When I started this job, I saw religion as one of the biggest obstacles to our work, particularly in the area of prevention. But I have seen some great examples of treatment and care that came from the religious community and lately in the area of prevention." These words from Dr. Peter Piot, executive director of UNAIDS from its creation in 1995 until the end of 2008, signal the changing attitudes of key leaders on the world scene toward the roles of faith communities in combating the HIV and AIDS pandemic.

In the words of another global leader, Dr. Margaret Chan of the World Health Organization: "AIDS is the most complex, the most challenging, and probably the most devastating infectious disease humanity has ever had to face. It is an unforgiving epidemic that can strike back in surprising, sometimes startling ways."

In discussing ways in which AIDS and religion are linked, we must recall that the pandemic is first and foremost a scientific, social, psychological, medical, economic, and political challenge; it is not primarily about religion. Nevertheless, AIDS and religion have been a discordant couple.

We should accept the fact that health officials, the scientific community, and the many organizations working for people living with HIV have had uneasy relationships with organized religion. Religious leaders were rarely seen as genuine coworkers in the global strategy to halt the spread of HIV and address the plight of those living with AIDS. A deep-seated suspicion permeated the HIV and AIDS community that "religion is against us." From religious groups, the criticism has been that those who advocate the case of those living with HIV and AIDS are taking moral issues lightly in defending lifestyles that spread the pandemic.

Why this gap between science and faith if religion is fundamentally about protection of life and care for the living? If faith is about relationships and human wholeness, should one not expect an open and embracing attitude of religious institutions to the community of those living with the virus and dying from its effects? If religions preach the dignity of every human being, should one not rightly expect that this God-given uniqueness would be affirmed and upheld? A spirituality that is mainly inward looking, or focused on salvation of the soul, will have little understanding of, or even interest in, the social issues around HIV and AIDS, nor in a holistic approach to human suffering. A theological anthropology, however, which regards a person both as an integral identity, with body, soul, and mind, and as a social being who exists in relationship to God, man, and nature, has a far better potential to recognize the HIV/AIDS agenda as congenial to the spiritual challenge.

My reflections on the relationship between faith and the pandemic are shaped by engagement on the national and international scene and by participation both in secular and sacred responses to this urgent human need. In August 2008, I participated in the seventeenth International AIDS Conference in Mexico City. This biennial conference is the world summit for people concerned about HIV and AIDS. This was my third such meeting (the first was in Bangkok in 2004, the second in Toronto in 2006, which I cochaired). I have advised the Norwegian government on HIV/AIDS for several years. Through this journey, I have witnessed the need for a theology of AIDS and a spirituality of care.

The International AIDS Conference brings together people from all over the world; the prevalence of the pandemic differs widely from region to region, but the human suffering creates the same urgency. All were there in Mexico City: scientists, health workers, civil servants and bureaucrats, pharmaceutical companies, world leaders and leaders of faiths, Asians, Africans, Europeans, North and South Americans, people of every color, every faith, and every culture.

And most significantly, "the community" was there--this multifaceted group of thousands of young and old, men and women, who are infected with and affected by HIV and AIDS. No other social issue has created a broad popular movement like this. This galvanizing of a community of people against this modern plague is linked to the nature of the pandemic, so deeply related to personal identities, individual lifestyles, and intimate relationships. The world of HIV and AIDS is a classless society in many respects; the virus does not differentiate by social status. It is an equalizer, on life's downside, but also a mobilizer, joining worlds of victims.

The Ecumenical Advocacy Alliance organizes preconferences linked to the International AIDS Conference, drawing up to five hundred people from all over the world. These leaders, health professionals, and activists work to mobilize a genuine response from faith-based organizations to the awesome challenges posed by the pandemic--no mean challenge.

The 2008 Mexico conference marked the first time the international AIDS summit had come to Latin America. As in Bangkok, the cultural and religious environment and context were palpable. The prevailing Roman Catholic tradition and the strong showing of the continent's conservative evangelical churches colored discussion of controversial issues such as prevention. This is, however, a continent where a pre-Christian, indigenous spirituality permeates official religion. In Brazil, for example, 90 percent of the people say they adhere to some religion but they blend their practices and beliefs. This mix opens people to a more accepting attitude about human sexuality. Basically, the question is how established religious institutions, more than individuals, come to terms with human realities.

