By Anna Pulley
By Erin Sherbert
By Chris Roberts
By Erin Sherbert
By Rachel Swan
By Joe Eskenazi
By Erin Sherbert
By Erin Sherbert
Another reason for the increased spread of the disease in Nepal is the escalating civil war with Maoist rebels. The Maoists began the People's War in 1996, and the government has been unsuccessful in quelling the increasingly powerful insurgents.
The Maoists now control most of the western districts of Nepal, where infection rates are on the rise as the conflict continues to force more than half of the male population to migrate to India in search of work. As many as 10 percent of men who work in India are likely to return to Nepal with HIV.
In 2003 the National AIDS Council was created in Nepal and chaired by then-Prime Minister Sher Bahadur Deuba. But on Feb. 1, 2005, Nepal's King Gyanendra disbanded the nation's parliamentary system and declared a state of emergency due to the Maoist insurgency that has killed nearly 13,000 people so far. Deuba and other government officials were unconstitutionally jailed by the king for much of the last year.
Sadly, Gyanendra's near-dictatorial rule and ill-conceived state of emergency have only fueled the insurgency. The king's penchant for censoring media and cutting off all communication going in and out of Nepal has only further isolated his people. Needless to say, the country's nascent AIDS agenda has also been put on hold. The Nepali government admitted in its 2005 progress report that the country is now extremely unlikely to achieve its target of stopping the spread of AIDS and reversing it by 2015.
"If Nepal goes to being [a] high-incidence country, it cannot possibly cope with what that means in health care terms. There are no roads to reach people. It is the people from the remote areas who are going to Mumbai or the Gulf or Malaysia. If they bring HIV back, they are not going to be able to get treatment. That is the danger," says Michael Bosse, the programs director of Equal Access in San Francisco.
Back in the Presidio office, Equal Access founder Goldfarb and her staff are fundraising and developing new programs and ways to measure the impact their programs are having abroad. It has been difficult to comprehensively gauge the influence the radio shows have had in terms of changes in attitudes and behavior.
But over the next three months, Equal Access will be conducting Nepal's first ever national radio survey. Partnered with ACNielsen, a global marketing research information company, it will conduct a 4,000-respondent survey in 55 of Nepal's 75 districts in order to develop a radio audience profile that can assess both what people are listening to and how Equal Access programs have changed people's knowledge and perception of issues like HIV/AIDS.
To date, all Goldfarb and the Equal Access staff of 21 in Nepal have had to go by are stories and letters that come in from listeners.
Some of the most compelling evidence of the impact the shows have is the letters that stream into a popular Equal Access show, Saathi Sangra Man ka Kura, or Chatting With My Best Friend, a talk show aimed at teenagers in Nepal.
"My girlfriend has threatened to commit suicide if I don't marry her," wrote one boy from Pokhara, the country's second largest city. "I've promised to marry her, [but] I am very apprehensive that society will ill treat me and hate me for being involved with an HIV positive person," he wrote.
According to Equal Access, the show receives thousands of letters each month, and they are all returned with personal advice.
While Equal Access continues to expand programming into new areas of Nepal, and new countries like Cambodia and Tajikistan, keeping programs funded and staying out of the political tussle over the appropriate use of U.S. aid money isn't easy. But so far, Equal Access has avoided political pressures from Washington on the subjects of AIDS policy and the new anti-prostitution funding restriction.
In the now-infamous 2003 State of the Union address in which President Bush first made his case for war in Iraq, he also announced the President's Emergency Plan for AIDS Relief (PEPFAR), pledging $15 billion over five years to help fight AIDS abroad.
The plan has been embroiled in controversy since its inception. While the United States' contributions to global AIDS funding should be lauded -- the U.S. gives one-third of the worldwide intake for global AIDS programs -- PEPFAR has come to represent all of the negative consequences incurred when AIDS becomes a matter of politics rather than health care.
Congress initially earmarked one-third of all PEPFAR funds for abstinence and "be faithful" programs. But a document leaked to the Baltimore Sun in December 2005 indicated that the administration plans to bump that number up to two-thirds.
In addition to the continual drone over abstinence, the new item on the conservative agenda is prostitution.
The U.S. Agency for International Development (USAID) issued a directive in 2003 that required foreign-based nongovernmental organizations (NGOs) to adopt a policy opposing prostitution as a condition for receiving federal funds. The directive was based on two pieces of legislation passed by Congress in 2003 that mandated that no U.S. dollars could be used to promote, support, or advocate the legalization or practice of prostitution.