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Allow me to begin my address by thanking the authorities of the University of the West Indies for inviting me, as part of the University’s special response initiative to HIV/AIDS in the Caribbean Region,
to share with you from my African experience. I am humbled and honoured that they have asked me to do so. But equally I am encouraged and heartened at the imaginative steps the University is taking to cope with this crisis. In the words of the united voice of Africa, enunciated in Addis Ababa in
December 2000, “Success in overcoming the HIV/AIDS pandemic demands an exceptional personal, moral, political and social commitment on the part of every (person). Leadership in the family, the community, the workplace, schools, civil society, government and at an international level is needed to
halt the preventable spread of HIV/AIDS”.

The activities so far initiated in the University are incontrovertible proof of the existence of this exceptional personal commitment. They are also proof that the university leadership is ready to confront the AIDS
epidemic through a more strategic, coordinated, programmatic response that will incorporate current individual initiatives into a broad institutional effort. I applaud the University for what it has accomplished so far and I congratulate the Vice-Chancellor on its significant achievements. In
addition, I join with his many well-wishers in acclaiming Professor Nettleford on his being honoured as the Gleaner Man of the Year for 2001. Not only is the University on the right track. It is manifestly in the hands of the right man.

In such auspicious
circumstances we can feel certain that the University will be a significant actor in responding to the threat that HIV/AIDS poses to human development in the Caribbean Region. The key role that the University has begun to play within the Caribbean Community framework, focusing on long-term
AIDS-related capacity building and curriculum development and addressing the needs of all the language groups in the Region, gives assurance of this. The Region is indeed fortunate in being able to look with confidence to the University of the West Indies to provide each and every one of the
acts of leadership necessary to prevent HIV/AIDS and to help those living with HIV/AIDS live a more decent human life.

HIV/AIDS: The Global Situation

When the people of Hiroshima in Japan woke up on
the morning of 6th August 1945, they did not know that they faced a day of catastrophic doom. It was on that day that the world’s first atomic bomb devastated their city, taking an estimated 150,000 lives.

When personnel from New York and the surrounding
areas arrived at the World Trade Centre on the morning of 11th September 2001, they did not know that they too faced a day of catastrophic doom. It was on that day that terrorist attacks destroyed the Twin Towers, taking an estimated 5,000 lives.

When the
people of the world awake each day, are they aware that because of HIV/AIDS they face an even more calamitous situation than either of these, a situation which sees almost 9,000 people dying every day—five to six every minute—from a disease that was almost unknown two decades ago?

This is the reality we face, a reality considerably worse than the worst-case scenarios of earlier years. Ten or twelve years ago it was projected that by 2000 there might be 15 to 20 million persons living with HIV/AIDS. Today we know that there are in fact 40
million, in addition to some 25 million who have died over the years from AIDS-related causes. Although there is more hope now than there was even five years ago, UNAIDS, the Joint United Nations Programme on HIV/AIDS, has warned that barring a miracle most of those who are currently infected
will die over the next decade or so. UNAIDS has also advised that “unless action against the epidemic is scaled up drastically, the damage already done will seem minor compared with what lies ahead”.

With each passing year we see an increase in the total
number of persons living with HIV/AIDS. The increase would be even greater were it not that the number is being depleted by AIDS deaths which currently occur at the rate of 3 million each year. At the end of 2001, it was estimated that 1.2% of the world’s adult population, those aged 15 to 49,
were living with the disease, up from 1.1% at the end of 2000. In the Caribbean region, the prevalence rate was also up, from 2.1% at the end of 2000 to 2.2% at the end of 2001, with the total number of infected persons increasing from 390,000 in 2000 to 420,000 in 2001.

But hope has also accompanied these long years of HIV/AIDS. There is the hope generated by the success of some countries, notably Uganda, Thailand, Senegal, and more recently but to a more limited extent, Zambia, in controlling and reducing the spread of the disease.
There is the success of the antiretroviral drugs that suppress the activity of HIV in the body for as long as they are being taken. There is the substantial reduction in the risk of mother-to-child transmission through the timely use of effective and relatively inexpensive drugs. There are the
efforts being directed towards the development of a vaccine. There is the evidence that through their leaders and organisations communities are assuming greater responsibility for prevention and care. There is the new determination shown by the United Nations and the world’s political leaders to
attack the epidemic with full force.

