MDGs and the media: ‘Meeting the goals is everyone’s business’


Five years from the 2015 target for the Millennium Development Goals – which aim among other things to combat HIV/AIDS – world leaders are meeting at the United Nations HQ in New York, 20-22 September, to review their progress so far.
According to the latest MDG Report: “the world possesses the resources and knowledge to ensure that even the poorest countries, and others held back by disease, geographic isolation or civil strife, can be empowered to achieve the MDGs”. The report stresses how meeting the goals is everyone’s business.
In a series of articles linked to our blogging competition, TH!NK3 Developing World, the EJC looks at major aspects feeding into the MDGs.
Beginning the series, EJC interviews Jimmy Kolker, head of the HIV/AIDS section at UNICEF in New York, asking him about the media’s role in raising awareness about HIV/AIDS, particularly Prevention of Mother to Child Transmission (PMTCT).
EJC: Raising awareness about Mother to Child Transmission is crucial to stopping the spread of HIV/AIDS. How difficult is it to get this message across?
JK: Eliminating Mother to Child Transmission is complex both in terms of the science and the services that need to be provided. At each step—from informing HIV positive people who may be thinking of having a child to helping HIV positive women who are pregnant to find available services to prevent transmissions to newborns—media organizations play a crucial role in ensuring accurate information is shared with the global community.
It is difficult to some extent because each case is surrounded by issues of stigma and confidentiality. The sense of how the media treats HIV positive parents, and what incentives they have for seeking care, all contribute to how media covers the stories of those affected.
There are good examples of accurate media coverage and awareness raising, but HIV remains a leading cause of death among women of reproductive age globally, of maternal mortality, and under-five mortality in several high-burden countries. Every day more than 1000 children in low-and middle income countries are newly infected with HIV via transmission during pregnancy, labour/delivery, and breastfeeding—so it deserves more global media coverage.
EJC: Are there legal and ethical boundaries that media should respect when covering HIV/AIDS?
JK: In 2010 we are living in an era where AIDS is openly discussed in most societies by governments, media and communities themselves, although it remains a sensitive topic. Still, testing for HIV and revealing that to your family and community are very difficult decisions for many people. The boundaries are in respecting the health, dignity and personal decisions of those affected.
As UNICEF continues to work with media outlets around the globe, sensitivities involved in filming women in clinics or posting images of children who are HIV positive are always highlighted. This is in addition to sharing information about stigmatization and the realities facing the individuals and families affected. It is important to have the consent or agreement of the HIV positive person or affected families before sharing their images and stories. It is about respecting the dignity of that person and family and protecting them, as they are not always treated respectfully in their own communities.
The fact is that HIV is still stigmatized or still seen as almost as a punishment in some societies.
EJC: You mentioned social stigma and discrimination faced by people with HIV/AIDS. Can media help build a more tolerant and open-minded society? 
JK: The most important role for the media is to talk about the medical process and rights of each individual to proper care, treatment and health services. Media outlets can and should demystify HIV and AIDS and talk honestly about what the science says and evidence shows and so reduce the stigma. It is a problem in most societies and communities worldwide—and we shouldn’t hide it or be in denial.
EJC: Why is there is so little coverage or follow-up of MTCT stories?
JK: Actually on the media coverage of Prevention of Mother to Child Transmission of HIV/AIDS, the journalists will be able to tell the story much easier and also document the process as a pregnant woman gives birth and if the baby is tested there is a beginning-middle-end to the story in terms of PMTCT.
But of course if that mother is HIV positive, she is going to be HIV positive for the rest of her life and what’s the father’s status may or not be known or what’s the status of other children in the household is may or may not be known, so the actual coverage of PMTCT needs to be done sensitively to open up the question of what this means in a broader sense for a family and a community.
EJC: Africa has the highest percentage of HIV infections. What communication tools are the most efficient in Africa?
JK: Cell phone communication and especially SMS [text messaging] is widespread and a prominent way of communication in Africa, and is being used by health workers in the field. It is also an effective way to remind mothers of their appointment, to try to bring fathers in for testing, to remind mothers that babies need to be tested and brought back for immunisation and so on. We’re working very actively on SMS as a way of communication and although it is not a mass media, the idea of individualised communication respects the confidentiality and individuality of the AIDS response.
Radio continues to play a greater role in many high prevalence countries in Africa than in the developed world. Many people are dependent on radio for their daily news as the main source about news of the outside world and of good practices, particularly radio programmes in local languages. So SMS for individualized communication and radio for mass communication are equally important, particularly in Sub-Saharan Africa.
EJC: Should the media be doing more to help governments achieve the MDGs? Has it failed so far?
JK: I don’t think the media has failed as such, but it does have an opportunity to expand its coverage. Around 33 million people are living with AIDS and prevention efforts continue, but more needs to be done. Media can play a more active role in bringing awareness, visibility and transparency to this process.
There are also examples where I think the media could do more. Recently, UNICEF Geneva published a report entitled ‘Blame and Banishment’—about the HIV epidemic among children and youth in Eastern Europe and Central Asia. But the media there has not been an active player because this group is partly invisible, as a result of the communities and governments considering them as social outcasts.
