Eye on Africa: AIDS beyond ABC
WASHINGTON, Dec. 6 (UPI) -- According to UNAIDS -- the Joint United Nations Program on HIV/AIDS -- 66 percent of the 38 million people infected with the virus worldwide live in sub-Saharan Africa. An estimated 3.1 million Africans newly contracted HIV in 2004, while 2.3 million died of AIDS. The statistics need no interpretation.
In the fight against AIDS, poor leadership is the real killer. National leaders waited too long to engage their countrymen in dialogue. Their greatest failure is communication. Like elsewhere in the world, sex talk is taboo in African societies. Therefore, notwithstanding its ravages, AIDS remains a distant concept to many an African.
From South Africa to Uganda to Nigeria, the leaders have failed their people. This is particularly true for women, who -- because of their physiology -- are naturally more susceptible to infection. Three-quarters of all women with HIV worldwide live in sub-Saharan Africa. They account for nearly 60 percent of all infected adults in the region. The feminization of HIV heralds dire consequences for the continent.
Historical sex discrimination promotes inequitable access to opportunities - educational, medical, professional and economic. Half of the 800 million Africans live on less than one dollar a day. The poverty disproportionately affects women and girls. Without resources, women are powerless in the face of the crisis. Too often, they stay in high-risk relationships and cannot negotiate safer sex. Consequently, HIV prevalence rate in pregnant women remains high: 37.4 percent in Botswana, 26.2 in South Africa, 13 in Ethiopia, 22 in Namibia, 5.6 in Nigeria and 6.2 in Uganda.
"HIV/AIDS is not strictly a health issue," says Paula Dobriansky, U.S. undersecretary of State for Global Affairs. "In some areas, eight out of 10 farmers are women, and their diversion from the productive sector leads to deprivation for the whole family, affecting even basic food security." Many women cannot afford antiretrovirals and other drugs. The pandemic has left them too sick and weak to farm, increasing the level of poverty.
The plague destroys the very foundation of African society - the family. Across the continent, communities crumble under a crushing number of orphans. Uganda has 2 million orphans for 1 million HIV-infected people. With an estimated 2.2 million HIV-infected people, Ethiopia counts 1.2 million orphans. Traditionally, relatives would adopt and provide for the orphans. However, in many countries, families are overtaxed by the pandemic - leaving no resources for the orphans.
"The systematic long-term outlook is gloomy," Learned Dees, senior program officer for Central Africa at the National Endowment for Democracy, reflects. "The large-scale orphan phenomenon pushes the family beyond the breakdown point. The burden is overwhelming for the traditional structure. Here we have a big group of people who are likely not to get an education. This is the emergence of a permanent underclass. The repercussions are serious for political stability and economic progress."
The gravity of the crisis requires a national dialogue. It is impossible to design sound policies when the issues are not defined. The road to poverty reduction and a healthier nation should be buttressed with the promotion of economic freedom for all citizens.
Women and girls need access to antiretrovirals and other AIDS treatments on an equitable basis. Along with a strong medical response, African governments should ensure the rights of women to education, equal opportunity for work and guarantee their property and inheritance rights. Orphan integration should also be an urgent priority.
AIDS threatens all sectors of society and challenges our definition of success. The so-called stable, economically successful countries are among the hardest hit. Held as the African success story -- Botswana, a stable, democratic and rich nation -- has the highest HIV prevalence rate among pregnant women. South Africa, arguably the most powerful country in Africa, is home to 5.3 million HIV-infected people - the world's largest.
Because of its relatively low national prevalence of AIDS, Uganda is deemed the African model for the fight against the virus. The prevalence fell from 13 percent in the 1990s to 4.8 percent in 2004. Uganda's progress on the AIDS front builds on dialogue. Ugandan President Yoweri Museveni trampled the sex taboo and initiated a policy debate. He regularly discusses AIDS and its consequences on the airwaves. Uganda's simple model, known as ABC (Abstinence, Be faithful and Condoms) has contributed to a substantial reduction of the number of infections. In spite of its "success," Uganda has the highest number of AIDS orphans.
Stephen Morrison, head of the Africa Program and executive director of the Task Force on HIV/AIDS at the Center for Strategic and International Studies explains. "ABC alone does not suffice. Local leaders should fight the stigma attached to HIV/AIDS." The stigma keeps people from getting tested and seeking help.
African leaders should be proactive and show the way to the AIDS testing center. Their example would send a strong signal and encourage more of their countrymen to do the same. Knowledge is power. Africa needs a vigorous information campaign to empower communities against this predator.
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