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The story of interfaith response to HIV/AIDS is one that moved from initial doubt, denial and moral hesitation -- even direct denunciation -- to one of global reach and scale. This is a story that demonstrates both the power and challenges that come from specific beliefs, morals, and theology. It also points to greater possibilities for bridging divides in faith and culture through the power of common action on so great an issue of shared concern.
About three-quarters of the entire world's population declares to belong to a faith community, so it should be no surprise that churches became deeply involved in responding to the HIV/AIDS crisis. What is surprising is that this engagement has become so extensive. The World Health Organization estimates that between 30 and 70 per cent of all healthcare provided in parts of Africa comes from faith-based organizations and, in many instances, the clinics and hospitals run by church organizations are the only ones available.¹ Detailed data remains in urgent need of better collection,² as the African Religious Health Assets Programme study of Zambia and Lesotho illustrates.³ It established that 30 and 40 per cent, respectively, of all national health care in these two countries alone was provided through churches. In addition to playing a key role in the provision of care for people living with HIV/AIDS, churches have also been vital in providing prevention initiatives and education, as well as pastoral counselling. Yet, perhaps even more important for the long term has been their role in caring for orphans. With an estimated 20 million children orphaned by AIDS worldwide, the provision of care for them by the church has been another area of engagement that is of particular importance in Africa.⁴
The latest goal of "getting to zero"⁵ for those engaged in preventing the spread of HIV/AIDS is amazing in itself, since only a few years ago such a goal would have seemed far beyond the bounds of reasonable expectation. Current drug treatments can stop the virus from damaging the immune system. Since 1996, the use of antiretroviral therapy for HIV, in combinations of three or more drugs, has not only dramatically improved the quality of life for people living with HIV, but in countries where the treatment is widely accessible, it has prevented them from dying early. However, these drugs do not eliminate HIV from the body, which means that if it is to remain effective, the medication needs to be taken continuously. This, in turn, poses major challenges in terms of ensuring and sustaining adequate provision, meeting costs, as well as ensuring equity in distribution.⁶
Further good news is that the prevalence of HIV among young people has recently declined by more than 25 per cent in fifteen of the twenty-one most affected countries, and the total number of deaths each year caused by AIDS continues to fall. This is encouraging, even though the total number of related deaths in the region was two million in 2009. Meanwhile, it is estimated that, worldwide, as many as one in two hundred people are infected, whereas in some cities in Africa, as many as one in three people between the ages of fifteen and sixty-five may be infected. Even though this crisis may no longer make daily headline news, it remains a crisis nonetheless.
AIDS is, to a significant degree, a preventable disease if people were to modify their behaviour. However, this point is manifestly not a simple one as, for example, in the rather different case of smoking, where an evermore normative governmental and public attitude has come to be expected, and is widely approved. It is, indeed, the specificity of moral precepts and attitudes towards certain behaviours that have constituted one of the areas of concern, insofar as church communities have been felt, at times, to carry over judgments about certain conduct into negative attitudes towards those living with HIV/AIDS.⁷ Campaigns in regard to abstinence and the use of condoms have also proven to be controversial. Many church leaders have gone to great lengths to address these points and, when Christian theology is explored in its fullness, it can be seen to warrant a positive message which merits better understanding and articulation. While certain perspectives may seem very specific to the Christian world view, there is every reason to see the positive content as having a much wider application.
Discrimination or violence against any person because they have HIV or AIDS is consequently and intrinsically not only wrong, but unjust. The value and dignity of the human person has important consequences, as it brings with it an obligation. This is the duty to live out and to express this dignity in action that reflects our personal responsibility as moral agents to help others and also to live our lives responsibly. Thus, obligation exists, both for us individually and for the wider society in which we live, while, at the same time, caring for others and their welfare. Churches have a particular responsibility to lead and offer an example of the fulfilment of this duty.
Beyond this, there are two specific Christian perspectives to add. The first is the Christian belief that God, as gracious and supremely loving, in the suffering and death of Christ, ultimately brought the resurrection joy of Easter to the world. This may seem narrowly Christian at one level, yet at another, it partakes of universality by affirming a common human aspiration in the message of hope. This narrative ultimately points to the possibility of a world that can be transformed, redeemed, and made whole. Moreover, in recent years, despite the many tensions between religious traditions, there have been initiatives such as the open letter "A Common Word between Us and You,"⁸ addressed by leaders of the Muslim faith to leaders of the Christian faith. The letter sought to build a bridge upon the common bond of our obligation to not only love God or the Good, but also our neighbour.
In discussing the role of faith-based organizations delivering care to people with HIV/AIDS, it has become apparent that this is an area where there is already multi-faith cooperation. The understanding that we have a common theological basis for doing so, by virtue of the shared obligation to love our neighbour, is surely a bond that can promote greater harmony and better relations across past divides. It is important to also note that in order for this response to be authentic, it should be truly rooted in the specific riches and particularities of faith, as well as the common call to love the neighbour. In the midst of the many tragedies of HIV/AIDS, it would be a great blessing for us all to grasp that our neighbour is most truly found wherever there is a fellow human being and child of God in need, whom we are called upon to help.
Notes 1 UNAIDS data: 2 The Mapping Religious Health Assets project, jointly promoted by CIFA and WHO, aims to address this key knowledge deficit and to derive hard data on the actual scale of the work being undertaken which everyone realizes is large, but unmeasured: . For a somewhat polemic take on the lack of awareness of just how much is done, see Ann Widdecombe "If only the Catholic Church did PR", The Guardian, 7 September 2010: . 3 "Appreciating Assets: The Contribution of Religion to Universal Access in Africa," World Health Organization (Capetown: ARHAP, October 2006), . 4 A number of sources are available on a church-by-church basis, with the following being illustrative of the work in Kenya. In relation to the Evangelical Lutheran Church see: and Bill Black, "HIV/AIDS and the Church: Kenyan Religious Leaders Become Partners in Prevention," FHI, (2011). , and also Catherine N. Machyo, "The Catholic Church and the HIV/AIDS Pandemic in Kenya: An Exploration of Issues," . 5 Getting to zero: 2011-2015 Strategy, Joint United Nations Programme on HIV/AIDS (UNAIDS), 2010. 6 For a discussion of best practice and optimal medication options, see for example the report Promising and best practices in STI/HIV/AIDS prevention and care in West and Central Africa (AWARE-HIV/AIDS, 2006), . 7 Another area of potential tension has been the use of condoms for example, though there are signs of a helpful convergence on such matters as an emphasis on abstinence, e.g. Paul Jeffrey, "Expert: UN study backs Church strategy on Aids," Catholic Herald, 21 July 2010, . 8 For further details see the official website: .