By Angela Ndinga-Muvumba, senior researcher at the University of Cape Town's Centre for Conflict Resolution, South Africa

In September 2000, 189 governments met at the United Nations ( U.N.) Millennium Summit in New York for a global ''talk shop'' about the catastrophic conditions of underdevelopment endured by the world's poorest citizens.

They committed, through the adoption of eight Millennium Development Goals (MDGs), to reverse underdevelopment by, among others, tackling poverty, empowering women, increasing access to education and improving health by 2015. One of the targets of MDG six is to halt and reverse the spread of HIV/AIDS.

Specifically, with the assistance of the U.N. and its agencies, all governments should by 2015 reduce the levels of HIV among 15-24 year old pregnant women; increase the correct use of condoms among 15-24 year old young adults; and increase the number of 10-14 year old orphans attending school.

Presumably, achieving these three objectives would indicate that the spread of HIV/AIDS had slowed and that prevention programmes were finally working. Unsurprisingly, in the countries at the frontline of the pandemic – Southern African states – the MDG target for HIV/AIDS is far from being realised.

Only Zimbabwe has shown evidence of a decline in its national HIV prevalence rates. There is almost no sign of containment in other Southern African countries.

The MDGs grew out of numerous commitments made at international conferences and summits in the 1990s. Thus, by 2000, some countries in Southern Africa were already making progress in areas of development.

For example, the incidence of absolute poverty in Mozambique went from 69 percent in 1996/1997 to 54 percent in 2002/2003.

But when it comes to HIV/AIDS, Southern Africa remains the centre of the global pandemic: only 3.5 percent of the world's population lives in this region, yet Southern Africans bear 37 percent of the global AIDS disease burden.

It is no coincidence that the region is experiencing the worst of the pandemic. The political, social, economic and cultural structures of Southern African states reproduce inequality. Inequality is a prime contributing factor to vulnerability to HIV/AIDS.

The region's social networks have expanded and intensified since the end of apartheid. People are more mobile than ever before. Yet, despite new freedoms, Southern Africans struggle to find jobs, and therefore lead lives of quiet desperation in hostels or informal settlements.

Rapid urbanisation has facilitated wider sexual networks, which have in turn accelerated the spread of HIV. Moreover, while male circumcision has become acknowledged as important in the reduction of the spread of the virus, it is not being practised widely.

The low incidence of male circumcision co-exists with the prevalence of other sexually transmitted infections and correlates with high levels of HIV in the region.

A chronic shortage of health workers in Southern Africa has exacerbated the HIV/AIDS crisis. The human rights non-governmental organisation Oxfam International estimates that four million more health workers are required to address the global pandemic, and that Africa will need most of these ''new hands on deck''.

Finally, although it is widely acknowledged that women' s unequal social and economic position in many Southern African societies leaves them the most vulnerable to the effects of HIV/AIDS, the empowerment of women is rarely seen as a strategic tool for reversing the spread of the disease.

The impoverishment of women – above all, young females in inter-generational relationships – exacerbates their lack of power to negotiate the conditions under which sexual intercourse takes place.

As comprehensive as the MDGs appear to be, they are not explicitly focused on how to transform these conditions. What is demanded is the alignment of AIDS-related work with serious efforts to transform the social order that spreads HIV/AIDS.

Unsurprisingly, African governments which merely follow the MDG blueprint without internalising socially transformative approaches to reduce vulnerability will fail to stop HIV/AIDS by 2015.

A Southern African Development Community (SADC) heads of state summit in Maseru in July 2003 adopted a strategic framework and programme of action for 2003-2007 in order to address this issue. Subsequently, an HIV/AIDS unit was established at the SADC secretariat in Gaborone.

While the MDGs highlight a public health perspective for reversing the spread of HIV/AIDS, the SADC plan builds on the MDGs by stressing the importance of reducing vulnerability.

The HIV/AIDS unit has been working to reduce the socio-economic impact of HIV/AIDS while trying to mobilise a coordinated response across public and private sectors.

It has lobbied and supported Southern African initiatives to mitigate the effects of HIV/AIDS across development, governance and security sectors.

What are some of the ''comprehensive'' initiatives that SADC has engineered in the last three years to meet its objectives? The organisation has provided support to the University of Botswana for including HIV/AIDS issues in water resources management.

It has created an ethics and principles forum for the SADC region's media outlets and editors. The SADC HIV/AIDS unit has presented the region's governments with a model called ''Circles of Support'' for the care, support and education of HIV/AIDS orphans and other vulnerable children.

Finally, the Gaborone office is endeavoring to strengthen Southern Africa's network of people living with HIV/AIDS, as well as networks of healthcare workers such as nurses and midwives.

However, the benefits of these initiatives will only be realised in the long term. Therefore the MDGs, while emanating from promises made in the 1990s, seem like an ephemeral wish list.

This becomes apparent when the MDGs are juxtaposed with the effects of decades of apartheid in South Africa, conflict in Angola, Mozambique and Namibia, and underdevelopment throughout the region. The vast majority of Southern Africa's chronic poor are history's victims.

If we imagine that the MDGs will lead to miraculous reversals by 2015, we are underestimating the trajectories of the region's history and political economy. It means, to say the least, that we are euphoric in our expectations of the latest policies and projects of the international community.

Instead, Southern Africans must understand that until the even greater struggle to build new egalitarian states and societies is won, HIV/AIDS will continue undefeated. (ENDS)