AIDS in Africa
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HIV-AIDS has infected over thirty million people in the world. Over 95% of all AIDS cases in the world are in Africa and in some of those countries over 40% of the people are infected (Frederickson and Kanabus HIV and AIDS in Africa 1). AIDS does not solely affect homosexuals, or any certain ethnicity of people, either; HIV-AIDS can affect any type of ethnicity including African Americans, Caucasians, Asians, Indians, and Hispanic people. AIDS cannot be reversed or cured, but with proper treatment this deadly virus can be controlled and people can live a nearly normal life. In Africa, though, proper treatment is not nearly as available as it is in some other countries. Approximately 2.3 million people died in 2003 in Sub-Saharan Africa alone and that is only the beginning (Frederickson and Kanabus HIV 1). Because of AIDS and its devastating effects and increasing infection rates in Africa, organizations and governments are increasing their efforts to stop this disease. Hundreds of millions of dollars have been spent on AIDS efforts, but still the disease continues to spread and take thousands of people?s lives each year.
In 1992, 20% of Botswana, Africa was infected with HIV-AIDS. In 1995, 1/3 of the country was infected. Today over 40% of Botswana is infected with HIV-AIDS, and these numbers continue to increase (Epstlen 70). The rest of Africa is mimicking these same numbers as infection rates continue to rise. Of the 27 million infected in Africa, 3.2 million were new cases diagnosed in 2003, and over 2.3 million people died in Africa because of HIV-AIDS last year (Frederickson and Kanabus HIV 1). Such numbers are astronomical compared to the rest of the world. In the United States less than 1% of the population is infected; in Russia and India the numbers also match the United States. In Thailand, where it is claimed to be more corrupted in sex and drug trades and have even fewer anti-AIDS efforts than in Africa, the infection rates are still less than 2% (Frederickson HIV 70). Sub-Saharan Africa is the worst region to be infected with AIDS. While countries like Swaziland, Botswana, Lesotho and Zimbabwe all have infection rates reaching near 40%, West African countries barely top 10% in some places (Frederickson 2). In Sub-Saharan Africa, 11 million children have been orphaned by AIDS (Frederickson AIDS orphans in Africa 1). Of the 27 million people infected, 10 million are between the ages of 15 and 24, and 3 million are estimated to be under the age of 15 (Frederickson HIV 1).
In Francistown, Botswana, nearly half of all pregnant women in the main hospital tested positive for HIV. These pregnant women will give birth to children who will have as much as a 90% chance of contracting the virus from their mother (Epstlen 70).
The high rates of infection come despite efforts in many communities to conquer the HIV epidemic through educational programs, condom distribution and treatment for sexually transmitted diseases. Sexually transmitted diseases like gonorrhea and syphilis create ulcers and genital sores that make it easier for the HIV virus to spread. In most places, these efforts have had little effect and have forced AIDS experts to reconsider old theories they had about how HIV spreads in Africa.
Most HIV-positive Africans are believed to be injecting drug users and prostitutes, but they claim to have never used drugs before and also claim not to have had multiple sexual partners. Some scientists have theories based upon HIV infection rates compared to nutrition, and others fall back on the theory that people in Africa simply have more sexual partners than people elsewhere. Some studies show that Africans have more than one sexual partner, but it is not enough to clearly explain the number of infections. Some places in Africa, like Zimbabwe, where thirty-three percent of adults are HIV-Positive, most people had one to three sexual partners within a year. Most assume that prostitutes could have over a hundred sexual partners in a year, but most HIV-positive Zimbabweans were not prostitutes.
Dr. Martina Morris, a former member of the Sociology and Public Health Department at Columbia University, is now a Professor of Sociology and Statistics at the University of Washington in Seattle (Epstlen 73, 74). Dr. Morris, in 1993, flew to Uganda to gather data on sexual behavior between HIV positive Africans. Dr. Morris helped devise a computer program to predict the spread of HIV-AIDS in a given population based on factors such as the number of sexual partners people had and the duration of those relationships. She then conducted similar surveys in Thailand and the United States, but did not get similar rates compared to Uganda. Dr. Morris found that the average male in Uganda and the average male in the United States claimed about the same number of sexual partners in their lives, but these rates of sexual partners did not result in similar rates of infection. In Uganda, infection rates were estimated at 18%, while in the United States rates never exceeded 1%. In Thailand, where over 65% of men reported 10 or more partners, the infection rate was just a little over 2%. Men in Uganda claimed to have maintained 2 or more long-term sexual relationships at once (Epstlen 70).
