The global HIV/AIDS epidemic: A call on Africans

December 1st is around the corner again and the world will be marking the World’s AIDS Day 2007. What better health topic to discuss here than one which examines the African AIDS dilemma.

HIV/AIDS is in no way a new topic for us. It is, however, saddening to note that most of us are not making enough effort to stop the spread of the virus or at the very least, support those who are infected. There is a popular saying among HIV/AIDS activists, “even if you are not infected, you are affected”. The fact that the African continent is currently plagued by this pandemic makes all of us Afri-Cans affected. Funny enough, the majority of us do just the same things and practice similar lifestyles like those who have been infected. It is only chance that some of us are not infected and therefore, we should change and improve our behaviours to sustain this golden status.

I am quite sure that raising the topic of HIV/AIDS will not be welcomed by some African readers, as I have often heard that the issue shouldn’t be discussed as if it existed only with us. Let’s not get it wrong here: AIDS is NOT an African problem, BUT, the economic and social burden of AIDS lies disproportionately in Africa. The reality is that the bulk of the problem and the negative impact of the pandemic seem to be with us, right in our towns, villages, streets and maybe our homes. If we are to wait for a response from the international community, commensurate with the problem, we will be waiting forever.

A quick look at the recent statistics from the Joint United Nations Programme on HIV/AIDS (UNAIDS) Report of 2006 would be a good start.

· Globally, there are about 40 million people living with AIDS

· Two-thirds (63%) of those infected are living in sub-Saharan Africa

· In 2006, there were 4.3 million new infections globally

· 2.8 million (65%) of these new infections occurred in sub-Saharan Africa

· Globally, 2.3 million children (under 15 years) have AIDS. Of these, about 90% of them are in Africa.

· Over 85% of about two million HIV-infected pregnant women live in sub-Saharan Africa. If these women fail to receive antiretroviral drugs (ARVs), between 20% and 45% (340,000 - 765,000) of the infants may get the virus during pregnancy, birth or by breastfeeding. That would translate to about half a million new children infections in Africa.

· AIDS among other things have reduced sub-Saharan African life expectancy at birth to 47years (a massive 30years difference when compared to rich nations of the world like Canada, U.S.A. etc).

The world should act and act fairly! ARVs are freely distributed in most of the world’s top countries, yet dying Africans can’t get it! It is indeed heartbreaking. With such alarming statistics, there is every reason for concern as an African. AIDS is closer to us than we can ever imagine, and so, we must make efforts to see a decrease in the growth and spread of the pandemic in our dear continent and around the world. We, Africans must save our own Africa. Perhaps then the world will look to us for advice as to how to deal with their problems.

While we are not disputing the fact that Africa lacks enough access to ARVs, we on our part can contribute to overturn this trend.

Here’s a couple of things that Africans (of course, the rest of the world, as well) should do in order to support and win the fight against the disease.

1. HIV/AIDS Test and status confirmation:
A lot of the HIV positive individuals are not even aware that they have the virus, mainly because they have not been tested and also because they look apparently healthy. Studies have shown that less than one percent (1%) of the sexually active population in our urban settings in Africa have been tested and this proportion is even less in rural localities. A reason for this obviously low figure is the lack of access to the testing facilities especially in rural areas. With regards to the test, I am aware of certain concerns and worries that are often attached. The greatest barrier to testing among young people is fear: fear of a positive result and fear of eventual stigmatisation.

Africans/persons living in western cultures where there is access to testing facilities should make good use of the opportunity and know their status. This would aid them in reaching life saving decisions and adhering to a protective sexual behaviour that would sustain the enjoyed negative status or otherwise avoid infecting others, if already positive. In most AIDS Help agencies in the western world, the test is usually free and the process can be anonymous (meaning that no personal information about you will be taken). Again, if the result is positive, there exist free treatment and support. Please, consult your doctor, for further advice and counselling on how to go about this.

2. Help fight the Stigmatisation
For infected individuals, the pain from stigmatisation and societal ostracism is often worse than the disease itself. Having had a good knowledge of the pathways of HIV/AIDS transmission, we should avoid isolating infected individuals from the society. Today’s battle against HIV/AIDS in Africa is in fact led by people living with the virus themselves, as they try to make their communities aware of the disease and assist others living with the diseases. We know that one cannot get infected from socialising, sharing public places, eating from the same table, shaking of hands, etc., with infected persons. And always remember, the HIV-positive individuals did just what some of us are currently doing today. It was only by chance that they got infected. Rather than neglecting them, let’s show them love, care and support and we should seek assistance and empowerment from them in order to win the fight.

3. Abstinence
Since religion plays a strong role in our society, our religious beliefs and leaders have always seen this as a good way to go, until marriage. It is a good thing if we can be disciplined enough to practice this, but where this is impracticable, please, see the next tip as a way out.

4. Practice Safe Sex
Learn to always use a condom. In this way, you can save yourself and the lives of many others.

5. Male Circumcision
The World Health Organisation (WHO) has recognised this as an important intervention in reducing female to male transmission of HIV. This should be practised as it has proven to provide a partial protection. It is however pertinent to state that male circumcision does NOT provide complete protection from HIV infection.

While these tips are not an exclusive list to solving the world’s AIDS problem, I think if practised, it will go a long way in combating the disease and checkmating its rapid spread.

The overall purpose of this paper is in two folds:
(A) On one hand, this is a call on our African leaders, international governments, pharmaceutical companies and organisations. We demand universal access to HIV prevention, treatment, care and support. We demand prioritisation to the AIDS dilemma in Africa. We demand action. Enough of papers and talking! The UNAIDS Director, Dr Peter Piot recently reiterated this when he said “We are well into an important phase of the global response to AIDS in which deeds and results count more than statements or speeches”.

(B) To my fellow Africans, let us open our minds to the fact that we have a major role to play if the trend must be reversed. Stigmatization in Africa with regards to AIDS is even worse and more deadly than the disease itself. We have to change the perception. Let us see AIDS victims like one of us.

Finally, this is an appeal to Africans, the world over. Like Mahatma Gandhi rightly said, “you must be the change you want to see in the world”. Let us put our hands together to reduce the spread of the virus. It is our Africa, let’s save it!

Oghenowede Eyawo(photo),is a graduate student in Population and Public Health at the Faculty of Health Sciences, Simon Fraser University,Burnaby, Canada. E-mail: oea1@sfu.ca