HIV/AIDS has emerged as one of the foremost challenges for poverty alleviation and development. While sub-Saharan Africa is home to nearly 30 million of the world’s 42 million people living with HIV/AIDS, it is not only an African epidemic. The Caribbean region has the second highest prevalence and Eastern and Central Europe are showing the fastest increase. Absolute numbers per country are now largest in S. Asia and growing in E. Asia. At the same time, urbanization has been occurring at an unprecedented rate, with more than half of the world’s population expected to be living in urban areas by 2008.
Urbanization, when well-managed, can present an opportunity for development, facilitating sustainable economic growth and promoting broad social welfare gains.
Unfortunately, however, cities and towns are often the driving force behind the spread of disease as well as economic and social growth. This is due to high population density, the presence of transportation hubs and the existence of large groups of vulnerable persons (e.g. sex workers, unemployed youth, migrant labor, drug users). While affecting countless individual lives and livelihoods, HIV/AIDS also has the potential to undermine local governance in all its aspects. Through its profound impact on health and human resources, HIV/AIDS can undermine the capacity of local governments to carry out their core
functions of local service delivery (particularly to the poor) and local economic development.
As more people are infected with HIV/AIDS, a town or city will see decreases in labor productivity,increased demand for services, lower capacity of users to pay for services, greater household vulnerability and increased numbers of absolute poor (e.g. orphans, people living with HIV/AIDS). The climate for private investment will deteriorate and local government itself will suffer the absenteeism and
productivity losses that result from increasing prevalence.
Many countries are now making progress in developing and implementing National AIDS Programs. In most cases, however, local governments have not received sufficient support in dealing with the epidemic,even though they are closest to affected communities and their own capacity to deliver services is undermined by HIV/AIDS. In supporting local government responses to HIV/AIDS, this Handbook is intended as an input to strengthen local, sustainable and accountable responses to HIV/AIDS so as to ensure that local
governments can continue to address the key issues of poverty alleviation and local economic development.
Local governments cannot continue with ‘business as usual’ in the face of the AIDS epidemic. They need to be proactive and preemptive in order to avoid disruption of their core activities now or in the future. Local
governments are much needed partners in the fight against HIV/AIDS. We hope that Local Government Responses to HIV/AIDS: A Handbook will inspire and assist local governments to take action.