Most religions have a clear humanitarian agenda. The HIV/AIDS pandemic is one of today's leading humanitarian challenges. It wreaks untold suffering on the 33 million people who now live with the disease, their families, their communities, and their countries. Every fifteen seconds, someone in the world dies of AIDS-related illnesses, most often because they lack medicine.

The global pandemic thus has an important place in the political and economic agenda of most nations. It affects humanitarian and development programs. It is a central human rights issue. The United Nations has dealt with HIV/ AIDS as a matter of national security and survival. In many countries of Africa, large segments of the population are infected, leading to near breakdown of public services, schools, medical institutions, police, and army. AIDS carries the face of a cross section of the population, including political, civil society, and religious leaders.

Thus the pandemic has, paradoxically, become a great equalizer. It affects people from all sectors in society. It hits men and women in almost equal numbers. Neither young nor old go free. A huge number of victims are infants and children. It is a family affair both when it kills and when it heals.

At the opening ceremony in Mexico City, Ban Ki Moon, secretary-general of the United Nations, made special reference to people of faith: "I call on politicians around the world to speak out against discrimination and protect the rights of people living with or affected by HIV, for schools to teach respect, for religious leaders to preach tolerance, and for media to condemn prejudice in all its forms."

The challenge to all religious institutions that recognize a social agenda was also voiced by Dr. Margaret Chan in her opening speech: "In the interest of facilitating a sustained AIDS response, we must look for every opportunity to improve operational efficiency. One way to do this is to make linkages between existing health care services--for example, for youth, mothers, and children; for sexual and reproductive health; and for reaching out to men who have sex with men, sex workers, and injecting drug users."

Religious communities are responding in various ways with social services, education, and prayers, according to their spiritual profile. Every year on World AIDS day, December 1, the pain and suffering and lost lives of beloved ones are remembered. People whose lives have been shattered seek spiritual consolation, often outside the structures of established religion. Churches, temples, and synagogues open their doors for rituals and rites of remembrance and prayers.

Spirituality is about hope and persistence. The hope that we can have medicines that can offer a nearly normal life to people living with HIV only underscores the tragedy that so many are still dying. That one day there will be a cure to end the virus's reign finds too little nurture in science but is the fervent hope of millions affected. The hope of universal access to medicines that prolong life and enhance its quality is vibrant.

This hunger for hope beyond the human capacity of healing was clearly witnessed at the Mexico International AIDS Conference, which for the first time published religious events in its official program. A prayer room and religious facilities were advertised, and regular liturgies were celebrated according to different traditions.

In the struggles to overcome the scourge of HIV and AIDS, many have come to see that "to go it alone" as a faith group is no longer an option. Crosscutting human issues, such as war, hunger, poverty, and disease, must be addressed both within every religion and by different religions acting together. We must recognize the validity of the spiritual tradition of "the other."

One evening in Mexico, I joined a group for interfaith worship in a Methodist church in the city's center. Muslims, Jews, Christians, Buddhists, and Sikhs came together with members of indigenous spiritual movements to pray for healing and wholeness.

For several participants, even to enter the sacred space of another religion represented a dramatic crossing of boundaries. But the pandemic has opened hearts and doors and revealed new spiritual depths as it touches the deepest levels of a shared humanity. Thus it has moved people from different worlds of faith to a new understanding of solidarity. Like the tsunami that hit the countries in Southeast Asia some years ago, HIV has unleashed unprecedented acts of care across religious, ethnic, and cultural faultlines. In this sense the curse has also brought blessings.

The congregation that evening in downtown Mexico City epitomized this reality. They were young and old; some came alone, others with family and friends. This scene is familiar in many places of worship around the world, where drugs, prostitution, and unsafe sexual practices take a deadly toll, and where poverty and illiteracy multiply the odds against survival.

The haggard face of a man sitting by himself, almost hidden behind a pillar, reminded me of a piece I had read that day, penned by Aroosa Masroor, a Pakistani journalist. I was deeply moved by the way he agonized over the fate of the "unseen, unheard, unmourned, those whose lives already have excluded them from society and whose despair leads to death." The Edhi morgue in Karachi receives fifty nameless bodies every day, he wrote. "When buried there is nothing inscribed on their tombstone either. They die the most unfortunate death."

The simple liturgy, the music and songs, and the words spoken by people from different faiths made this a deeply moving event. Prayers were offered, greetings exchanged, candles lit, and money was collected for local outreach to people in the neighbourhood living with HIV and AIDS, many on the margins of society. This encounter epitomized the vital role of spirituality and worship within the world of AIDS.

