The author, Dr Scarlett Epstein, who takes up a post as an Honorary Professor at the Divine Word University, Madang, next year, will raise development issues of relevance to PNG readers and give examples of how these same problems are tackled in Britain, in particular, and other developing countries in general. Dr Epstein was recently awarded the Order of the British Empire for services to rural and women's development, especially in Papua New Guinea. HOW can the rapid rate of HIV/Aids spread be reduced - is the question to which billions of people belonging to different sections and strata of the world's population have over the past years been desperately seeking an answer.

Southern Africa was the first region to suffer an excessive HIV/AIDS transmission rate. Regrettably, numerous governments in the affected countries were rather slow in acknowledging the grave danger HIV/AIDS poses. In some cases this led to the loss of almost a whole generation of their citizens and resulted also in many thousands of HIV orphans.

According to the Asian Development Bank, Papua New Guinea now ranks among the first four countries in the Asia/Pacific region to be recognised as having a generalised HIV/AIDS epidemic. The PNG Health Department reported that between 1990 and 2003, HIV/AIDS cases in the country increased by an average of 37 a year. The National Capital District has a rating of 63% of confirmed national cases, or about 30,000 cases.

HIV/AIDS is still treated as a moral rather than a health issue, which can help to explain why the infection rate continues to increase.

For some reason that does not seem quite clear, HIV/AIDS is generally regarded as a blot on the moral standard of the victim, rather than as a disease that needs to be treated. Even until right now, to be diagnosed as HIV/AIDS positive usually marks you off as a 'criminal', or at least as 'immoral' rather than as a sick person who needs care. This means that individuals who suspect that they may have caught the disease are reluctant to admit their predicament even to themselves and are likely to continue spreading the disease. They seek help only when their health gravely deteriorates, by which time it is often too late for remedies to save their lives.
The stigma attached to HIV/AIDS also means that once a person has been diagnosed, he/she is treated like an outcast by her/his kin and friends and is ultimately left to die a lonely and miserable death.

Former South African president Nelson Mandela, motivated by the death from AIDS of his son, made recently a moving speech in which he appealed to society to accord the same compassion to HIV/AIDS victims as is usually offered to sufferers of other diseases.

It is high time that this is done. There are thus lessons the PNG Government and its peoples can and must learn from the African experience.

Declare war on HIV/AIDS

The PNG Government needs to consider HIV/AIDS as a deadly enemy, which it is, and put the whole country under a war alert. A HIV/AIDS War Cabinet needs to develop a strategy to ensure winning the war against HIV/AIDS by involving the total population of the country. If it fails to do so, it will threaten the security of present and future generations.

The director of the Monitoring and Research division of the Department of Health made it clear at a University of Papua New Guinea seminar that the economy of PNG would collapse if 10% of the workforce were to be infected by the deadly virus. To avoid such a disaster, it is important to bring home to PNG peoples the truth about the spread of the disease and the need for fundamental changes in sexual behaviour.

Up to now different agencies working in PNG have waged a gallant battle against HIV/AIDS by using different communication channels and methods to increase the public awareness of the dangers involved in practicing unprotected sex, yet the rate of HIV/AIDS spread continues to rise. A similar experience in Botswana, the country with the second-highest infection rate in the world, throws into relief the need for a more drastic communication strategy.

At the recent World Health Organisation (WHO) World AIDS Day workshop, Drs Edwin Mapara and David Morley related in their TALC (Teaching AID at Low Cost) presentation of their work in Botswana. "We began to have organised discussions with local people about HIV/AIDS. The response we heard was often: 'You talk about this terrible disease, which may affect us, but show us a patient'.

"This is how we came to use a set of slides from TALC . . . We emphasised the essential messages about AIDS prevention by using coloured pictures of black Africans. "These pictures included explicit images of ulcers on a penis and a vagina. "Showing these pictures to local people was hugely controversial . . . The government gave our teaching project very little support in the early days. The church, too, wanted nothing to do with our programme of 'loose morals' . . .

"Given the terrible impact that AIDS has had on the community, the same community members who once resisted our teaching project ask us now angrily why doctors were not sufficiently aggressive in using pictures in the early days of AIDS.

"One telling statement made in a workshop was: 'You doctors are to blame for what has happened to Africa, and particularly to our children. You should have done this 10 years ago before one quarter of the population became infected. The blood of our children who have died rests on your heads'."

I hope that this letter will encourage many responses suggesting different ways by which this PNG war on AIDS should be organised to ensure it will be won as quickly as possible.