CONCLUSIONS

It seems unnecessary to recap the specific conclusions of this paper since these have been identified as the discussion proceeded. What is being asserted is that SHD, which is a weighted set of objectives which are social, economic and political, is unlikely to be achievable in many countries with high levels of HIV and AIDS. Even in the best of conditions to seek to eradicate poverty within a foreseeable future is improbable, in part because of the scale of the task and in part because the enabling conditions for its achievement are rarely present in many countries. Some of the objectives of SHD require collaborative action between countries with widely divergent interests and are unlikely to be attainable.

But the core proposition, based on the empirical evidence of the effects of the HIV epidemic on many countries in sub-Saharan Africa, is that the losses of human resources and the erosion of social capital will seriously impede the achievement of SHD. Indeed in countries with high levels of HIV prevalence it is impossible to see how it could be feasible to achieve SHD given the scale of the socio-economic consequences of the epidemic. On the other hand, in low HIV prevalence countries, many of which are in Asia and the Pacific region, this is precisely the time when efforts to achieve SHD need to be intensified. For the structural causes of the epidemic, such as poverty and gender inequity, together with structures of governance which are unrelated to what is needed for an appropriate response to the epidemic, are what SHD is intended to redress. Setting in process those activities essential to the achievement of SHD will simultaneously put in place those conditions which will slow HIV transmission, and also strengthen the capacity of social and economic systems to cope with the impact of the epidemic.