Media outlets around the globe need to read this publication and learn about those who are actually vulnerable to HIV and it would be great if the media in Eastern Europe and Central Asia would cover the epidemic and its impacts from the medical and human rights angles and give a voice to these people.
While protecting their confidentiality, it is important that their stories are told: e.g. how people with AIDS are turned away from clinics. People are dying because they are exposed or engaged in high-risk behaviour and many are afraid to seek the proper medical treatments. The media should cover these untold stories.
EJC: Do reporters need to be specialised to properly report on HIV/AIDS?
JK: I don’t think the journalists that cover these stories need to be scientists, but I do think they need to be aware of the evidence and to be able to talk to professionals about public health issues with some understanding of the basics of why the response to AIDS is different from other diseases – i.e. what makes HIV not very contagious, but very dangerous.
To interpret data about behaviours that can lead to HIV and how to prevent them I think general knowledge of science and epidemiology and the history of the AIDS epidemic is important. It doesn’t mean the journalists have to be very specialized health professionals; it can be some good background reading and talking to one or two people who have been through the epidemic and know the circumstances.
EJC: Do you involve bloggers in raising awareness? 
JK: UNICEF as a whole is very much involved in blogging and social media and there is a section in our division of communication in NY that is young people talking to other young people about different issues including AIDS. We have blogs when our colleagues visit various countries during emergencies and also non-emergencies as we monitor the programmes on the ground.
Specifically on PMTCT, the kind of networking we are looking for is at the community level in which there would be peer educators—mothers who’d been through the process to help those who are going through it for the first time, as well as development of support groups for HIV-positive people.
UNICEF has made blogging a priority for those in developing countries undertaking the process for the first time. There are some very good organisations in Uganda, for instance, TASO and Straight Talk, which use blogs and online communication as part of their message. We have our own best practices, a kind of community of practice, but I think that PMTCT is an area which is not very well-developed in terms of blogging. So there is an opportunity for people who are now in the process or have some years of experience to share those experiences.
EJC: The media and general public are not keen on pure statistics. Do you use data visualizations or other ways to explain hard facts in an easy-to-understand format?
JK: UNICEF’s annual stock taking report is called ‘Children and AIDS. Stocktaking Report’ and there is one in every world’s AIDS Day, so the last one was last December 2009 and another one will come out a day before 1st December this year, 2010.
This key annual report does try to explain to a broad audience and not just to a specialized public the issues that are facing children in the AIDS epidemic and some of the successful examples of how to react to those issues. That is definitely for a general audience. ‘Blame and Banishment’, which I mentioned earlier, is very acceptable, written in a way that the general audience can easily understand what we are talking about and not only what the issues are, but also what some of the best practices are and the challenges and things that remain to be done are.
Some of the epidemiological updates seem complicated, so we’re trying from UNICEF side and with our partners, UNAIDS and WHO, to make these publications readable and to explain things in ways that a non-specialist can easily understand.
EJC: What is the most difficult message to get across?
JK: The hardest message to convey is that unless you know the HIV status of your partner any sexual relationship is a high risk relationship, especially in a country where there is a generalised epidemic. Where 1/3 of adults are HIV positive any partner has a higher percentage of being positive than the partner imagines because of the patterns of past sexual activities.
EJC: Is there a region where it is particularly difficult to work with the media or to attract the media to take on an active role of raising awareness?
JK: In those countries with concentrated epidemics, where the epidemic is among drug users, sex workers, and men who have sex with other men, in Asia, in Eastern Europe, Central Asia, in Latin America, the media often does not cover those groups adequately and certainly does not reflect society’s attitude of not treating them with respect, where it is often condemned by religions, societies, parents, and partners.
Where social exclusion is part of the equation, the media, like the rest of society, tend to stereotype those people and not to look at their health concerns or disease but to look at their behaviour in defining them. The behaviour of homosexuals is simply condemned, and it’s the same for prostitutes or drug users. They are socially condemned in many countries and that inhibits the press from looking into the public health aspects of HIV vulnerabilities of those populations.
EJC: What is the main message that UNICEF wants to send to the media?
JK: HIV/AIDS is a global problem. There are new HIV cases in every country in the world. We now have the medicines, knowledge and programmes that can prevent HIV infection. The people who are HIV positive should know their HIV status and get the treatment and care they need, as it is available almost everywhere and the costs have come down dramatically. This is not a disease where the costs are so astronomical that life time treatment is out of the question for many people. This is now a treatable disease. 
We know how to eliminate MTCT and in industrialised countries, in the West, it is a very rare occurrence that a baby would be born HIV positive. So we really need to concentrate on using what we already know to achieve the AIDS free generation.
The babies, who are born positive, if they are tested early and put on treatment, can live a normal life span and be healthy children, so AIDS is not a death sentence. We know how to prevent newborns being born HIV positive and we know how to prolong lives of all those people: mothers, fathers and children who are already infected.
The top line message is that a generation free of HIV is now possible and we know the way forward, but of course it is going to need accelerated efforts to do that: it is making treatment and health services more available, making them integrated with other maternal and child services. It means testing, it means family involvement, it means de-stigmatising HIV, working with those populations who are most at risk and most difficult to reach because of social exclusion or marginalisation.
Images: Flickr users Trevino (top) and Alemush (bottom)