Dr. Morris also conducted a survey at a bar where approximately 15 people, mostly men, sat on tree stumps drinking beer. She approached a group of 3 young men and asked if they would answer some questions. One man told her, after she had asked, that it would take him approximately 15 days to use about 10 condoms. He also told her that he had 3 girlfriends, 1 open relationship, and the other 2 were secret. He said that most men did about the same and that he only used condoms with the secret girlfriends, but not with the real one. The man said that he used the condoms on the secret girlfriends, because ?a man can never trust women and that they probably have secret boyfriends themselves?. Most women that Dr. Morris questioned said that they have never had any other partners other than their husbands or fiancés. From her research, Dr. Morris came to the conclusion that sexual contact with a prostitute who has HIV-AIDS is not as bad as being in a long-term relationship with someone who has HIV-AIDS. It is believed that the likelihood of contracting HIV-AIDS during sex to be as low as one in one hundred to one in one thousand. If a man has sex with hundreds of different people, it is estimated that only one of them will contract the virus from him. However, having sex continuously with the same person, as in a long-term relationship with someone with AIDS, is more likely that they are to contract the virus (Epstlen 73, 74).
Infection of HIV-AIDS varies with the concentration of the virus in the blood: The more virus there is, the more likely it will contract into the genital fluids and be passed on during sex. Estimates also suggest that a person who has recently been infected with HIV-AIDS may be as much as a hundred times more likely to transmit the virus to a partner than someone who has been infected for some time (Epstlen 72).
During the first few weeks and months after infection, a person?s blood teams with the virus. The immune system produces antibodies that attack the HIV virus, fighting the disease off but not becoming immune to it. The HIV virus may remain low for years, flaring up only when the person?s immunity is low due to other illnesses or diseases. It is then that the symptoms appear and if not treated within adequate time, victims of the virus could become very sick and die. Without proper treatment nobody is guaranteed a very long life and in Africa this is usually the outcome. (Epstlen)
To conquer the outcome of the increasing eleven million orphaned children in Africa, the HIV-AIDS virus must first be under control. Four of the ten worst infected countries in Africa: Botswana, Malawi, Zimbabwe and Zambia, are starting efforts to protect orphaned children. In Botswana, the government encourages communities to help care for children that have been orphaned by offering their homes to the children, and turning to institutional care only as a last resort (Frederickson and Kanabus AIDS Orphans in Africa). The cost of caring for children that have been admitted into institutional care is between three and five hundred American dollars yearly. This is three times the average annual income of one person in Africa (Frederickson AIDS 1). Unfortunately institutions have their shortcomings. Siblings are often split up and overpopulation contributes to lack of proper treatment and care for the children (Frederickson AIDS)
Most orphaned children are not as likely to stay in school; in Kenya, 52% of orphans with HIV-AIDS do not attend school (Frederickson and Kanabus AIDS). Without any proper education and the assumption that they have HIV-AIDS themselves, children are usually shunned, forced into prostitution or child labor. Also, children orphaned by HIV-AIDS are not adequately treated for illnesses because they are assumed to be infected with HIV-AIDS. People believe that they will die anyway, and do not want to waste precious and expensive antibiotics on them (Frederickson HIV).
In 1999, Botswana established a National Orphan Program to respond to the immediate needs of orphaned children. Some of the services that they provided are to review and develop policies, build and strengthen institutional capacity, provide social welfare services, support community-based alternatives, and to monitor and evaluate activities. So far, this program has been highly successful and continues to help the needs of orphaned children in Africa (Frederickson HIV).
