Most countries have been slow to address the growing epidemic of HIV/AIDS, although the response is improving. This is for a number of reasons:
- Despite the steep increase in recent years, HIV/AIDS prevalence rates remain very low, below 1 percent of the adult population.
- The view of HIV/AIDS as an epidemic that is spreading fast among normal youths who experiment with drugs and sex is very limited. The epidemic is driven primarily by the high-risk core group of injecting drug users (IDUs), hence there is a perception that HIV/AIDS is a problem of "social deviants". As such, it has been politically difficult to mobilize effective programs on a large scale for a problem that is perceived to be confined to a group with limited political clout.
Most prevention programs in ECA are small pilots. Thus, even when the contents of such programs are well conceived and based on reasonable evidence of what works in early-stage epidemics, the scale is too small to have much impact countrywide. The result is that a spread from high-risk core transmitters through bridge populations to the general population would be due not to the failure of such methods of prevention, but primarily a result of inaction and failure to do what works.
There is cause for optimism, however. A number of countries have prepared national strategic plans. They are committing more domestic resources and securing external grants and credits to fund their national programs.
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