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In Silenceby Susan Meiselas

Each year half a million women around the world die in childbirth. Twenty percent of those deaths are in India.

That’s just an estimate. Many more die uncounted. Most of the deaths are preventable with access to proper healthcare.

Photographer Susan Meiselas and reporter Dumeetha Luthra traveled to India for Human Rights Watch to retrace the steps of one
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Access To Life / Mali. © Paolo Pellegrin / Magnum Photos

For 25 years, AIDS has ravaged the lives and livelihoods of millions of people. Since the early 1980s, nearly 30 million people have died from AIDS. But over the past few years, a quiet global revolution has enabled millions of people infected by HIV to live healthy lives.

In the early 1990s, when antiretroviral drugs became available, AIDS was transformed from a certain death sentence to a manageable chronic disease–but only for some. The expense of the drugs and their distribution prevented 95 percent of those living with HIV from getting access to them. International outrage that millions were dying because of economic disparity helped reduce drug prices and to create the Global Fund to Fight AIDS, Tuberculosis and Malaria in 2002. Through the Global Fund and the U.S. President’s Emergency Program for AIDS Relief, the world began to invest in a massive rollout of antiretroviral treatment in more than 100 developing countries. Doctors and healthcare workers around the world have adapted complicated procedures to settings where people often could not access even the most basic care. Already, millions of lives which otherwise might have been lost are being saved. Equally important, providing treatment is becoming a central part of the efforts to prevent further spread of the disease.

In Access to Life, eight Magnum photographers portray people in nine countries around the world before and four months after they began antiretroviral treatment for AIDS. Here are faces, voices, and stories representing those millions of people who by now would be dead if not for access to free antiretroviral drugs–people who are living with HIV, working, caring for their children, and experiencing the joys and struggles of being alive. But there are also the stories of those for whom treatment came too late or where tuberculosis or other diseases brought their lives to an end – showing how the fight to bring access to AIDS treatment is a difficult one, often filled with setbacks as well as success.

Today, three million people around the world are alive thanks to antiretroviral treatment for AIDS, up from 350,000 just five years ago. By 2010, more than five million people are likely to have been given access to these drugs. Yet there is a long way to go before all the people with HIV who need these life-saving drugs have access to them. Today, the need is for 10 million people, but until we can stem the growth in new HIV infections, that number will continue to grow.

There are other challenges. Even where those infected have access to antiretroviral treatment and their immune systems begin to recover, infections and illnesses they have already developed because of HIV may take their lives. Tuberculosis continues to be the leading cause of death among people living with HIV/AIDS, and hepatitis, liver diseases and HIV-related cancer also take their toll. Nonetheless, ARV treatment is generally successful: After two years on treatment, eight out of every ten people who started are still alive.

Free antiretroviral treatment is saving millions of lives, and that alone is reason enough to continue to widen access to it. But the main challenge in the fight against AIDS today is preventing new HIV infections. Worldwide, 2.5 people are infected by HIV for every person that begins treatment. To win the fight, we must turn those numbers around. Antiretroviral treatment helps in this struggle by turning a certain death sentence into merely a chronic disease. In doing so, fear and stigma is reduced, more people will dare to be tested for HIV, and it will become easier to talk openly about how it spreads how to protect against infection.

The success in rolling out antiretroviral treatment against formidable odds inspires us to do more. The stories portrayed here, just a small sample of the millions of people given a chance to rebuild their lives, offer a glimpse of what the world has achieved against the greatest public health challenge we have faced to date.
http://www.theglobalfund.org/html/accesstolife/en/about/about-access-life/

Access To Life Exhibition
Access To Life is on view at the Corcoran Gallery of Art in Washington DC, from June 14 to July 20, 2008. The exhibition will then travel to Mexico City, Paris, London, Berlin, and Rome throughout 2008 and 2009. http://www.theglobalfund.org/html/accesstolife/en/exhibition/

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