Understanding the AIDS Epidemic in Africa


Wendy Cross

Another World AIDS Day has come and gone. This day serves as a call to action to remember the millions of people in communities all around the world that are affected by HIV and AIDS.

However, AIDS weighs on my mind far more than once a year. It wasn’t until four years ago that I even knew a person who had been impacted by AIDS. I had heard all of the statistics. I knew the severity of the pandemic, especially in counties such as Swaziland and South Africa with some of the highest prevalence rates in the world.

But the severity of the disease and the broader impact on life in affected communities was beyond my comprehension. That was until 2006, when I traded in my comfortable Los Angeles existence working in TV commercial production for a one-year volunteer stint in a rural South African village. My new home at NextAid’s Community Center construction site was located in the rural township of Dennilton, Mpumalanga Province.

During my first year of living there, Dennilton had an estimated 30 percent HIV prevalence rate. This number, while astounding, still didn’t fully resonate with me until I was able to hear the stories of the locals who were shouldering the burden of a village ravaged by the disease.

NextAid’s pilot project in South Africa, where I was volunteering, was intended to provide a home to children and youth who had been orphaned by AIDS. While I was familiar with the term “AIDS Orphan”, the gravity of these children’s reality was not really fathomable to me until I found myself living among ten or so children who had lost one or both parents to “the disease”.

One heartbreaking story after another is the reality of life in Dennilton during the time of AIDS. One boy, at age 11, had to take his mother to the hospital in a wheelbarrow where she later died. Ambulances and even regular cars are beyond the reach of most. A family of young teenage girls were living as a “child-headed household” in order to care for their younger siblings.

Among these countless stories, one can’t help but wonder why? Why here? Why still? It wasn’t for lack of awareness about the disease. Upon driving into the town of Dennilton, you are bombarded by a series of odd roadside billboards. Each of these signs promotes HIV prevention through some quirky slogan and graphic. Dennilton had an advantage over many rural South African communities in that it had a government hospital as well as a non-profit community clinic focused on treating HIV/AIDS. This clinic was privately funded by Dutch donors and received U.S. government PEPFAR funding. Several community-based organizations, including NextAid’s local partner in the community center project, were active in addressing various aspects of the disease such as home-based care or school and church-based prevention campaigns.

As my year in South Africa went on, I asked a lot of questions in my attempt to understand why AIDS was so pervasive. I remember one of the first things that struck me about Dennilton was that there were more coffin shops than food markets in the town. Death was a booming business and in this town — it is easier to buy a tombstone for a family member than to shop for nutritious and life-sustaining food.

Many of these examples reflect a system that promotes short-term, welfare-based solutions to a much bigger problem. I don’t claim to have all the solutions, but I do know that if girls and boys received quality education and knew that there would be opportunities for decent jobs in their adult futures; and if women felt empowered to stand up to men; and if there were more ways for people to access nutritious food and be economically self-sufficient, we would be a lot further in tackling the AIDS pandemic in a holistic and sustainable way.

But no singular approach is sufficient for the magnitude of this disease. Without simultaneously working to uplift the community with empowering opportunities such as education, income-generation, and sustainable agriculture, all the billions of dollars from government and private donor funds will not be as effective as they need to be.

Decades from now, maybe and hopefully, AIDS will be an obsolete topic. But if we don’t focus our efforts now on addressing root causes such as poverty and lack of education that are risk indicators for HIV/AIDS in developing countries (and in the U.S.), there will likely be another disease that will disproportionately affect the most disadvantaged populations.

It’s not too late to do something this year. NextAid commemorates World AIDS Day all month long throughout December with a series of fundraising and awareness raising music events and an online campaign on Twitter and Facebook. For more information go to www.nextaid.org/wad2010 .

Wendy Cross is the Program Director for NextAid, a Los Angeles-based NGO
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Text messaging to combact malaria

Mobile phones could soon be helping re-assure Nigerians and Ghanaians they are getting genuine medicine.

Text messaging to combat fake pills
Text messaging to combat fake pills

A pilot scheme in the two nations has begun putting unique scratch codes on more than 500,000 medicine bottles and packets of pills.

When the code is texted to a free phone number, a return message will reveal that a drug is genuine.

The scheme hopes to boost efforts to tackle diseases such as malaria and combat the rise in fake medicines.

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About 700,000 people suffering from malaria and tuberculosis die every year around the world because of fake drugs, suggest statistics from think tank International Policy Network

Globally, about 10-15% of all drugs are believed to be fake but in some parts of Africa this rises to 50%. The problem is made more acute in Africa because some fake medicines being offered to the sick are watered down versions of the real thing and dent the efficacy of the full strength drug.

“Some genuine medicines have lost their potency because of the counterfeiting,” said Gabriele Zedlmayer, a spokeswoman for HP which is a partner in the labelling scheme.

