CONTENTS | ANB-BIA HOMEPAGE | WEEKLY NEWS
by Hobbs Gama, Malawi, September 1998
THEME = AIDS
Aggressive measures to combat the AIDS epidemic are needed
throughout Africa.
But sub- Saharan Africa is worst affected due to a number of factors -
poverty, lack of tangible health resources and high illiteracy.
These make AIDS the most daunting disease in the already poverty-stricken region
Since the first cases were diagnosed in the region, it has not been easy for health experts, aid agencies and governments to come up with accurate statistics. This means that as long as people lack information on the killer disease, it will continue to spread. Governments in much of sub-Saharan Africa do not seem to be committed to combatting AIDS.
African governments must make prevention of HIV/AIDS, and mitigation of its impact, an urgent public priority. They need the support of donors and non-governmental organizations if the epidemic is to be overcome, says a World Bank report. The report shows that the cost of inaction is "potentially enormous" and that preventing people from contracting AIDS and then spreading it, is still the most cost-effective way of reducing infection rates.
The World Bank report, entitled: "Confronting AIDS: Public Priorities in a Global Epidemic" states this is particularly true for Africa and other developing countries where 90% of HIV worldwide infection occurs.
It laments the fact that health systems in sub-Saharan Africa are overburdened and lack resources. The new and sophisticated drugs for controlling HIV infection and for treating and preventing AIDS-related illnesses, are reaching only 10% of the people who are living with HIV.
The Bank's report argues that until a vaccine or cure, affordable to developing countries is found, the best way to stop the epidemic, is to assist individuals in reducing "risky" behaviour that may lead to HIV infection.
On the other hand, the Joint UN Programme on HIV/AIDS (UNAIDS) indicates that governments have been reluctant to intervene in the HIV/AIDS epidemic, and too few countries have mounted a truly comprehensive response to the current emergency.
Dr.Peter Piot is UNAIDS' executive director. He is worried that this failure is all the more critical because recent UNAIDS data shows that the rate of HIV transmission in sub-Saharan Africa has been grossly "underestimated".
Both the World Bank and UNAIDS emphasise the need for African governments to be more aggressive - to prioritize their national resources with the help of donors - making AIDS information more accessible to vulnerable groups. People must learn to understand the devastating effects of AIDS.
Released to mark World AIDS Day, the UNAIDS report states that sub-Saharan Africa has the fastest growing epidemic. Here, a staggering 7.4% of the 15-45 age range are now believed to be living with HIV. In 1997, some 3.4 million adults were newly infected, and about 530,000 infants.
Previous figures relating to the rate of HIV/AIDS transmission in Africa were underestimated, according to UNAIDS, because calculations were made from data gathered from the few countries with the best surveillance systems, such as Uganda, and then extrapolated to the entire region. Uganda's statistics showed that infection levels were beginning to fall.
By 1997, data available from other countries indicated that the epidemic has not followed the pattern in Uganda. In these countries, infection has gone further than the levels thought possible when previous data was collected.
UNAIDS says that while East Africa was one of the first areas to experience a regional HIV epidemic, today, Southern Africa is the worst affected part of the continent. From this region, statistics paint a bleak future.
Some 2.4 million South Africans - or one in 10 adults were HIV positive by early 1997 (up by more than a third from 1996).
In Botswana, the proportion of the adult population living with HIV doubled over the last five years, with 43% of pregnant women testing positive in the one urban centre in 1997. Here, life expectancy has fallen to levels of the late 1960s.
In Namibia, AIDS is the most common killer disease, accounting for nearly twice as many deaths as those caused by malaria.
In Zimbabwe in 1996, one person in five was believed to be living with HIV, and in one town alone having a large migrant worker population, seven out of ten expectant women were tested positive for HIV in 1995. Based on current trends, Zimbabwe's infant mortality rate may rise by 138% by the year 2010 because of AIDS; its under-five mortality rate may rise by 109%.
In Africa, Uganda was the first country to take strong measures to contain the virus. This country continues to experience a drop in the proportion of adults infected. Figures gathered in 1997 from three surveillance sites, indicate infection levels of between 5% and 9% - a decrease of about one fifth compared with 1996. The decrease appears to be concentrated on younger age groups, thus confirming findings that the youth have adopted safer sex methods. HIV prevalence among women attending ante- natal clinics is also declining.
But Uganda's situation is not common to all countries. In Malawi, the transmission rate of HIV/AIDS is clearly on the increase. Figures show that out of 100 tuberculosis TB cases treated in hospitals, 60% are HIV positive. Last year alone, according to reports from the Ministry of Health, 20,000 TB cases were treated. With a population estimated at 12 million, Malawi has a 60% illiteracy level and people are still shunning the use of condoms. Towards end of last year, the World Bank report indicated that there were 600,000 people infected. But recently, the Minister of Health and Population, Harry Thomson, said the figure could be as high as 1 million. "We have reached a crisis situation. We must prevent those who have not contracted the disease, from contracting it so that we can control its spread, mainly by changing our patters of behaviour", he said.
The World Bank report notes that in Africa and other developing parts of the world, many public health problems such as malnutrition and preventable childhood diseases compete for care resources. But the AIDS epidemic calls for special attention because it continues to grow and has already begun to have an impact on life expectancy. In the hardest hit countries, life expectancy is back to where it was more than a decade ago.
AIDS is likely to aggravate poverty in these countries, as it kills the productive age group and much needed trained workers. It also leaves children without parents. Poverty and gender inequality have been recognised as among the factors facilitating the spread of HIV/AIDS. Poor women in a situation of dependency, often find it more difficult to arrange for safe sex. Even married women find problems with their husbands concerning safe sex. Accelerated labour migration, rapid urbanization, cultural modernization, conflicts, large scale population movements (e.g.refugees in war-torn countries), facilitate the transmission of HIV-related diseases. Angola, suffering from three decades of civil war is one example.
The World Bank report emphasises that early intervention is especially critical in those countries where the epidemic is still nascent, citing North African countries, Cape Verde, Madagascar, Mauritania and Somalia.
The World Bank's message to governments is clear: "Prioritise AIDS control".
END
CONTENTS | ANB-BIA HOMEPAGE | WEEKLY NEWS
PeaceLink 1998 - Reproduction authorised, with usual acknowledgement