Unlike many countries where government AIDS programs have become obsolete; countries like Botswana and Nigeria are out to fight the virus until they are able to conquer it. Anti-AIDS banners and flyers are everywhere; news about the epidemic appear everyplace you look, including the newspapers and radio, and free condoms are available almost anywhere too, including remote clinics, bars and shops. Botswana?s was the first African government to offer free treatment with antiretroviral drugs (Epstlen). Despite all of the efforts that have been powered forward to educate and treat AIDS victims, very few signs of actually surpassing this epidemic have been shown. Botswana?s government, like many African governments, has been heavily influenced by western donors. These donors have spent billions of dollars on promoting condoms, but have placed very little emphasis on advising people to have fewer sexual partners. Condoms, on average, fail ten percent of the time due to breakage and human error, contributing to the increasing pregnancies among HIV positive women (Epstlen). Most people use condoms early in a relationship, but as a signal of trust, stop using them. In Uganda, where the slogan of the government HIV programs was ?zero grazing,? HIV rates fell from 18% to 6% today, and the number of sexual partners fell from 35% to 15%. Uganda also has one of Africa?s oldest, most vigorous woman?s movements, dating back to the 1940s (Goering 1). Like the HIV-AIDS fights in the 1980s by gay men, which had a rapid decrease in infection rates as their activism gained strength, the fight against HIV-AIDS in Uganda has done the same. In 2000, Nigeria was able to provide life extending AIDS drugs to those who needed them. They could only provide for 10,000 people and this treatment plan only lasted a year due to the lack of funding (Donelly 1). This is an example of how very helpful AIDS treatment programs are in the beginning but are not able to continue to provide to people who need them due to the lack of funding. ?Many African countries are going to have these problems because of the sheer numbers of people crying out to be treated,? says Dr. John Idoko, chief medical consultant for Nigeria?s AIDS treatment plan. ?If we have a problem with 10,000, consider what will happen with 100,000 or 200,000 (Donelly 1).? The treatment had cost the patients 1,000 naira, or about 7 dollars a month. Dr. Idoko?s clinic offered drugs for 14,000 naira, or roughly 93 dollars a month ? a cut rate from the lowest generic prices on the market of about 300 dollars a month, but still too expensive for most (Donnelly 1).
Another effort that helps HIV-AIDS victims is Patches for Hope, which provides medications for HIV-AIDS victims in Cambodia. They also provide hospice care, clinic visits, rent, and food programs for approximately forty-five to fifty woman living with HIV-AIDS who are below the poverty level. The women who contribute to this effort make patchwork quilts and sell them, donating all of money made to help the lives of others (Gitobu 1).
To contribute to the efforts to help control HIV-AIDS the government will now allow private pharmaceutical companies to sell antiviral drugs on the international market as long as they conform to the National Drug Authority guidelines. Generic drugs cost just one-forth as much as name brand drugs. This would make AIDS drugs more affordable to more than thirty million people in the world. Brand name pharmaceutical companies strongly oppose the use of generic drugs, ?mainly for safety reasons (Lueck 1).? President Bush pledged last year to spend fifteen billion dollars over the next five years on AIDS in Africa, saying they must choose a path of direction by fall of 2004 at the latest. The immediate question is whether the treatment programs in Africa will be able to use U.S. funds to buy the generic products to use in the combo treatment. The combo treatments, a treatment of two medications, Triomune and Triviro, lack approval from the FDA, but have won the backing by the World Health Organization. While WHO isn?t a regulatory body, it set up a process to review the combo generics that include evaluations of the drugs safety and quality by regulatory experts from Canada, Europe and Australia. ?You can?t just mix them together and put them on market? says a PhRMA spokesman (Lueck 1). ?You have no idea how it?s going to work in tandem. You need at least a years worth of clinical trials and testing.? On the other side, though, Dr Dybul, Deputy Chief Medical Officer of US Global AIDS, says, ?Our prediction is to use them if all possible, [SIC] the activists should be jumping up and down shouting ?hallelujah,? this is a major movement in international health? (Lueck).
?Donor nations, including the United States, have stepped up funding for HIV treatment, offering new hope for tens of thousands who until now had no treatment options (Goering 1).? The new, cheaper drugs are expected to extend AIDS sufferers? lives up to five to eight years: For some parents, long enough to raise their children. It is expected that thousands on disability should become well enough to return to work (Goering 2).
As the Africa government, along with the help of other countries governments, the war against HIV-AIDS will strengthen and one day this disease will be conquered. Until then, however, people will have to overcome their fears of people with this deadly disease, and understand the only way to overcome it, is to help them. ?It is believed that only one in ten infected Africans have been diagnosed with HIV-AIDS because these people are shunned by even their own families and because finding out has long been tantamount to being a death sentence (Goering 2).? Effective, affordable AIDS treatment, everyone hopes, will begin to reduce the stigma for people with HIV-AIDS and will for the first time provide an incentive for millions to step forward and be tested. People with AIDS who were shunned and made fun of felt that they could do nothing else but hide and wait to die; now with effective and affordable drugs and care efforts to help them, these feelings should disappear.
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