The fight against HIV/AIDS needs a pragmatic approach (update)

K. Amponsah-Manager

On December 14 2010, the World Health Organization (WHO), the UN agency which over ten years ago started a campaign to cut the number of malaria cases and deaths in half by 2010, reported that Malaria is fast declining in countries where it had been endemic. The report was surprisingly optimistic that we could have a malaria-free world by 2015!

The progress on the malaria front did not come by wishful thinking; it was the result of pragmatic efforts on the part of governments and various organizations. In the past three years alone, 578 million people at risk of malaria have been provided with insecticide-treated mosquito nets. Another 75 million have benefited from indoor residual spraying, the report said.

While such a report gladdens our hearts, it should also remind us of the twin brother HIV/AIDS.

 

Significant efforts have been expended in combating the spread of HIV with some results to show already. However, it is believed that what has been achieved is minimal compared to what is possible if the energy already spent was used to do the right thing most of the time.

There is the popular notion that HIV is caused by people doing stupid things, and some even think it is a curse for our disobedience of natural laws. Surely, there are some who are living with the virus as a result of doing stupid things, but that is just part of the story. In any case, such perception does nothing to save the millions who continue to contract the virus each year. Some of them are our brothers, sisters, uncles, and our teachers.

Rather than perpetuating the stigma associated with AIDS, I will suggest it is time we spend that energy to discuss how to curtail the rate of spread of the killer and save lives of mothers, fathers, and infants, some of whom have to live with the parasite for no fault of theirs.

There are practical ways that work and those are what we need to focus on. I’ll mention only two here for the sake of space.

Case 1: Sharing needles by drug users: The consequences of the use of illicit drugs on the health of our citizens and the effect it has on our economies and health care system are well known. The practice can therefore never be condoned or encouraged

But the reality is that people will continue to abuse drugs. Several studies have established that the sharing of needles by drug users is a significant avenue for contracting the HIV.

The approach here has to be two fold. The first is a continued education on the consequences of sharing needles which I believe is already well known. The second I think should be an effort on the parts of governments and foundations to consider providing accessible avenues by which the addicts can obtain clean needled when the lust for the substance is uncontrollable. They will continue to use the drugs anyway, but why should we look on while such acts continue to overburden the already stressed health and economic structures and continue to add to the AIDS statistics.

Case 2: Laboratory and epidemiologic studies have shown that even though condoms are not 100% HIV/AIDS-proof, the use of condoms in sexual intercourse reduces the risks of HIV infection significantly. We would wish that people will abstain from sex until they’re in a committed relationship, but the reality is that this approach will not work for all. The truth is that HIV is acquired by having unprotected sex with someone carrying the virus, and not just by having sex.

The massive campaign to encourage the provision and use of mosquito nets is yielding results with the possibility that we could have a world without malaria in less than a decade. It’s time to do same for AIDS.

The campaign to encourage people to stay away from sex until marriage or until they’re in a committed relationship should continue. However, this weapon will work for only a fraction of the population. It is time to be practical and tell people in a plain language that if you cannot abstain, then they should simply cover it.

 

Even though, it may be appear rather radical, I may suggest that Governments, Non-governmental Organizations (NGOs) and foundations working on HIV/AIDS in Africa should consider making condoms (both male and female condoms) available for free to prostitutes (at least, until a solution is found to the problem of prostitution).

Given the choice, I’ll rather opt to use our scarce national resources to do that which will produce tangible and measurable results.

To the toddler taking care of a sick single HIV/AIDS parent, the issue here is not just statistics, it is life.

Let us learn from the anti-malaria campaign.

You may also like this ‘Why African women are embracing the female condom’

(To learn more on Condoms and HIV, click here)

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By Kwabena A-Manager

Kwabena, is the founder of Give Back Africa Foundation, a non-profit dedicated to helping kids from underprivileged communities realize their potential. He is a scientist in Pharmaceutical Research & Development. To support his charity, please visit http://givebackafrica.org

6 comments

  1. thanks for discussion this here. I realize that to some people mere the mentioning of drugs, condoms, and prostitution is sin or taboo. but we cannot just pretend these problems don’t exist. we’ve have to deal with them practically.

  2. Thanks to all of you for your comments.
    First to Steve: I agree with you that it’s easier said than done, but we can devise a means for achieve that. That’s exactly why we vote for and pay policy makers. Also there’re 1000s of NGO and private organization already working with drug addicts. All that I’m saying is that making sure these folks have access to clean needles should be part of the comprehensive anti-HIV/AIDS strategy.

    Now Akpene: Sure, I’ll recommend a system that ensures that prostitutes have access to condoms, both male and female condom. Unlike the prostitute at Los Angeles, the prostitute at Nairobi , Harare, or Abuja makes almost nothing. Most of these folks are in a ‘profession’ that they dread day and night. The women, especially, are abused by the male customers and treated as nothing. I wish there were no prostitutes at all. But which is easier: Wiping prostitutes out of our cities OR providing an avenue by which they can protect themselves and hence hundred of people?

    Again, thanks to both of you for joining the conversation

  3. Hi Steve,
    Yes, that exactly what I meant. let us remember that the drug addict already presents a burden to our economic and health-care system. Imagine what the weight of this burden will be if the addict contracts HIV/AIDS in addition. I will say that living with the drug problem alone is better than adding on AIDS.
    And it doesn’t have to be governments distributing needled to drug addicts. The NGOs and the foundations working on AIDS will need to model how they can tackle AIDS from this perspective also.
    I can see why a lot of people will disagree with me. It appears radical. But imagine what the impact will be if the drug addict knows where to get a clean needle when his lust for the substance is uncontrollable as compared to sharing needled with other addicts.
    In any case, thank you for your comment. Please come back.

  4. I may disagree with you. Are you trying to say that we should use national money to buy needled for drug users? How on earth?

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