Fake pills are a big problem in Africa where diseases such as malaria are endemic
Fake pills are a big problem in Africa where diseases such as malaria are endemic

This can be a particular problem with malaria as the disease is so widespread in sub-saharan Africa where it is the leading cause of death.

The scheme is being backed by governments and drug companies who have pledged to publicise how it works in pharmacies, surgeries, hospitals and community centres.

Painkillers, anti-malaria drugs and amoebicides from pharmaceutical firms May & Baker in Nigeria and Kama in Ghana will be the first to get the scratch-off labels.

Such a scheme was very important in Africa where about 80% of medicines are generic, said Bright Simons, founder of mPedigree which developed some of the technology to underpin the pilot.

By using the codes, people would get to know pharmacies, hospitals and other outlets they can trust, he said.

Mobiles were the best way for people in Nigeria and Ghana to find out about their medicines because they were so ubiquitous said Mr Simon, adding that even those who do not own a handset themselves can get access via friends and family.

Each packet or bottle has a scratch-off code that can be used only once, said Mr Simons. The security system behind the scenes flags any attempt to re-use codes. As well as letting people know they are getting genuine medicine, it will also alert people when fake medicines are being peddled.

If the pilot proves successful, the scheme will be extended to cover more than six million bottles and packets in the next 12 months.

“This is just the first step,” said Ms Zedlmayer. “It can be applied to any kind of medication.”

(Story by BBC)

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Aggregated Health News

Malaria control ‘best in decades’, WHO

(AP) –

GENEVA (AP) — The World Health Organization says a massive malaria control program since 2008 has helped reduce infections across Africa and eradicate the disease in Morocco and Turkmenistan.

The U.N. health agency says the billions of dollars poured into the program have helped buy anti-malaria nets for almost 600 million people in sub-Saharan Africa.

It said this has contributed to a drop of over 50 percent in malaria cases in 11 African countries, and two-thirds of the 56 malaria-endemic countries outside Africa. Malaria cases, however, increased in parts of Rwanda, Sao Tome and Principe and Zambia.

S. African to double HIV patient treatment

(AP)

JOHANNESBURG — South Africa’s health minister says he has brought down the cost of HIV drugs by 53 percent, enabling the government to treat twice as many patients in the next two years.

Health Minister Aaron Motsoaledi said in a statement Tuesday that the government saved 4.7 billion rand ($689 million) by encouraging potential suppliers to participate in the bidding process, requesting a breakdown of costs from suppliers and monitoring price changes.

South Africa has the largest anti-retroviral distribution program in the world but pays significantly higher drug prices than other countries, Motsoaledi says. South Africa has more people living with HIV than anywhere else in the world, with 5.7 million of 50 million people infected

New UN partnership seeks to promote reproductive health in Africa

http://www.un.org

December 2010 – The United Nations has teamed up with the Millennium Villages Project (MVP) to promote universal access to reproductive health in sub-Saharan Africa, focusing mainly on young mothers.

The partnership between the UN Population Fund (UNFPA) and MVP will use the Project’s primary health-care provision strategy and the UN agency’s expertise to promote reproductive rights and sexual and reproductive health.

The MVP initiative seeks to reach the Millennium Development Goals (MDGs) – eight anti-poverty targets with a 2015 deadline – in African countries within five years through community-led development.

Infant mortality rates are almost double among women who have children before the age of 20, compared to mothers in other age groups, a factor that makes it necessary to improve maternal and child health by providing voluntary family planning, medical supplies, training and education among younger women.

The UNFPA-MVP partnership will help local governments to provide supplies to clinics and hospitals in Millennium Village clusters. It will also identify trainers for health personnel.

“We look forward to joining forces with the Millennium Villages Project to widen the availability of sexual and reproductive health services – including family planning, skilled birth attendance, emergency obstetric care and prenatal and postnatal care – across sub-Saharan Africa,” said UNFPA’s Executive Director, Thoraya Ahmed Obaid.

“This partnership will go a long way in saving the lives of more mothers, and allowing more families to enjoy a life of prosperity and good health,” she added.

Jeffrey Sachs, the Director of the Earth Institute, said: “Many programmes such as those in the Millennium Villages show that scaling up primary health systems in rural and remote areas plays a decisive role in reducing child and maternal mortality.

“It is partnerships like these that will make a difference and enable us to achieve Millennium Development Goals 4 and 5 in the toughest parts of Africa,” Mr. Sachs added.

MVP, a partnership between the Earth Institute at Columbia University, Millennium Promise, the UN Development Programme (UNDP) and governments, provides a new approach to fighting poverty.

Currently covering approximately 500,000 people, the Project has shown that an integrated package of development interventions, supported by a modest financial investment, about $110 per person annually over 5 to 10 years, can facilitate the achievement of the MDGs.

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