World AIDS Day article: Targeting the outlawed

9.42.01am UTC (GMT +0000) Fri 1st Dec 2006

A red ribbon for World Aids Day on 1st December

• Malcolm Bruce highlights the need to focus on certain marginalised groups in tackling AIDS

Reaching this 19th World AIDS Day we cannot yet claim we will fulfil the Millennium Development Goal to have halted and begun to reverse the spread of HIV/AIDS by 2015- let alone be on track t achieve the target, set at the G8 Summit at Gleneagles, to aim for as close as possible to universal access to HIV/AIDS treatment for all those who need it by 2010.

Russia, China, Indonesia and Vietnam have all reported increases in HIV prevalence. India, which has seen levels decline in certain areas, still has the largest number of people living with HIV anywhere in the world.

The rising prevalence of HIV has largely been attributed to marginalised high-risk groups or populations, which include sex workers, injecting drug users, prisoners and men having sex with men.

These groups are the drivers of the epidemic, which is why the International Development Committee is focusing on these links in its annual HIV/AIDS report this year, due to be released on World AIDS Day.

These groups are stigmatised, often criminalised and excluded, which makes reaching them and offering advice on behaviour and treatment difficult, yet they are the key to achieving the international targets.

Forty-one per cent of those living in the South African penal system are living with HIV; in China, 19 per cent of sex workers and their clients and 44 per cent of injecting drug users live with HIV.

The UK Government has recognised that reversing the spread is not just about resources for condoms and antiretroviral drugs. It requires a whole health infrastructure to deliver an integrated approach.

Since 2000, funding from the global community has increased significantly and $10bn is expected to be available in 2007. Some of this comes from faith-based sources that have difficulty facing the moral dilemmas in dealing with marginalised groups.

However, to build the necessary infrastructure to tackle AIDS and related illnesses, such as TB and malaria, will require still more resources and effective targeting of high-risk groups.

• Malcolm Bruce is the Chairman of the House of Commons' International Development Select Committee. This article first appeared in House Magazine, 27 November 2006