THERE is no comparison between the bafflement of 14th-century Europe about the Black Death and the world of the 21st century, which knows the cause of AIDS and how to limit its spread. Today there is little excuse for contracting HIV, just as there is no excuse for not treating AIDS.
Treatment and mortality rates for HIV/AIDS differ so dramatically between first-world and developing countries that it is tempting to see the pandemic as two diseases. That is a mistake. Persistent failures in stopping its transmission in the rich countries demonstrate that in all parts of the world, prevention must be pursued with equal vigour.
But what does prevention entail in light of the relentless increase in HIV infection rates despite calls for sexual abstinence, monogamy and safer sex?
In KwaZulu-Natal the incidence of HIV/AIDS has recently reached 40,5%, and the virus continues to spread fastest through the economically productive segments of the population. Statistically, sexual transmission will continue to increase unabated, with other modes of infection playing a much lesser role. Prevention, as we traditionally understood it, needs an overhaul.
I have always believed that HIV/AIDS cannot be fought successfully without shoring up developing countries’ capacity to sustain themselves. That means working to keep people alive and healthy for as long as possible so that they can help to raise children and hold society together. It is a matter of saving lives now in order to save more lives later.
Allowing HIV infection to turn into “full-blown”, symptomatic AIDS must not be an option. It is more expensive to treat complications of AIDS than to prevent them with antiretroviral therapy. Antiretroviral medicines have shown remarkable results. With scientific progress, their efficacy is improving, side effects diminishing, and the complexity of daily dosage is decreasing.
The other key component is to provide clear and uncluttered political leadership. In dealing with national issues of this magnitude, I entirely subscribe to former US president Theodore Roosevelt’s depiction of the presidency as a “bully pulpit”. In a similar way, the fight against HIV/AIDS resembles another former US president Jimmy Carter’s concept of a “permanent campaign”.
As far back as 1986, President Yoweri Museveni responded to the emerging HIV crisis in Uganda swiftly, embarking on a nationwide tour to tell people that avoiding AIDS was a patriotic duty, and that they should abstain from sex before marriage and then go on to remain faithful to their partners and use condoms.
By 2000, the government began to “mainstream” HIV/AIDS issues in Uganda’s poverty eradication action plan. Consequently, UNAIDS estimated data indicates that national HIV prevalence had fallen from 30% to around 5% in 2001.
Similarly in Botswana, the success of its bold and standard-setting programme to offer, in conjunction with the international drugs companies and the Bill and Melinda Gates Foundation, treatment with lifesaving drugs to every citizen with HIV/AIDS followed President Festus Mogae’s warning that his nation faced “extinction” unless the epidemic received the appropriate public policy interventions.
Likewise, SA requires the same kind of leadership to cut through the prevailing stigma about HIV/AIDS and gender identification. References to HIV and AIDS are too often buried, or bracketed with other problems in keynote speeches and public documents. Whilst this may not be technically improper, the gravity of the crisis is inevitably obscured.
In his state of the nation address in February, President Thabo Mbeki described SA’s HIV/AIDS prevention strategy as being comparable with anywhere in the world. But as I pointed out in my response, we are not facing a comparable situation. The prevalence rate in SA is without precedent. A Herculean effort is needed to construct a national coalition against AIDS. We need to walk that extra mile.
One of the major challenges for any leader is to find a language; an alphabet or narrative, in which to couch one’s campaign. We must not talk, for instance, about “AIDS orphans”, thus further stigmatising children who have experienced anguish they should have been spared.
As is well documented, poverty, abuse and violence, lack of access to information, and men having multiple sexual relationships are trapping women in a gigantic web of infection. There needs to be a transformation of the relations between women and men at all levels of society.
Who better than our leaders can agitate to free boys and men from the cultural stereotypes that entrap them? It is not manly for men to show their girlfriends and wives “who is boss” or for boys to experience their first sexual act with a sex worker at the tender age of 12 or 13. It is manly enough to afford women freedom to control their sexual relationships.
This is cache, read story here
