Leading article: Aids: still dying of ignorance

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The Independent Online

It was 25 years ago this week that doctors in California published a report about an unusual syndrome that seemed to be affecting gay men in Los Angeles. It was briefly known as "Gay Related Immune Deficiency", but it gradually became clear that the condition affected haemophiliacs who had received blood transfusions and heterosexuals, especially Haitian immigrants. So it was called Aids, and within five years its essential features were understood. In 1986, the virus that causes it, transmitted mainly by unprotected sex, was renamed HIV and it was discovered that a drug called AZT could slow the advance of the disease.

Since then, 25 million people around the world have died of Aids and it is estimated that about 40 million are currently living with HIV. It is sad that so many deaths and some of the spread could have been avoided by vigorous campaigns of honest and explicit education. It is unforgivable that so many governments, the Roman Catholic church and Muslim leaders continue to obstruct the most effective action against Aids on a global scale.

Last week, Kofi Annan, the UN Secretary General, expressed his frustration with the evasive wording of a declaration issued by a UN conference on Aids. It avoided mentioning homosexuals, prostitutes and drug addicts as groups of people who are most at risk. "You cannot deal with a problem without confronting the issue of the most vulnerable who need assistance most. It's counter-productive. It's like putting your head in the sand and saying, 'I don't want to know'." In many African countries the stigma that attaches to Aids, which is assumed to be a poor person's disease, produces a culture of denial. Often it strikes down relatively well-off young men because they are the ones who can afford to go to prostitutes.

Although the UN communiqué speaks of the protection afforded by condoms, Mr Annan fears that the message will not get through to the billboards of the African street. "People need to understand what you are saying," he said. "You cannot code it for people to interpret it as they want."

He is right. There are too many influential groups that still, two decades after Aids was understood, confuse the provision of information with the endorsement of private behaviour of which they disapprove. The US administration, the most important single source of Aids funding, is too frightened of domestic Christian opinion. The Vatican, despite recent hints that it might accept condom use within marriage as the "lesser of evils", continues its unhelpful teaching throughout the developing world. Conservative African élites and the governments of Muslim countries have long obstructed effective international co-operation.

Progress is being made, but it is much too slow, and all the while, thousands of people are dying needlessly every day.

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