''All of us must recognize AIDS as our problem. All of us must make it our priority.'' Kofi Annan, UN Secretary-General

 ''We are encouraged by the gains that have been made in some countries and by the fact that sustained HIV prevention programmes have played a key part in bringing down infections. But the reality is that the AIDS epidemic continues to outstrip global and national efforts to contain it. It is clear that a rapid increase in the scale and scope of HIV prevention programmes is urgently needed. We must move from small projects with short-term horizons to long-term, comprehensive strategies,'' Dr Peter Piot, Executive Director, UNAIDS, 21 November 2005

1 December is World AIDS Day, dedicated to the fight against the global epidemic. The theme of World AIDS Day 2005 is 'Stop AIDS. Keep the promise.'  

“Keep the Promise' is an appeal to governments and policy makers to ensure they meet the targets they have agreed to in the fight against HIV and AIDS. But it is also a reminder that a commitment to stop AIDS must occur at all levels: personal, community, organizational and governmental. 

According to UNAIDS estimates, there are 38 million adults and 2.3 million children living with HIV. Around 95 per cent of people with HIV/AIDS live in developing nations, but HIV today is a threat to men, women and children on all continents around the world.

HIV/AIDS is not just a health issue. The epidemic is a development challenge. It exploits weaknesses in our societies and takes root across societal inequalitites, be it gender, age or geographical. Recognizing these weaknesses and responding to them is key to an effective response.

AIDS and rural poverty

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 rates of migration and lack of social power of women.

AIDS is a serious obstacle to development. It strikes young adults just as they are about to enter their most productive years, robs children of their parents, or forces them to drop out of school, leaving a generation without care or education. Rural poverty is deepened as families are forced to sell their assets to care for the sick and to compensate for lost income.

IFAD works in rural areas of developing countries to reduce the causes of the HIV/AIDS crisis and to build resilience to the impact of the disease. Recognizing that HIV/AIDS seriously affects agriculture and rural development, IFAD is addressing the epidemic through its rural investment programmes. Increasingly, IFAD-funded projects are used as platforms from which to fight HIV/AIDS. This is particularly the case in Africa , however IFAD aims eventually to build HIV/AIDS prevention and coping strategies into all of its projects. The emphasis is on strengthening the capacity of communities to respond to the crisis. IFAD has developed an HIV/AIDS strategy to guide its operations in East and Southern Africa.

Greater prevention is needed to slow the epidemic

Access to HIV treatment has improved markedly over the past two years. More than one million people in low-and middle-income countries are now living longer and better lives because they are on antiretroviral treatment and an estimated 250,000 to 350,000 deaths were averted this year because of expanded access to HIV treatment .

But despite decreases in the rate of infection in certain countries, the overall number of people living with HIV has continued to increase in all regions of the world except the Caribbean . There were an additional five million new infections in 2005, according to the annual report by the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the World Health Organization (WHO) released in 2005 .

  The number of people living with HIV globally has reached its highest level with an estimated 40.3 million people, up from an estimated 37.5 million in 2003. More than three million people died of AIDS-related illnesses in 2005; of these more than 500,000 were children. Far greater HIV prevention efforts are needed to slow the epidemic.  

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 rent for 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 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 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 1 036 households with a total of 7 404 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 UGX 200,000. ''With UWESO's help I increased the size of my store and opened 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 the money and training they need to start a successful small business. ''It is microfinance with a difference,'' says 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 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% of those in need.''