AIDS is devastating sub-Saharan Africa

Epidemic: AIDS spreads unchecked through much of the continent, but prevention campaigns have taken hold in some nations.

July 16, 2000|By Mike Adams | Mike Adams,SUN STAFF

On the surface Botswana appears to be a success story -- one of the few in post-colonial Africa.

The nation of 1.5 million is a parliamentary democracy and its economy, fueled by diamond mining and tourism, is one of the most prosperous in Africa.

Botswana gained its independence from Great Britain 34 years ago, and for much of its history, it's served as a model for good government and wise fiscal management -- a bright spot on a continent marred by instability, strife and suffering.

But today Botswana has come to symbolize something far different -- the AIDS epidemic that is ravaging sub-Saharan Africa. Of the 18 million AIDS-related deaths that have occurred worldwide, 15 million were recorded in sub-Saharan Africa, according to the United Nations Program on HIV/AIDS.

In Botswana more than three out of 10 adults are HIV positive -- the world's highest infection rate. Botswana stands at the top of a list of 16 African nations where at least 10 percent of the adult population (aged 15-49) is infected with HIV.

One of Botswana's neighbors, South Africa, has the largest number of HIV-infected people in the world -- 4.2 million -- which equals 19.9 percent of the nation's population.

The HIV statistics coming out of Africa are grim, and the impact is even more powerful when you can connect names and faces to the numbers.

In early May, I met victims of the HIV/AIDS epidemic when I toured South Africa and Botswana with a group of journalists. To me, the plague in those nations is more than numbers, it's real people who gave us firsthand accounts of their plight.

Black South Africans have difficulty talking publicly about sexual matters. Their culture discourages it. So people with HIV often suffer silently to avoid the scorn, the ridicule and even the violence they'd be subjected to if they acknowledged their condition. But in Soweto we found a group that had banned together for support, and instead of hiding from the community, they were trying to save others from HIV by preaching prevention. The group is partially funded by the U.S. Agency for International Development.

Our meeting with the group members began with festivities. They greeted us with songs, warm smiles and food when we arrived at their meeting place. They clasped our hands as they sang and we formed a circle. When the singing ended, they told their stories, including details about how they became infected. Most of them were women, but there were a couple of men.

In Africa, HIV is primarily transmitted through heterosexual intercourse and as a result, far more young women are infected than young men. The average rate for teen-age girls is five times higher than for boys.

Most of the women said they were infected by husbands or boyfriends. At least one said she was raped. Some became choked with emotion and were unable to finish their stories. One of the men acknowledged that he had not practiced safe sex and had probably infected his sex partners.

Our visit came shortly after South African President Thabo Mbeki questioned whether HIV was the actual culprit in the AIDS epidemic. He pointed to poverty -- with the unhealthy conditions that accompany it -- as a possible cause. Mbeki also questioned the safety of AZT, a drug commonly used in the West to combat AIDS.

Although South Africa made a peaceful transition from apartheid to black majority rule, the nation is beset by problems. High crime rates in urban areas and corruption haunt the nation. And much of the nation's wealth remains concentrated in the hands of the white minority. One of the top priorities for Mbeki and the African National Congress, the nation's ruling party, is raising the standard of living for black South Africans, many of whom are mired in poverty. Until recently, HIV has not been at the top of the ANC's agenda.

Last week, the 13th International AIDS Conference convened in Durban, and Mbeki's steadfast refusal to renounce his stand on HIV sparked protests. Mbeki's position has left many people baffled, including researchers at Chris Hani Baragwanath Hospital in Soweto.

The mainstream medical community maintains that the link between HIV and AIDS is well established and beyond debate. One doctor said that Mbeki's position confused people who were undergoing treatment and undermined AIDS prevention efforts.

"Some people have said, `I'm going to stop taking my medication because Mbeki said HIV does not cause AIDS,'" one doctor told us. "Mbeki is a highly intelligent and intellectual man, and when he says something, the people on the ground believe it to be true, and it has an impact on people who are HIV positive, who go back to unprotected sex or stop taking their medication."

The researchers also told us that the government has not only failed to spend enough money on lifesaving drugs, but the nation lacks the support system necessary distribute them effectively.

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