EFA vs. HIV-AIDS
Gudmund Hernes
International Institute for Educational Planning
UNESCO, Paris
THE STATUS OF THE EPIDEMIC
• The epidemic is not leveling off, even in the
most affected countries
– More than 9 of the 10 of the 40 million now
affected live in developing countries
The epidemic is becoming truly global
• By December 2002 42 million people were living
with HIV/AIDS , up from 36.1 million in 2000
• All regions of the world are affected
• Most devastating in Africa, but Caribbean
strongly affected
• Increasingly taxes the economies and public
health systems of countries such as China,
Russia, Ethiopia and Nigeria – and Indonesia
can now be added to the list
• Though India’s national prevalence figure is less
than 1%, after South Africa it has the second
largest number living with HIV.
The impacts are spreading more widely
• WFP : HIV/AIDS decreases productivity, exacerbates
malnutrition and increases fatigue facilitating a more
rapid progression to AIDS
• These factors undermine a person’s ability to provide
enough food for themselves and his/her family
• Just as wars, HIV/AIDS can force families to sell off
productive assets, like cattle and crops, can force
them to spend their savings on food and medicine,
and to withdraw children from schools to care for sick
adults
• Lack of food increase likelihood for high-risk behavior
to survive, such as trading unprotected sex for food.
Some of the most affected countries are
approaching a state of social breakdown
• Life expectancy falling: Sub-Saharan Africa now 47 years –
without AIDS 62 years
• Exceptional impact on the economy
– Loss of productivity by loss of the most productive
– Increasing burden of caring for sick and tending for orphans
• AIDS is wiping out decades of investment in education and
human development
• Sub-Saharan Africa: growth may be reduced by a quarter
over the next 20 years
• Not even rich countries could afford treatments on a scale
needed in those countries
• Replacement of professionals increasingly difficult – eroding
access to educating: the capacity to cope may be
overwhelmed and the social may fabric unravel.
Children are at risk on an unparalleled scale
• Millions already infected – in some countries
more than a third of 15-year olds will die of
AIDS related illnesses in coming years.
• Millions more becoming orphans – more than
30 millions in 10 years
• Many will grow up deprived, desocialized and
disconnected
• Classes will be dropped and schools will
close many and will get a poorer education
The epidemic is becoming feminized
• 2002: The first year when the number of
women infected equaled the number of
men
• In Sub-Saharan Africa, fully 58%
infected are now women – often at a
tender age.
What can be done?
• There is no cure
• A vaccine is not in sight
• Treatments are too costly in the
countries most affected
- only 30,000 on ARV treatment of 30 million
in Africa – 1 treated out of 1000 infected
IGNORANCE IS A MAJOR REASON WHY
THE EPIDEMIC IS OUT OF CONTROL
The need for preventive education flows from the
types of ignorance associated with the epidemic
• Most of the infected do not know it
• The sparse knowledge in developing countries
about the nature of the disease
• Misconceptions about the disease lead to
counterproductive behavior
• Faulty knowledge results in prejudice and
discrimination
KNOWLEDGE IS NOT ENOUGH
Millions know about the virus and the risks – yet do
not adopt safer practices
• Prevention must address mentalities…
• ...and the culture within which they are
embedded – otherwise new knowledge is
undercut by established belief systems
• Changes in conceptions and attitudes require
targeted messages and effective communication
PREVENTIVE EDUCATION - THE BEST
AND CHEAPEST STRATEGY
Lessons from Uganda, Senegal, Thailand, Brazil
• If done right it works
• If done immediately it has long term impacts
• If done massively, it can turn the tide
Preventive education must
• Generate attitudes, provide skills and sustain motivation
to reduce risk and vulnerability
• Focus not just on attitudinal but also organizational
change
• Start before the epidemic is out of control.
Kofi Annan: ”All cultures will be pushed to put
cultural mores aside to save lives”
Why education works
• Incomparable reach – even where low enrolments
and high drop-out rates, schools reach children,
families and communities like no other institution –
even the young most at risk
• Education prerequisite for knowledge (literacy)
• Education fundamentally enters every
communication on prevention
• Intrinsic to every program on prevention and care
• Necessary for reducing stigma and discrimination
Education protects – the more ED the less HIV
BUT: Prevention programs are slow in
stemming the epidemic
• Behavior change are hard to achieve
• And are slow to take effect
WHY?
• Still too much focus on school health
programs
• Projects often separate, uncoordinated and of
short duration
• Not explicit about implications for personal
living
• Not yet supported by necessary resources
and materials
• Mostly directed towards young – not enough
towards functioning of the education system
WHY 2: The rationalistic bias
• Curriculum driven by model of man as
calculator of risks and volitional actor
• Often overlooked the affective , the
emotional and irrational
• Not capitalized on social embedding of
individuals
• Seldom drawn in local cultures, values,
meanings and identity
The double task
• Maximize impacts of education on
epidemic
• Minimize impacts of the epidemic’s on
education
What is to be done
• Anticipate what will happen
• Forestall undesirable situations
• Manage the circumstances that arise
– Enable education to pursue its essential
goals: learners learn and teachers teach in
an environment that supports learning
– Use the sector to slow the spread
– Provide care and support to the affected
and infected
Change the perspective
• From dejected and depressed about what
undercuts education to seeing opportunity in
crisis
• HIV/AIDS forces us to do what w have long
said we will do but have postponed
• More costly the longer we wait
• Said “EFA!” – cannot stop epidemic without it!
• Said advance human rights – cannot stop the
epidemic without stopping stigma and
discrimination
• We must address the many benefits that can
flow from our common calamity!