related Development Index (GDI), and HIVprevalence among countries. It appears that lowlevels of gender equity and low levels of humandevelopment achievement have some associa-tion with high HIV prevalence, with a fewnotable exceptions, as shown in Fig. 1. There areseveral countries where the GDI and HDI arelow, and HIV prevalence is also low. Based onthe data available, these are key outlier coun-tries. Empirically, one finds that gender inequi-tiesinthelevelsofschoolenrolmentandincome,for example, create the type of social inequitythat contributes to the vulnerability of femalesto HIV infection (see also Gordon
et al
. 2000).However, while the available data do notdemonstrate any causal relationship, policy-makers and programme planners need to under-stand why HIV infection has been so rapid insomecountries,buthasincreasedmoreslowlyorhas remained at lower levels in other countries.They need to see that HIV/AIDS requiresresponses much broader than health alone.Unless the social conditions that facilitate thespreadof HIVandAIDScanbeimpacted,itwillnot be possible to slow down its transmission.Just as perfect democratic governance doesnot exist anywhere in the world, perfect resourcedistribution, even in so-called developed coun-tries, does not exist. Nevertheless, the way inwhich inequity in resource distribution plays outin the presence of HIV is reflected in the gaps ineconomic development between countries.Along the continuum from the poorest to therichest countries, the poor exert their efforts intrying to access resources and income; the richuse their income and resources to gain powerand influence,
2
thereby enabling them to in-crease and safeguard their wealth.By contrast, the democratic governanceprocess addresses the issue of income andresource distribution. Thus, it deals with thebackground to HIV vulnerabilities that rangefrom puttingpeople incircumstances where theyare exposed to infection, to pushing individualsto take risks that they would not have takenunder normal circumstances, had the environ-ment been more favourable to their livelihood(United Nations 2003).Just as there are some common elements inwhat constitutes democratic governance, simi-larly, an analysis of the mechanisms for buildingHIV resilience reveals a number of commonelements, as seen in the following country casestudies. It is worth examining these before consi-dering the general application of the principlesthey demonstrate.
The case of Brazil
In the early 1990s, the Brazilian Governmentrecognized the threat posed by HIV and AIDSand devised a national AIDS strategy.
3
Thatcomprehensive strategy called for the provisionof free medication, initiation of a major mass-media campaign through prime-time televisionto disseminate HIV-preventive messages, andthe distribution of condoms free of charge to sexworkers.
Figure
1. Correlations between the Human Development Index, Gender-related Development Index and HIVprevalence.
Source
: Graphics prepared by Lee Nah Hsu and Vincent Fung. Data taken from
UNAIDS Global HIV/AIDS Trend Report, 2002
and
UNDP Human Development Report, 2003 and Human Development Index, 2001
.
Building dynamic democratic governance and HIV-resilient societies
701
r
UNESCO 2005.
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