When the German AIDS Foundation presented its annual report in Bonn on Friday, it revealed that even in Germany, one common side-effect of HIV infection is poverty.
Compared to AIDS sufferers in parts of Africa, Asia, Latin America and eastern Europe, HIV patients in Germany enjoy first-class treatment. They can rely on health insurers to pick up the tab for their medical costs, while state-of-the-art therapies allow them to continue to lead practically normal lives. But judging by the applications for financial assistance submitted to the German AIDS Foundation in recent years, a high number of AIDS sufferers in Germany are, in fact, living on the poverty line. Since its inception in 1987, the organization has been accepting donations -- totalling 935,830 euros ($1.1 million) in 2004 -- which allow it to grant applicants anything from a new pair of winter boots to a new bed or even art materials, on the one condition that existing financial sources such as family and welfare support have been exhausted.
A downward spiral
Last year, it fielded some 4000 applications. "It might not sound like many," said Ulrich Heide from the foundation committee. "But given the relatively small number of people with the AIDS virus in this country -- roughly 5000-6000 -- we see it as a shockingly high number. We believe that up to 50 percent of HIV positive people in Germany are obliged to turn to our foundation for financial help."
The foundation has also noticed that applicants for emergency funds are getting older. Ten years ago, 80 percent of them were under 40, whereas today, 50 percent are over 40.
According to the foundation, one factor in this shift is that HIV care has been revolutionized by new anti-retroviral drugs and people infected with the virus can live longer -- but the problem is, they fast feel the pinch of having to live on a pittance.
Among the applicants are many AIDS patients who failed to pay into social security schemes for any length of time and who therefore have reduced eligibility for benefits. Hardest hit are women who either never worked, or worked part-time before their diagnosis.
A rise in migrant poverty
Another development the foundation has observed is that more and more migrant AIDS sufferers are living in tight financial circumstances.
"As well as the increase in older and female applicants, we've seen that one third of applicants are now migrants," said Heide. "Many come from eastern Europe, and there are also high numbers from countries where AIDS has reached epidemic proportions, such as southern Africa and sub-Saharan Africa, South-East Asia and also the Far East."
The private foundation's original mandate was to care for people infected with the HIV virus in Germany alone. But in 1999, it also turned its attention to overseas projects, primarily in Africa.
"We can't build walls"
One of these is the HOPE outreach programm in Cape Town, which concentrates on medical aid and educational work. The project was set up by Reverend Stefan Hippler and would never have seen the light of day without subsidies provided by the German AIDS foundation.
"The cooperation is a financial one, which means a lot to us," explained Hippler. "But it's also based in an exchange of expertise and experience."
Ulrich Heide stresses that there are many advantages to branching out with projects abroad.
"The center of our activity will always be Germany," he said. "But five years ago, we decided to go international for various reasons. An infectious virus such as HIV can't be tackled at a local level only. We can't build walls to contain it, and the spread of AIDS in Africa, India and China inevitably affects us, too."