As I listened to the open and direct way the religious leaders spoke that evening, I recalled a time when the existence of the dreaded disease was only whispered. In Africa it was called "the slim disease," in the United States the "gay cancer." Indeed, religious institutions and people of faith have come a long way since medicine first named the disease in 1981.

Looking around at my fellow worshipers, I wondered at how they had been changed, that their faith drew them to share an interfaith worship service in a Christian church. And I remembered the first interfaith conference in Africa on AIDS organized by the World Conference of Religions for Peace in Nairobi, Kenya, in 2002. During one session, a religious leader stood up and confessed that in his community they did not bury a person who was suspected of having died of this "unclean cause." "We do not want to contaminate the soil." As we reacted with shock, he paused and added: "I have now learned differently and I am going home to change our ways."

And indeed there is a changing of ways. Today--thirty years after the disease got a proper scientific diagnosis and a medical name--parts of religious establishments have followed the human path of those who live the pandemic. The path has led from hidden corners to the open, from stigma and shame to acceptance. Many religious leaders and communities have moved from silence and rejection to advocacy and inclusion.

No other issue has--to the same degree in a relatively short period of time--so deeply affected the way religious people relate to the diversity of human sexuality. Today there is growing support among well-informed religious leaders and activists for the goal of universal access to HIV prevention, treatment, care, and education. Religious leaders, more and more, see them all as necessary elements in an integrated and viable strategy to respond.

To appreciate fully the significance of this change, one must be conscious of the taboos inherent in many religious traditions. Religious leaders have paradoxically been uncomfortable in speaking about one of the most fundamental features of human existence, that of sexuality. And contrary to their professed love and care, religious institutions, teachings, and attitudes have stigmatized victims of HIV/AIDS.

Put with stark simplicity, religious leaders and communities perceive that AIDS equals sex, which equals sin, which equals death. In the most primitive form, it comes out as a judgment: you deserve this punishment for your wicked life. Today there is greater recognition that HIV/AIDS is an illness, not a sin. It is a virus, not a temptation. This understanding does not deny the fact that the virus is frequently spread by risky and irresponsible and therefore immoral behavior.

If a spiritual message of care and hope is to be communicated, religious leaders, pastors, bishops, and teachers must associate actively with all vulnerable groups. One must be fully informed about the nature of the virus. Especially, teachers of young people should be able to discuss all issues related to the various ways the virus is transmitted. This raises complex issues related to human sexuality, issues like prevention, prostitution, promiscuity, gender-based violence, rape, and incest. Homophobia, often nurtured by religious and cultural traditions, needs to be addressed, especially in religious teaching about the nature of man. Moral codes should not be obstacles for communication about the realities of life.

Many outstanding and innovative initiatives to confront HIV/AIDSs have come through people who themselves, or whose family members, have been infected. Such individuals have often led the way and worked to change the way religious communities react to the pandemic. They are Buddhist monks, Muslim imams, Jewish rabbis, Hindu priests, who with compassion and courage have followed their spiritual calling to side with the vulnerable and the oppressed.

One such outstanding religious leader is Canon Gideon Byamugisha. This Ugandan Anglican cleric lost his first wife to AIDS and then found that he himself was also infected. His bishop did not reject him but encouraged him to turn his fate into a blessing for others. He began to speak openly about his HIV status, drawing strength from his Christian beliefs.

In the process he found many religious leaders in the same situation. He started a network for religious leaders living with or personally affected by HIV and AIDS, called ANERELA+ (African Network of HIV-affected Religious Leaders living with or personally Affected by HIV and AIDS). Soon this organization counted more than three thousand members from all faiths on the African continent. In 2008 it expanded to become a global network, INERELA+. This truly interfaith work empowers religious leaders to be agents of hope and change in their own communities and beyond.

This transforming vision is reflected in the words of the Episcopal Conference of Africa and Madagascar (December 2003), which might serve as a clarion call to people of faith in every corner of the world: "Facing the serious threat of AIDS, . . . we are committed to promote changes of mentality, attitude and behaviour necessary for confronting the challenge of the pandemic; work tirelessly to eradicate stigma and discrimination and to challenge any social, religious, cultural and political norm and practices which perpetuate such stigma and discrimination; and play a major role in eradicating the damaging myths of stigma and discrimination."