Imagine a place where children have no parents, schools have no teachers, hospitals have no doctors and businesses have no workers.

For the 2.35 billion people living in impoverished countries, this isn't an imagination, this is the reality of the destruction caused by AIDS.

HIV/AIDS is indeed a global epidemic. Sub-Saharan Africa is the worst affected region in the world, followed by the Caribbean where Haiti, with a debt burden of $1.3 billion, has an adult HIV prevalence rate of 3.8 percent.

In Asia and Eastern Europe, HIV rates are rapidly rising. In 2005, 2.8 million people died of AIDS-related diseases. Millions more will die each and every year unless drastic action is taken now.

Wealthy countries like the United States can help stop the rapid spread of HIV/AIDS by lifting the burden of unjust debt in impoverished countries and providing affordable medications and funds for education, care and treatment. In 2007, the world community needs to invest more than $18 billion to fight HIV/AIDS and other diseases such as tuberculosis and malaria around the world. Currently, low-income countries pay out $100 million a day in debt repayments. Simply, this doesn't add up.

A Disease of Poverty: AIDS in Africa
The continent of Africa is home to 34 of the 48 most impoverished countries in the world. It is no coincidence that it is also the continent most plagued by HIV/AIDS. Sub-Saharan Africa holds only 12 percent of the world's population, yet accounts for 64 percent of persons currently infected. 

In rich countries, most people with HIV/AIDS live well for years. This is primarily because they have access to good health care and medication. Most Africans, unfortunately, lack these things. Their governments, thanks to two decades of structural adjustment programs, cannot afford to fund even the most basic health care or provide the essential anti-retroviral treatment drugs.

Ninety percent of all children living with HIV/AIDS live in Sub-Saharan Africa and less than 1 in 10 are being reached by basic support services. This fact is directly related to the reality that countries have to pay for debt service instead of health care.
 

A Global Effort
In 2005, world leaders came together at the Group of Eight (G-8) meetings and committed to canceling the debt for some of the most heavily indebted countries in the world. At these meetings, the G-8 also committed to work towards universal access to AIDS prevention, care, and treatment by 2010, following the call of the United Nations Millennium Development Goals to end extreme poverty by 2015. We are frighteningly close to this date yet very far from achieving this goal.

World leaders have made commitments time and again to fight this virus, but have not taken the bold action that is necessary. The limited debt cancellation that 20 countries, 16 of them in Africa, will obtain in 2006 under the G-8 agreement is only a first step -- and an insufficient one. The six countries with the highest HIV/AIDS infection rates have received zero debt cancellation under the agreement. Of the 60 countries most burdened by AIDS, debt and poverty, the G-8 debt cancellation only amounts to 13 percent of their total debt.

Debt, Structural Adjustment Programs & HIV/AIDS
In order to qualify for debt relief, countries are often forced to implement harmful economic programs dictated by the International Monetary Fund and World Bank. Much of the debt is owed back to these two public institutions, which were designed to help reduce and prevent poverty.

However, their policies -- such as the privatization of basic services, budgetary spending restrictions, removing subsidies, and trade liberalization -- undermine, rather than contribute to, the fight against poverty and global AIDS.

One problematic reform is the IMF's restriction of national budgets and wages. The IMF imposes limits on spending and as a result, countries often have to make cuts from the sectors that need money the most. As a result, countries cannot invest sufficiently in the health sector, hire enough doctors or nurses, or pay competitive wages to retain the trained professionals they have.

Uganda could only use $186 million of a $201 million grant from the Global Fund to Fight AIDS, Tuberculosis and Malaria because of public spending ceilings. In Kenya in 2003, the IMF conditions prevented the hiring of thousands of unemployed nurses.

Many governments have also been forced to cut the number of clinics they support and often must charge user fees for the ones that continue to operate.

As many people cannot afford user fees, they do not go to clinics when they need medical care. The World Bank and IMF also support global trade policies that hurt rural economies and limit the access of impoverished countries to generic and inexpensive anti-retroviral drugs. 

Debt Cancellation Works to Fight AIDS
AIDS affects every aspect of the lives of citizens in impoverished countries and improving any social service from education to sanitation helps in the fight against HIV/AIDS. The past decade of experience with debt cancellation has shown that countries have used these newly available resources for essential public services. 

Uganda has been one of the most successful countries combating HIV/AIDS, in large part due to the government's use of debt relief funds.

According to Oxfam International, ìIn 2000, the Ugandan government abolished user fees for primary health care, giving poor people free access to clinics. The result: health units reported an increase of between 50 and 100 per cent in attendance almost overnight. Immunization rates more than doubled.î

As a result of the 2005 debt deal, Tanzania eliminated out-of-pocket costs for HIV testing services and Benin invested 54 percent of money saved from debt relief on health including primary health care and HIV programs.

In 2003, Zambia spent twice as much on debt repayments as on health care. Now the 2005 G-8 debt deal has allowed the country to invest in free health care for all citizens living in rural areas.

Before the deal, Zambians had to pay between $5 and $10 per visit to the clinic due to IMF-imposed user fees, even though the average citizen lives on less than $1 a day. The country's leaders have also committed to providing free anti-retroviral drugs to 100,000 citizens, which is vital in a country where 1 in 5 people are HIV positive.

Become Part of the Solution
The AIDS crisis is unparalleled in its devastating effects on lives and communities. Substantial resources are required to combat it now and payments on external debt divert essential funds for treatment and prevention of the virus. Given the illegitimate origins of much of the debt in impoverished countries, broader debt cancellation is not only a question of human need, but also a matter of justice. 

The economic disruption caused by World Bank and IMF imposed structural adjustment policies only worsens the problem. Full debt cancellation for impoverished countries without harmful conditions will not by itself solve the problem, but it is an important piece of any comprehensive solution to address the challenges of prevention and treatment of HIV and AIDS.

Join us now to drop the debt to fight global AIDS. Become part of the solution.

Visit www.stopglobalaids.org and the Get Active section of our website to learn more and get involved.

Sources: UNAIDS 2006 Report; World Bank, World Development Indicators 2006; KAIROS Global Justice Report July 2006 ìG8 Inaction Betrays People with AIDSî; Jubilee USA, ìThe Unfinished Agenda on International Debt,î July 2006; Shacinda, Shapi, ìZambia to Put Debt Relief into AIDS Fightî, Reuters June 20, 2005; Jubilee Debt Campaign, Oxfam International, ìPaying the Price: Facts and statistics on debt from Jubilee Debt Campaign, 2006.