But these developments, which give rise to hope, are being accompanied by other, more ominous rumblings. The exponential rise of new HIV cases in Eastern Europe and Central Asia, the region which is currently seeing the
world’s fastest rate of HIV increase, is a cause for great alarm. There are dire predictions that HIV expansion in the world’s most populous countries, China and India, could grow out of all control in the coming decade. The very availability of antiretroviral drugs in the United States appears
to have triggered a sense of complacency that has resulted in an increase in HIV incidence. And most worrisome of all, recent studies suggest the emergence of strains of the HIV virus which are resistant to some of the antiretroviral drugs currently in use. One almost feels that blocking off one
channel used by HIV/AIDS to perform its devastating work is the signal for opening new and potentially more destructive avenues of death.

HIV/AIDS and Development

size=”2″>HIV/AIDS poses a major threat to human welfare and
development progress. Its most immediate impacts are experienced at the individual and household levels where the effects have many facets: prolonged and repeated illness, physical and psychological pain and suffering, health care and costs, income loss, reduced household productivity, death,
funeral costs, mourning and grief, increased poverty, increased vulnerability of women, growth in the number of orphans, the social dislocation of those who survive, and in some cases the ultimate disappearance of households and whole communities.

These very
personal experiences adversely affect household, industrial, commercial and national economies. All experience similar economic problems: a reduction in the labour supply, because of the way the disease brings sickness and death to young adults in their most productive years, and increased
outlays due to the direct costs of AIDS-related expenditures and the indirect costs of lost labour time, training expenses, and orphan care.

In countries where the disease has established a firm hold it is exerting a crippling effect on current activities and
future development prospects. Although the epidemic is more than a health problem, it has significant adverse impacts on the health sector, necessitating the diversion of considerable resources and expertise to dealing with an increasing number of AIDS-related illnesses, and giving rise to a
reduction in the number of health-care personnel due to AIDS-related illness and mortality. Through its toll on the agricultural labour force and in other ways, HIV/AIDS affects agricultural production and food security, first at household level and then by spillover effects at national level:
remote fields tend to be left fallow; there is a switch from labour-intensive crops to less demanding ones; there is less variety in crops being grown; animal husbandry and livestock production show decline; food storage and processing are impaired; and staff illness and mortality lead to a
breakdown in support services.

In many respects, these adverse social impacts are being surpassed by the enormous challenge of massive increases in the number of orphans. In some countries, it can be said that every household is caring either directly or
indirectly for an AIDS orphan. In others, one-third or more of children below the age of 15 have lost a parent to AIDS, and the proportion may rise higher. As with AIDS itself, nothing of such all-encompassing magnitude has ever before been experienced by humanity. No well-developed paradigms
exist for coping with it. There is no real understanding of how best to support millions of children who have no caregivers in their households or how to enable communities respond to the care, nutrition, health, education and other needs of children who have lost one or both parents to AIDS.
Questions are asked about how orphans in rural areas can learn to be productive when there is nobody to pass on to them the relevant knowledge and skills. Questions are also raised about how today’s orphans will become tomorrow’s parents when they will never have known the formative years of a
normal childhood, being parented in a normal family with father, mother, brothers and sisters. In severely affected countries, concerns are expressed that the increase in the number of orphaned juveniles as a proportion of the general population will lead to a sustained increase in crime levels.

In a recent address, the Vice-President of Malawi underlined that the orphans crisis is an integral part of the security risk that HIV/AIDS poses to global security. The destabilizing potential of the disease, especially in light of the way it is expanding in very
populous countries that possess nuclear capability, should not be underestimated. In response to the potential threat that HIV/AIDS poses to global security, the United Nations Security Council made a significant departure in January 2001 by debating the issue, the first time the Security
Council had ever discussed a health or development matter.

Why the Education System Must Respond to HIV/AIDS

It is against this sombre background that we ask why the education system must respond to
the situation being created by the HIV/AIDS epidemic. Essentially there are three reasons.

