What can be done?  The AIDS epidemic poses an unprecedented challenge to policymakers – a challenge that must be met on two fronts.  First in keeping with the strategy long urged WHO, the emphasis should be on prevent especially in areas where the epidemic is in its earliest stages (as in Asia).  Short of a vaccine is an unlikely development before the year 2000, this means changing sexual behavior.  But as many prevention campaigns have demonstrated, improved knowledge does not necessarily lead to reformed behavior.  The use of condoms and the treatment of other sexually transmitted diseases can also help – Thailand for example, has a well-established and highly visible program to deliver contraceptives, especially condoms, which could be tailored quickly to promote safe sex.  Blood screening, use of protective medical garments (gloves) and clean syringes add to the effort.

 But even if all new transmissions were stopped tomorrow, there would still be a staggering number of AIDS cases, especially in Africa, with potentially profound implications for human resource development and economic growth.  Thus, policymakers must also concentrate on designing measures to mitigate the consequences of the epidemic, which will involve taking stock of the potential magnitude of the epidemic as it affects various economic sectors.  Since AIDS is no longer solely a health issue, ministries across the board should be involved in both planning interventions to mitigate the consequences (e.g.: school fees for orphans and labor-saving technologies) and disseminating prevention messages (e.g. through teachers, agricultural extension agents, political organizations, social groups, and religious bodies).  Local communities and nongovernmental organizations (NGOs) must also be enlisted – indeed, many instances, they have already been instrumental in responding to the needs of patient care and providing for orphans.

 What started out as a disease of concern of national health ministries and international health organizations has now become a problem with many dimensions.  It is imperative that countries where the epidemic has already made inroads, that governments openly acknowledge about the seriousness of the problem and take urgent action to stem the further spread of the virus.  Even where the incidence of HIV infection is low – but where there are facts are known to facilitate its transmission – early prevention measures, such as informational campaigns, should also be promoted.  The challenge for the donor community is identify areas of comparative expertise and move forward quickly in a coordinated approach.  Failure to do so will only exacerbate what is emerging as a major challenge to economic and social progress in developing countries and, above all, a human tragedy of mass proportions.