Breda Gahan - Reflections, Thoughts and Hopes on World AIDS Day 2015

01 december 2015

Breda Gahan of Concern Worldwide was awarded Dóchas Global Citizen of the Year 2015 for her decades of work in the fight against HIV and AIDS. She is a proud member of the Dóchas HIV and AIDS Working Group. Today, on World AIDS Day she shares her personal reflections...


I witnessed the terrible impact of HIV and AIDS in Tanzania and in Uganda in the mid 1990’s when I first visited. I had read the statistics before I went, but nothing could prepare me for all the dying people I met. They were often indoors as stigma and advanced illness meant people did not want to or were too weak to be outdoors. I could not understand why the world was not responding, urgently. The saddest part was seeing frightened children who did not understand why they were being robbed of their parents. There were far too many funerals and local people told me that coffin making was sadly the biggest business then. Before the introduction of ART – anti-retroviral therapy, everyone died from AIDS. 

Previous to working with Concern Worldwide, my fellow nursing and medical colleagues and I in St. James’s Hospital in Dublin were confronted with this same insidious infectious disease, did all we could do in terms of palliative care for people living with HIV and AIDS, yet despite our best efforts, everyone died in Ireland back then also. Death came far too early for far too many young people. A 1997 Irish Times headline reported ‘Red Ribbon on Liffey marks lives and deaths of victims’. A black cross, bearing the words "AIDS" and "RIP", lay in front of the Red Ribbon. Thankfully this kind of language and these images are not used in Ireland today as HIV treatment is working well for most people allowing them to live healthy, productive lives.

The first combination therapy - HAART, (highly active antiretroviral therapy to reduce HIV viral load in the body) was approved for use in the US in 1995. In 2001 finally, drug companies allowed the generic production of cheaper antiretrovirals (ARVs), and in 2002 the Global Fund to respond to HIV and AIDS, TB and Malaria was set up to support treatment access in worst affected countries in sub-Saharan Africa firstly.

AIDS is not over

I still find it hard to believe as I look at the UNAIDS factsheet for end of 2015, that 2 million people became newly infected with HIV in 2014 (about 5,600 per day) and 1.2 million people died from AIDS-related illnesses last year. A total of 36.9 million people are living with HIV today and about 30% are young people aged 15 to 24 years old. Of the total infected, only 41% of the adults and 32% of the children have access to treatment. The right to life and their right to health is not being realised for the 59% of adults and 68% of children living with HIV who have yet to access treatment. 

Extreme poverty, social and economic inequality, stigma and discrimination and lack of clean water and sanitation, low knowledge and education and weak health systems continue to be the main drivers of infectious diseases including AIDS, TB and malaria. 

Since year 2000, the MDGs have provided a global framework for aiming to reduce the spread of infectious diseases, resourced by international aid and special financing mechanisms including the Global Fund, the Bill & Melinda Gates Foundation and PEPFAR – the US President’s Emergency Plan for AIDS Relief. Progress is been made.

The AIDS epidemic has now reached a defining moment. There is great hope resulting from advances in science and treatment expansion, and death rates have been declining.

What happens next 

Much has been learned and debated, and tremendous progress has been made in stalling the spread of HIV over the past 25-30 years due to committed scientists, researchers, activists, outstanding leaders and frontline health and community workers, and in particular by people living with, and affected by HIV and AIDS. Lessons indeed are now being taken on to support the Ebola response.

HIV is technically 100% preventable and HIV and AIDS related illnesses are increasingly treatable. The virus can be lowered by ART – anti-retroviral therapy. Millions of lives have been saved in the past two decades, and more and more people are ‘living positively’ with HIV almost everywhere today. 

In areas such as HIV prevention, research and development, global HIV spending has stagnated and even declined however. This is not the time for complacency. There is more to do.

The Dochas HIV and AIDS Working Group of which I am a member issued a policy paper in late 2013 entitled: AIDS is NOT OVER – Ireland’s responsibility to help finish the job.

AIDS is still not over for the 1.2 million families who lost a family member to HIV and AIDS related illness last year.

I hope that the Sustainable Development Goals (SDGs) agreed at the UN in the September 2015 New York summit will as proposed ‘by 2030 end the epidemics of AIDS, tuberculosis, malaria’, under Goal 3- Ensure healthy lives and promote well-being for all at all ages.

Please let there be No complacency until we get to ZERO by 2030! 

Please support World AIDS Day 2015 events on December 1st

The World Aids Day Theme for 2015 ends a five year campaign aiming for -

Zero new HIV infections.

Zero discrimination 

Zero AIDS-related deaths

We have some way to go to get to Zero. AIDS is not over.

Some useful resources to find out more: