I. INTRODUCTION

In collaboration with the United Nations Population Fund (UNFPA) and the Global Programme on AIDS of the World Health Organization (WHO), the Development Policy Forum of the German Foundation for International Development (DSE) organized an international round table in Berlin from 28 September to 1 October 1993, to discuss implications of the AIDS epidemic on population policies and programmes. Representatives from governments, international agencies, nongovernmental organizations and research institutes examined impacts of HIV/AIDS on issues of social and economic development, population, and health care. They further considered how family planning, reproductive health programmes, education, and research could address the challenges of AIDS prevention and care. The round table is part of the preparatory process for the 1994 International Conference on Population and Development (ICPD) in Cairo, and the experts’ findings and recommendations (section II, below) will be used in the documentation for the conference and in the resulting Plan of Action.

According to the most recent WHO estimates, 14 million people are currently infected with the human immunodeficiency virus (HIV), which is the precursor to the almost invariably fatal disease known as acquired immunodeficiency syndrome (AIDS). This number is projected to rise to 30 to 40 million by the end of this decade. Sub-Saharan Africa is particularly hard hit, with 8 million people already affected. However, the infection is now spreading with alarming intensity in South and Southeast Asia.

There is growing awareness in the international community that HIV/AIDS is not only a critical health problem hut also a complex global development issue. While projected mortality will not significantly affect already rapid population growth, the loss of productive workers, burdens on health systems, growing numbers of orphans, and disruption of families will threaten social, economic, and political stability in many parts of the developing world. The health and welfare of the most disadvantaged people, particularly women and children, are especially jeopardized by HIV/AIDS.

Given the absence of any known cure and the uncertain prospects for developing one, the first line of attack in curbing the spread of HIV/AIDS is to change sexual behaviour and practices of millions of people - a daunting but not impossible challenge. This will require a high-level policy commitment by governments and international organizations, as well as a policy climate characterized by flexibility, frankness about sexual realities, and a nonstigmatizing approach to vulnerable and infected people. It also demands actions to empower women to have more control over their exposure to HIV/AIDS and other sexually transmitted diseases (STDs).

In terms of programmes, a multi-faceted approach is necessary, emphasizing education; integrated family planning and reproductive health programmes, with special attention to STDs; particular focus on women, adolescents, and high-risk populations, including sex workers; and targeted social science and biomedical research.