How can I tell you the truth?

I have travelled in 54 nations over the years.  Just over the last weeks I have seen and heard things I cannot talk about.  If I do, ACET and other programmes could be closed by governments and I could even – with their project leaders – end up in prison.  If I told you the actual stories, project leaders would lose trust with the people they are trying to help, and people who recognised themselves in these words would lie awake at night fearing they had been publicly exposed.

As a physician I can say that AIDS is a truly dreadful disease – and I am already in trouble with some activist groups for telling you that in case it upsets people with HIV.  But it is the truth.  It has already destroyed over 40 million lives – dead, with another 40 million to follow among those living with HIV.  12 million children have been robbed of parents, with another 12 million soon to be orphaned.  Despite media stories, the spread of HIV is not over.  We are seeing at least 2.5 million more people infected every 12 months.  There is still no cure and no vaccine, despite treatments which prolong life by many years.

Without good treatment, dying of AIDS can be really awful, and even with the best treatment in the world, the end stages of AIDS are not ones I would wish on anyone I care about.  Sadly most people who have HIV live in places where treatment options are few as people get sick, unless they are wealthy.

The hostility against those with AIDS is still appalling, despite great efforts over more than 20 years.  Yes many attitudes are changing, churches have been mobilised:  but many people with HIV are still being mistreated, abused in the street, shamed publicly in churches (who should know better), beaten up and sometimes killed.  Their children are often ostracised, rejected by other family members, avoided by other children at school.  Most of those with HIV in many communities live in daily fear of discovery, afraid of being recognised in AIDS clinics or on AIDS wards, afraid of HIV test results being leaked.  They live secret lives.  They may be politicians or church leaders, mothers or fathers, husbands or wives, office workers or rural farmers.  And when they die, in many cases their secrets will be buried with them.

Clinics and hospitals in many places are often unsympathetic to those with AIDS.  People with AIDS from lower social groups are often particularly despised.   The promise of free treatment is often a cruel illusion: nothing more than a disguise for big medical bills, for every other element of treatment than the free antivirals that may or may not be available, despite government promises.

Large numbers of people who know they are infected are keeping the knowledge from their partners, and from their children, placing them at risk either from infection, or from lack of access to treatment.  Many women fear being beaten by their husbands and thrown out of the home if they admit they have HIV (or even that they have had a test) – even though they are certain they have been infected by their husbands.

To make matters even worse, there is widespread corruption in AIDS work.  In many nations it is almost impossible to get AIDS funding from global organisations that channel funds through government departments, without paying bribes or agreeing for up to 50% of all funding to be filtered off by corrupt officials.  In some nations projects are expected to deliver 100% of the programme with only 50% of the funding that was originally promised.  The situation is so bad that Global Fund recently pulled out of Uganda altogether.  But the same kind of problems are to be found in many other nations.  Many AIDS programmes are inefficient, badly run and have little impact.

And the good news?   HIV has slowed down dramatically in many places such as Uganda.  Infection levels are stable in countries like Nigeria and Congo.  Millions of people have been reached with life-saving messages.  In places like Plateau region of Nigeria one in three of the entire population has already been tested for HIV and most who need it are getting access to free antivirals.  In that area alone over 6,000 community workers are going from house to house, hut to hut, village to village, encouraging HIV testing and access to treatment.

Tens of thousands of churches across hard-hit regions are rising up as a mighty people movement to stop spread of HIV and care for those affected with compassion, love, understanding and practical support.  Pastors are waking up to AIDS within their own congregations and even among their own children.   Tens of thousands of Christian volunteers in many different nations are visiting the sick and bereaved in their own homes, with food and other essentials of life.

Millions of high school pupils are being reached each year by Christian workers who are encouraging healthy choices, including abstinence and faithfulness.

Hundreds of new support groups for those with AIDS are being formed every year.

And in all this ACET has had a part to play over the last 21 years, alongside hundreds of other AIDS agencies, development organisations, government departments and community groups.

Together we can make a huge difference:  the challenges are daunting, the opportunities are almost beyond measuring.

Lives are saved one by one.  People are cared for one by one.  As Stalin once said:  a single death is a tragedy, a million deaths merely a statistic.  With your help we can prevent more tragedies, and turn statistics into changed lives.