Contributor: Jessica Quarles

We've come a long way since December 1 was first declared “World AIDS Day” in 1988. Back then, AIDS was a relatively new, commonly misunderstood disease that left an estimated 5 to 10 million with the disease with little hope of long-term survival.

Today, despite major advances on testing, treatment, and mother-child transmission, HIV/AIDS is still outpacing us. We know how to prevent it, and yet last year an estimated 4.3 million people became newly infected with HIV. Only a fraction will be treated. Today alone, 11,200 people will contract the virus — the vast majority in developing countries.

So why, in light of all the progress we've made, are the number of new infections so staggering? The answer is access to the means of prevention — or the appalling lack thereof. A quarter century after the discovery of the disease we now call AIDS, fewer than one in five people at risk of contracting HIV has access to effective prevention.

Consider this: Fewer than 15 percent of young women in Southeast Asia — home to one of the highest rates of new infections — know how to protect themselves from infection. Worldwide, fewer than one in eight people at high risk can find a nearby clinic offering HIV testing and counseling. Fewer than one in ten people at high risk have access to condoms. And in Africa, where the majority of people living with HIV/AIDS are women, fewer than one in ten have access to treatments to keep their newborns from inheriting the virus.

In Zwedru, Liberia, a provincial capital carved out of the dense West African forest, several young people I met held dangerous misconceptions about how HIV is transmitted. Some told me it came only from people in neighboring Cote D'Ivoire, and that they could tell whether someone had HIV just by looking at them. Even those who did know how the disease spreads said the nearest place to get condoms was a town two hours away. To reach a clinic that offered an HIV test required more than a day's drive.

Thankfully, a year later, those same young people know a lot more about HIV/AIDS. Today more than 1,500 Liberian youth know how to prevent HIV — and how stigmatizing those with the virus makes it even harder to curtail its spread.

Together with Nike and an innovative non-profit group called Grassroot Soccer, Mercy Corps equipped Liberian soccer coaches with information on how to prevent HIV/AIDS and the skills to teach the young people they mentor. In short, soccer is helping people save their own lives.

Mercy Corps helps people deal with HIV/AIDS from China to Sudan to Zimbabwe, and we are driven by the belief that unless we step up efforts to halt the epidemic's spread, AIDS will derail broader efforts to improve food security, fight poverty and stimulate economic growth throughout the world.

World AIDS Day is a call to action. Today in Nepal, Mercy Corps is supporting an event hosted by Nava Kiran Plus — a group led by HIV-positive activists— to bring their prevention message to young people at risk. Here at home, you can get the word out in your community about what's at stake in the fight against AIDS, and join international efforts such as The ONE Campaign to lobby governments to spend more on access to prevention. It's estimated that universal access to effective prevention would avert 28 million new HIV cases in the next ten years, saving immeasurable suffering, loss of life and an estimated $24 billion in treatment expense – human and financial costs we simply can’t afford.

A quarter-century into the battle against HIV/AIDS, there's a lot to be proud of. But success in the next quarter-century will not be judged only by the number of new drugs or prevention technologies, but also by the number of people with access to the basic tools of disease prevention. Because in the end there's only number that really matters: the number of lives saved.

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In this year of natural disasters, a great deal of attention has been placed on the tsunami in Asia, Hurricanes Katrina and Rita here in the United States, and most recently, the earthquake in Pakistan. These events, charged with emotion and filled with unforgettably horrific images, captured our hearts and minds. More importantly, they challenged us to think about how we can help those impacted and affected - those whose lives changed forever in a single day.

However, another emergency is claiming 8,000 lives around the world every day. More than two decades into the epidemic, HIV/AIDS is our silent tsunami.

Today is World AIDS Day. This is a day to remember those that we have lost to this devastating disease, and a day when we think about the many people whose lives were impacted by HIV/AIDS. This is a day that we use as a call to action.

Each day, 14,000 people are newly infected with HIV. More than 40 million people are living with HIV - a staggering 95% of them live developing countries. It is the number one killer of people aged 15-49 in the world, and increasingly impacting women. While we have prevention methods that we know will work, and effective treatment is available, more often than not it fails to reach those who need it most.

My organization, Mercy Corps, partners with communities in the midst of extreme economic or social transformation, and countries in transition from war or natural disaster. HIV/AIDS presents an increasing challenge in these environments, and it is critical that we respond appropriately to HIV/AIDS - not only as a health issue, but also as a development issue.

Mercy Corps' HIV/AIDS interventions have ranged from working with war-affected youth in Liberia, to supporting people living with HIV/AIDS in Uzbekistan, to increasing access to needed health services for indigenous populations in remote rural areas in Guatemala. In each program we seek to combat stigma and deliver hope. By intervening in key areas, engaging with national coordinated responses, listening to the needs of our communities and leveraging our connections in local communities, we can win allies and form decisive strategies in the struggle against HIV/AIDS.

The long-term development focus is critical. While HIV/AIDS presents an enormous and immediate crisis today, it also promises to be with us for decades to come. Looking to the future, it is clear that HIV/AIDS simply cannot be treated solely as a health issue. Poverty, social exclusion and gender issues all drive the spread of the pandemic; these concerns must be addressed in any truly effective approach to combat HIV/AIDS.

To be effective, HIV/AIDS interventions must be inclusive, coordinated, community-owned and multi-sectoral. In particular, we must actively combat stigma, which alienates people living with the virus and undermines efforts to prevent and treat HIV/AIDS. In addition, responses must be infused with hope, empower communities to build on their successes and encourage individuals to become agents of change themselves.

While Mercy Corps tailors its responses to meet the unique circumstances of each country, in all settings we believe that enduring change comes when people take charge of their own futures and plot a course for change in their own communities - whether communities are recovering from a natural disaster or trying to escape from the lethal wrath of HIV/AIDS.

The theme of this World AIDS Day is "Stop AIDS. Keep the Promise." It is a call to action for governments and donors to fulfill their commitments to combat this disease. But it is also a commitment to the communities we serve every day. By responding to HIV/AIDS as a challenge that asks us to be more compassionate, more inclusive and more visionary, we're promising communities to help them build bridges to a better, brighter future.

Jessica Quarles is Mercy Corps' HIV/AIDS program officer. Read about her trip to Liberia in October 2005.

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