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Universal access to HIV/AIDS prevention, care and treatment by 2010 ‘will fail’ without effective communication

Government communication strategies must be fully resourced and informed by the experiences and priorities of those people most affected to ensure universal access to HIV/AIDS prevention, care and treatment by 2010.

In 2005, G8 governments, the African Union and the UN World Summit called for 'as close as possible to' universal access by 2010, and governments are now in the process of setting targets and will develop detailed plans about how they propose to deliver on these later this year.

The report, Breaking Barriers, published by international development NGO, Panos, was launched on the final day of the inaugural World Congress on Communication for Development (25-27th October 2006, Rome). It argues that if governments are truly committed to achieving universal access, then they must make HIV/AIDS communication central to their plans, and ensure it tackles the wider social and cultural realities that people face every day such as stigma and gender inequity – identified as two of the main social barriers to universal access by UNAIDS in country consultations in 2005/2006.

"In the past, communication in development has often been thought of as simply how to provide information and messages to people such as'wear a condom', in order to change their individual attitudes and behaviour", says Robin Vincent, Senior HIV/AIDS Advisor at Panos London.

"But in some cultures, for example, where masculinity is associated with having many sexual partners, and where women often have little power to negotiate safer sex, messages like these make little impact."

The report argues that effective communication needs to be a two-way process and not just top down, so people can find their own solutions relevant to their lives and situations.

One such example highlighted in the report are the 'community conversations' developed by UNICEF and UNDP in Ethiopia. By training local people to act as facilitators in their own communities, people can openly talk to each other about 'taboo' subjects for the first time. This has led, for example, to some communities discontinuing traditional practices that put people at risk of contracting HIV such as female circumcision, widow inheritance and wife sharing.

The report also argues for clear HIV prevention communication based on evidence rather than ideology. It highlights recent evidence which indicates many countries fail to resource and address prevention among high risk populations. For example, less than 20 per cent of drug users worldwide receive prevention services. In some countries of Eastern Europe and Central Asia, where drug use is one of the main driving factors behind the epidemic- this failure to employ evidence-based prevention is compounded by unhelpful laws and policies that prohibit drug substitution therapy and criminalize drug users.

"If countries are truly committed to providing universal access by 2010, then they need to engage with those most affected by HIV and AIDS, however politically controversial that may be," argues Robin Vincent, "and base their communication plans on what is actually happening and not on their own moral agendas."

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