''Over the past few years, we have seen a terrifying pattern emerge: all over the world, women are increasingly bearing the brunt of the epidemic. Women now account for nearly half of all adult infections. Among people younger than 24, girls and young women make up nearly two thirds of those living with HIV. And yet, one third of all countries still have no policies to ensure that women have access to prevention and care. Knowing what we do today about the path of the epidemic, how can we allow that to be the case?'' -UN Secretary-General Kofi Annan addressing the 15 th International AIDS Conference, Bangkok , 11 July 2004

 ''Poor people in rural areas, particularly women, are the largest and weakest segment of Africa 's population. They have fewer economic opportunities and limited access to education, information and public services such as health care. As a result, they are the hardest-hit by HIV/AIDS. Their families and communities become even poorer and even more vulnerable. They exhaust their already meagre resources in caring for the sick, and they are permanently weakened by the loss of their most active family members.'' -IFAD President Lennart Båge - UN Chronicle, Volume XII Number 3, September -November 2004.

Today is World AIDS Day, dedicated to the fight against the global epidemic. The theme of World AIDS Day 2004 is women, girls, HIV and AIDS. HIV is affecting women and girls in increasing numbers. Globally, just under half of all people living with HIV are women and girls and that proportion is continuing to grow, particularly in Eastern Europe , Asia and Latin America . And in sub-Saharan Africa, women and girls make up almost 57 per cent of all people infected with HIV, according to the 2004 joint annual report of the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the World Health Organization (WHO).

The emerging emphasis on a multi-sectoral response to HIV/AIDS has highlighted the fact that the epidemic is a development challenge, and not just a health issue. HIV/AIDS exploits weaknesses in our societies and takes root across societal inequalities, be it gender, age or geographical. Recognizing these weaknesses and responding to them is key to an effective response. We can do so from a position of strength, particularly if women are socially and economically empowered to take action.

Biological, sociological and cultural factors put women at special risk of HIV infection and the consequences of AIDS. Women are less able to protect themselves from infection, are infected at younger ages and are less able to cope with infection. They are also on the frontline of dealing with the devastating impact of the epidemic. Women's vulnerability to infection is mirrored by the vulnerability of their households to the impact of HIV infection, given that in most societies, women bear the major responsibility for meeting the daily needs of their families.

AIDS and rural poverty

Although Africa remains the worst-affected region, the epidemic is spreading rapidly in other parts of the world, particularly Eastern Europe and East and Central Asia . The number of people living with HIV in Eastern Europe and Central Asia has increased by almost 40 per cent, and by almost 50 per cent in East Asia, according to figures released by UNAIDS in 2004. AIDS is a crisis with severe socio-economic repercussions, particularly in rural areas of developing countries. Poverty is the underlying cause of much HIV infection in rural areas, but poverty is also aggravated by the impact of HIV/AIDS. AIDS is a social disease that is especially prevalent in rural areas characterized by fragile economies, high rate of migration and lack of social power of women.

Increasingly, IFAD-funded projects are used as platforms from which to fight HIV/AIDS. This is particularly the case in Africa , but IFAD aims eventually to build HIV/AIDS prevention and mitigation strategies into all of its projects. The emphasis is on strengthening the capacity of rural communities to respond to the crisis -and with special focus on women and highly vulnerable at-risk groups. Guiding its contribution to fighting the epidemic is the IFAD HIV/AIDS strategy for East and Southern Africa.

Strengthening families' ability to cope: the Uganda Women's Effort to Save Orphans (UWESO )

When her husband died of AIDS, Regina Nankabirwa could not afford to rent a house large enough for her and her eight children in the town of Masaka in southwest Uganda . Without a husband or income, she was forced to move into a small house in the village of Kitante . There she had more land and could grow food to feed her family. She decided to open a small retail shop to generate some income.

Over the next 15 years, AIDS devastated Ms Nankabirwa's family. She lost brothers and sisters to the disease, and in the tradition of African extended families, she took in all of their children. There are now 18 people living under her roof in Kitante.

Fortunately, she has help. Thanks to the Uganda Women's Effort to Save Orphans (UWESO), she is able to provide for all those in her care. Supported by an IFAD/Belgian Survival Fund Joint Programme, UWESO is a non-profit organization launched in 1986 by Janet Kataha Museveni, wife of the country's president. The goal of UWESO is ''to improve the quality of life of needy orphans by empowering local communities to meet the social, moral and economic needs of these children.'' UWESO now has 36 branches working in 15 districts throughout Uganda . In the Masaka area alone, the organization is helping 1036 households with a total of 7404 orphans.

The statistics on orphans in Uganda are staggering. In Uganda , the latest figures show there are more than 880,000 orphans due to AIDS. Most have lost one or both parents to AIDS. Families with five or six children of their own are now looking after as many as 20. UWESO has stepped in to provide help for large households such as Ms Nankabirwa's, filling a gap left by the breakdown of the traditional family structure.

Ms Nankabirwa joined UWESO in 1997 and received a loan of 100,000 Ugandan shillings (US$ 67) to start her business. She has since repaid that loan and two others, and she has just secured her fourth loan from UWESO, this time totalling 200,000 Ugandan shillings. ''With UWESO's help, I was able to increase the size of my store and open a small restaurant,'' says Ms Nankabirwa. Most of the vegetables she serves in the restaurant are grown on the land beside her house.

With her profits from the shop and restaurant, Ms Nankabirwa bought two cows and three goats. ''The business is doing well,'' she says. ''Soon, I hope to secure a small piece of land and put up some apartments to rent. My daughter Harriet will run this business.''

Harriet, who is 24, already works for her mother in the restaurant and store. She is evidently a shrewd businesswoman, who can regularly be seen haggling over prices with merchants who have come to sell items to the shop.

UWESO has developed a unique approach to helping people like Harriet and her mother. The organization's strategy is to alleviate poverty by giving women access to savings and credit services and training they need to start a successful small business. ''It is microfinance with a difference,'' says the former UWESO Executive Director Pelucy Ntambirweki. ''Banks do not deal with grandmothers and widows. They bombard them with paperwork and want them to write and sign things. We have designed savings and credit programmes that work for families in these situations, and we have taught them how to manage, how to use a loan and how to save.''

UWESO's methods and message are expanding. Membership in the organization has grown to 10,000 volunteers. More than 100,000 orphans across the country have received some form of aid from direct UWESO involvement. This includes help to finance schooling for young orphans and vocational training for adolescents.

However, according to Mrs Ntambirweki, there remains much to do. ''We have helped 100,000 children,'' she emphasizes, ''but despite all of our efforts, that is still only 5 per cent of those in need.''