing ridicule, ostracism, loss of employment and violence.
Stigmas are barriers to education, testing, counseling and treatment.
Stigmas attached to HIV weigh disproportionately on women, who are more vulnerable to the disease, predominantly subject to male control of their sexuality and more likely to suffer severe social and economic consequences. Only when HIV is discussed openly will transmission rates decline and those living with HIV receive the medical and social support they need. A third tool is money and effort aimed at improving health systems. It is not surprising that many of the nations with the worst health indicators also have the highest HIV rates, reflecting a need to strengthen health services overall. While it is unlikely that expensive drugs or a vaccine soon will be available to most of the world, modest enhancements to national health systems will help prevention and management of the disease.