First, the epidemic places every system and institution under profound threat. An education system that does not come forward with an appropriate response
runs the risk of being overwhelmed by the epidemic and the variety of its impacts. When a person is infected with HIV, the immune system slowly but inexorably breaks down, leaving the individual vulnerable to the hazards of several opportunistic illnesses. HIV does something similar to
institutions and systems. In the absence of an appropriate response, they are likely to experience various problems that can develop to the stage where they are no longer capable of functioning in the way they ought. Our first task will be to gain insight into some of these problems so that
recognizing them we may be able to plan for dealing with them.

The second reason why an education system must respond to HIV/AIDS is that in the present state of human knowledge every prevention effort, the majority of coping strategies, much of the
activity directed towards the mitigation of impacts, and virtually every programme designed to outwit and get ahead of the disease, depends on education
. HIV/AIDS is relatively new to the world and hence there is need for extensive learning about it and its management—and learning is the
core business of education. Messages relating to the prevention of HIV transmission are educational messages. Messages on the need for public and private systems, organizations and institutions to adjust to the impacts of the disease are educational messages, which must likewise be followed
through by further messages on how to make such adjustments. Every legitimate response to the disease has a basis in education. Hence it is of paramount importance that the education system itself respond in a visionary and dynamic way to the disease—partly in order to equip individuals to cope
with it, but of even greater moment, in order to equip them to outwit and get ahead of HIV and AIDS.

There is a third reason why an education system should respond to HIV/AIDS. Both have a particular interest in the young. It is mostly the young
who are in schools, colleges and universities, acquiring the values, attitudes, knowledge and skills that will serve them subsequently in adult life. But if education is largely the sphere of the young, so also is HIV/AIDS. About one-third of those currently living with HIV/AIDS are aged 15–24,
while more than half of all new infections (over 7,000 each day) are occurring among young people. In addition, since the epidemic began, more than 13 million children below the age of 15 have lost their mother or both parents to the epidemic and this figure is forecast to more than double by
2010.

Very clearly, young people are at the centre of the HIV/AIDS epidemic, just as they are at the centre of an educational system. This common sphere of interest makes it imperative that the education system grapple with the epidemic so as to equip young
people with the values, attitudes, skills and knowledge they need to prevent HIV transmission, to cope with the consequences of the disease, and to strengthen one another and humanity in the creation of an AIDS-free world. We simply must save the young, and it is largely through education that
we can do this.

What HIV/AIDS Can do to Education

When considering the impact of HIV/AIDS on education, we can think of it as affecting the system in a number of different ways. The disease

  • reduces the demand for education
  • affects the pool of those who should be attending school
  • reduces the ability to provide or supply educational services
  • affects the availability of resources for education
  • affects the way schools can go about their business
  • affects the content of what is taught at all educational levels
  • affects the way schools and much of the education system are organized
  • affects the planning and management of the education system

  • 1. HIV/AIDS reduces the demand for education. One reason for this is that the epidemic results in the population of school-going age being smaller than it would otherwise have been. This is because AIDS brings increases in
    child mortality, a reduction in births owing to the premature death of women in their child-bearing years, and a lower fertility rate. Hence there will be fewer children seeking admission to schools and ultimately fewer young people seeking admission to colleges and universities. The number of
    children who will want to enter or stay in school also declines because those in AIDS-affected families must engage in economic activities to support themselves, or they must attend to the needs of sick parents and relatives, or there is fatalistic disillusion with school, with older people
    asking why bother sending children to school when they will die young from AIDS and will not live long enough to reap the benefits of their education.

    This decline in demand at the very base of the system will, of course, work its way progressively through
    the system as each cohort grows older. The result will be a smaller pool of applicants seeking admission to higher level education programmes and ultimately a less well educated population, something that no country can afford.

    2. HIV/AIDS affects the pool
    of those who should be attending school.
    This is because, with the peak age-range for AIDS deaths being 20 to 35 for women and 30 to 45 for men, parents are dying before they have had time to finish their work of rearing their children. The result is a very
    rapid growth in the number of orphans and the consequent massive strain this places on the extended family and the public social and welfare services. The evidence from a number of countries bears out that when orphans have been incorporated into a household where resources are scarce, they come
    last in the pecking order: they receive less food, less is spent on their personal needs, and there is less chance that they will be sent to school or that school fees will be paid on their behalf.

