[Vision2020] HIV-AIDS in Southern Africa: The World's Highest Infection Rates

nickgier at roadrunner.com nickgier at roadrunner.com
Tue Dec 1 14:59:20 PST 2009


Hello Visionaries:

This is one more column in a series on Southern Africa inspired by my August trip to the region. Today is World AIDS Day, so I held my notes until this week.

The full version with images of the school posters from Zimbabwe can be read at www.home.roadrunner.com/~nickgier/AIDSday.htm

Nick Gier

HIV-AIDS IN SOUTHERN AFRICA: THE WORLD’S HIGHEST INFECTION RATES

As we commemorate World AIDS Day on December 1, we should celebrate the fact that fewer people are dying from this dreaded disease.  The number of deaths in the world peaked at 2.2 million in 2007, but the 2 million people who died in 2008 are still a great tragedy.  

The other good news is the dramatic increase the use of antiretroviral drugs (ARVs) has increased 10-fold over the last five years, reaching 4 million more people in the Third World. AIDS patients on ARVs experience a dramatic reduction of the virus in their systems, especially in the male semen. 

During my six-week tour through four countries in Southern Africa in August, I encountered friendly and outwardly healthy people everywhere I went.  Our tour group visited a medical clinic in rural Namibia.  The nurse there said that she saw very few AIDS cases, and she showed us the condoms that she handed out free.  Among them was the female condoms, which is being promoted as a way of protecting women from males who refuse to wear condoms.

I did not visit any AIDS clinics, but if I had done so, I would have witnessed what I knew only as statistics: these countries have the highest AIDS infection rates in the world, averaging 18 percent of the adult population. 

In Botswana where 23 percent of the adult population is HIV-positive.  As I traveled through the northern part of the country, I saw large billboards strongly recommending male circumcision.  Tests have shown that circumcision may prevent HIV infection by 50-60 percent.  

A friend of mine in Zimbabwe told me that clinics run by Population Services International pay men to have their foreskins cut off, and many are eagerly lining up for the procedure.  There is fear, however, that these men will think that they are completely immune.  

When our tour group visited a school in Zimbabwe, we were impressed with the strongly worded posters that appeared in elementary grade classrooms.  The most compelling picture was a man in a clerical collar who says: “I’m an HIV-positive pastor. It can happen to anyone.”  The removal of the stigma of AIDS--that is only a gay or prostitute disease--is the one of the most effective elements of successful AIDS education.

A public relations campaign in Zimbabwe featuring billboards such as “Anyone can contract HIV-AIDS and everyone can prevent it”; and “What smart guys are wearing” (a condom) appears to have had good effect.
Although some critics dispute the claim, the government reported that the infection rate has dropped from 24.6 percent in 2003 to 15.3 percent in 2007.  Namibia has had similar success in the same period: down from 21.3 percent to 15.3 percent.

In 2008 5.7 million people were living with HIV-AIDS in South Africa, more than any other nation and 17 percent of the world’s total.  The country has an 18 percent infection rate and lost 350,000 to the disease in 2008 alone.  On a positive note, the percentage of people are using condoms in their first sexual encounters rose from 31.3 in 2002 to 64.8 in 2008.

South Africa could have been well ahead of neighboring countries if it had not been for the disastrous policies of former president Thabo Mbeki. Early in his presidency Mbeki came under the influence of Peter Duesberg from the University of California at Berkeley.  Duesberg is a maverick scientist who, along with other some distinguished researchers, did not believe that HIV caused AIDS. 

Mbeki refused offers from drug companies to provide ARVs free or at little cost, and insisted that AIDS was caused by poverty and general poor health.  A 2008 Harvard study estimated that Mbeki’s stubbornness caused 330,000 unnecessary deaths.

The new president Jacob Zuma has removed Mbeki’s health minister, he is moving forward with a plan to offer ARVs to every infected South African by 2011.  (By contrast Botswana met this goal already in 2006.) For this effort the U.S. will add $125 million to the $560 million that has already pledged for South Africa in 2010.

There is one important lesson to be drawn from the AIDS disaster in South Africa. In life and death matters, such as AIDS and climate change, policy makers have an obligation to go with broad-based scientific consensus, not with a few scientists no matter who distinguished they might be.

Nick Gier taught philosophy at the University of Idaho for 31 years.




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