    A particularly tragic result from the way HIV/AIDS is
    decimating families is the phenomenon of the child-headed household. These are households where all adult members have died and the children must fend for themselves, frequently under the guidance of the oldest among them who may be a boy or girl aged 14 or less. The education needs and
    schooling possibilities of these children, and those in their care, differ very substantially from the needs of those from households headed in the usual way by an adult. The relevance of conventional forms of schooling can also be questioned in regard to the many children who seek their
    livelihoods on the streets of towns and cities, and the even larger numbers of rural children for whom HIV/AIDS has converted formal education into an almost meaningless ritual.

    3. HIV/AIDS reduces the ability to provide or supply educational services.
    The supply of teaching and other educational services is reduced because of the impact on human resources. Trained teachers and lecturers are either dying in large numbers or are leaving teaching to take up more lucrative positions that have become available because of AIDS deaths in other
    sectors. Teachers whose HIV infection has not developed into full-blown AIDS are not able to work at their full potential—it is estimated that repeated bouts of sickness will lead to such teachers losing about six months of teaching time during the years of infection, prior to the period of
    terminal illness. During this latter period, which usually lasts for about nine months prior to death, they will, of course, be completely incapable of teaching. In addition, the education system finds its ability to provide various services disrupted because of the loss, through mortality or
    sickness, of education officers, inspectors, finance officers, building officers, planning officers, management personnel, curriculum and examination specialists, and teacher educators.

    4. HIV/AIDS affects the availability of resources for education.
    This is because there are fewer private resources, owing to the numerous negative effects AIDS has on household economies. In particular family incomes decline because of the reduced productivity of those in self-employment or the loss of household income when the breadwinner succumbs to the
    disease. Moreover, family resources that might have been used for educational purposes must now be diverted to the care and medical treatment of infected household members. Public funds for the sector are also less than they would otherwise be, owing to the AIDS-related decline in national
    income and the need to allocate more to health and AIDS-related interventions. Moreover, some of the funds allocated to the education sector do not bring due benefits because they are committed to paying salaries for sick but inactive teachers. Further, the ability of the community to contribute
    in cash or kind for school developments is growing smaller because of the way AIDS weakens communities and increases claims on the time and work capacity of those who survive.

    5. HIV/AIDS affects the way schools can go about their business.
    This is largely because of the presence in the school community of HIV-infected individuals or of individuals with infection in their immediate families. This is the place to pause and reflect on the chilling fact that HIV is no respecter of age and that school, college and university enrolment
    may well include several young people with HIV/AIDS. Internationally, relatively few AIDS cases manifest themselves among those aged 5 to 14, but there is a very sharp rise in AIDS incidence among young people aged 15–19, especially among girls. Since it takes five or more years for HIV to
    develop into full-blown AIDS, it seems clear that these young people must have become infected when they were still attending primary or lower secondary school. Also, the fact that the peak age for AIDS among girls begins at age 20 suggests that many become infected while they were still of
    school-going age. Recently, the Jamaican Minister of Health underlined the scale of this problem when he reported that the number of HIV/AIDS cases among adolescents has been doubling each year, and that 17 girls in the 10 to 14 age group tested positive for HIV in April 2001.

    Because of the low occurrence of AIDS among those aged 5–14 many regard these children as a “window of hope” who constitute the genesis of a future HIV-free society. But there is growing realization that such children also constitute a “window of concern” and that the
    school—even primary school—may constitute a high-risk situation that facilitates HIV transmission. Mutatis mutandis, colleges and university campuses may also constitute high-risk situations where the transmission of HIV can all too readily occur.


    Almost two decades ago, Jonathan Mann, the late former director of the WHO’s Global Programme on AIDS, spoke about “the epidemic of stigma, discrimination, blame and collective self-denial”. Fear, anger, stigma, ostracism, and discrimination, directed towards those infected with HIV or coming
    from AIDS-affected families, also affect the way a school or educational institution goes about its business. The sickness of HIV or AIDS may affect only a few. The sickness of discrimination and negativity is unfortunately much more widespread and is something that every educational institution
    must seek to cure.

    6. HIV/AIDS affects the content of what is taught at all educational levels. Speaking at an International HIV/AIDS Conference held in Burkina Faso in December 2001, Peter Piot, the Executive
    Director of UNAIDS, asked: “Can we imagine a response to AIDS without schools changing what they teach?”

    This challenge extends far beyond the simple curriculum introduction or development of reproductive health and sexual education. The epidemic imposes a
    variety of demands for changes in what schools and other institutions teach and communicate:

  • every educational institution should seek to influence its students to adopt appropriate life-protecting value systems, those learned concepts of the desirable which motivate individuals and which serve as criteria against which they appraise and evaluate
    actions;
  • curriculum content needs to be targeted specifically at HIV/AIDS prevention in order to help equip learners and teachers with the attitudes, knowledge and skills to avoid infection;
  • facility in exercising psycho-social life-skills, important at all times, needs to be enhanced in order to equip learners for positive social behaviour, strengthen their ability to withstand negative social pressures, and enable them to base their practice
    of interpersonal relationships on a more comprehensive understanding of themselves and others;
  • earlier inclusion in the school curriculum of work-related training and skills is necessary, so as to prepare those compelled to leave school early (because of orphanhood or for other reasons) to care for themselves, their siblings, or their families;
  • HIV/AIDS needs to be mainstreamed within the professional dimensions of college and university programmes with a view to producing AIDS-competent graduates who are equipped to deal with the epidemic in their professional areas;
  • teaching methodologies require adjustment so that they can promote greater flexibility on the part of all learners, with greater emphasis on independent and self-initiated learning, in order that in their subsequent life they may be better equipped to take
    over roles and responsibilities from those whom HIV/AIDS is removing from the work-force;
  • colleges and universities need to introduce or expand programmes and courses to respond to new needs arising from an AIDS-affected society.

  • 7. HIV/AIDS affects the way schools and much of the education system are organized. This is because the disease is creating the need for a flexible timetable or calendar that will be more responsive to the income-generating
    activities that many students must undertake. The role of children in attending to sick members in their families, and the hazards that young girls may experience if they have to walk long distances to school, also point to the need to provide for schools that are closer to children’s homes. The
    inability of many orphans, street children, and children from infected families to attend school in the normal way suggests the need for a revolutionary form of educational provision whereby, instead of requiring children to come in to some central educational complex called “school”, schooling
    goes out to them. Recent advances in information and communication technology appear to be bringing such a revolution within reach.

    The absolute imperative of helping young children remain free from HIV infection necessitates the careful examination of a wide
    range of assumptions about schooling. At what age should children commence? What can be done to prevent age-mixing in class? Do boarding schools provide any answer or do they create greater HIV/AIDS problems? Should special, closely supervised boarding provision be made for girls? Is it prudent
    to bring together large numbers of young people in relatively high-risk circumstances? The importance of these and similar questions is now being faced by some education ministries which are grappling with the problem of how to protect the young while providing universal access.


    8. Finally, HIV/AIDS affects the planning and management of the education system.
    Negatively, the disease affects the ability of systems to plan because of the loss through mortality and sickness of various education officials
    charged with responsibility for planning, implementing, and managing policies, programmes and projects. Positively, systems find themselves obliged to attend to a variety of AIDS-related planning activities, such as:

    • ensuring the provision of HIV prevention programmes directed to students, educators and support staff;
    • providing for personnel losses so that schools continue to function, with teachers teaching and students learning;
    • developing schools into institutions that are safe, adequately resourced, multi-purpose centres of hope, learning and service in their communities;
    • establishing care and support programmes that will deal sensitively with the personnel and human rights aspects of AIDS-affected employees and their dependants;
    • forging partnerships with communities, faith groups and others that are based on mutual respect and shared commitment to a healthy AIDS-free future;
    • expanding the potential of an education ministry to play a leading role in the national response to HIV/AIDS.
    What personal data we collect and why we collect it
    Preventing HIV Transmission through Education

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