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Southern Region: In death’s face there’s a ray of hope
Moyiga Nduru, Inter Press Service News Agency
July 28, 2004

http://www.ipsnews.net/africa/interna.asp?idnews=24724

In death’s face there’s a ray of hope

Strong leadership, access to life-prolonging drugs and reducing infections will be the main challenges facing southern Africa in the next decade, AIDS campaigners say.

Southern Africa is currently at the epicentre of the HIV/AIDS epidemic. Around 70 percent of people living with HIV are in sub-Saharan Africa, with the majority of them in the 14-nation Southern African region, according to the United Nations Joint Programme on HIV/ AIDS (UNAIDS).

In Botswana, Lesotho, Malawi, Mozambique, Namibia, South Africa, Swaziland, Zambia, and Zimbabwe, at least 18 percent of the adult population is infected with HIV, says UNAIDS. South Africa, with an estimated adult prevalence rate of 21.5 percent, has the largest number of people living with HIV/AIDS in the world (5.3 million). Meanwhile, its tiny neighbour, Swaziland has the highest prevalence rate in the world (38.8 percent), followed by Botswana (37.3 percent), says UNAIDS.

These challenges demand a strong leadership, say campaigners and policy makers. But U.N. Secretary-General Kofi Annan stressed that leadership, in the fight against HIV/AIDS, also comes from within the family. ’’Leadership comes not only from those who hold positions of power. Leadership comes from partners who make sure they always use a condom,’’ stressed Annan at the opening session of the 15th International AIDS Conference in the Thai capital Bangkok, on Jul. 11. Added the U.N. chief: ’’ Leadership comes from fathers, husbands, sons and uncles who support and affirm the rights of women.’’

Annan also pointed out that leadership meant freeing boys and men from some of the cultural stereotypes and expectations that they may be trapped in. The belief that men who don’t show their wives ’’who’s boss at home’’ are not real men; or that coming into manhood, when one is 13, means having sexual initiation with a sex worker, must be dispelled, he said. Annan also said that leadership meant respecting and upholding the human rights of all who are vulnerable to HIV/AIDS - whether sex workers, drug users, or men who have sex with men. That includes their right to treatment, if they are infected, he said.

Across the southern African region, people living with HIV/AIDS have provided leadership in the campaign against the pandemic. One such campaigner, Zackie Achmat, who is living with HIV, chairs the activist group Treatment Action Campaign (TAC). Achmat protested government negligence and refused to take life- prolonging drugs until it is affordable for all South Africans living with the virus.

Achmat’s campaign and determination prompted former apartheid-era president F.W. de Klerk to tell foreign journalists in South Africa’s commercial hub, Johannesburg, in March that without the TAC pressure the government would have continued to drag its feet over the life- prolonging anti-retroviral drugs (ARVs).

Antiretroviral drugs are substances used to kill or inhibit the multiplication of retroviruses such as HIV.

Similarly, in Zambia, campaigners like Winstone Zulu have filled the leadership gap. Nelson Mandela, former South African President, who admitted having been diagnosed with TB while in prison between 1964 to 1990 for opposing apartheid, shared a platform with Zulu in Bangkok. ’’There have been so few TB survivors who have stepped forward to share their stories. We need more advocates like Winstone to tell the world about TB and the effect it has on so many millions of people,’’ Mandela said.

The other challenge facing the sub-region is access to ARVs. Only 400,000 people in sub-Saharan Africa, or less than one percent worldwide, are on ARVs. Right now, at least 2.8 million people need ARVs in Africa, with the majority of them in southern Africa, Omokhudu Idogho, a medical doctor with Action Aid, an international charity, told IPS. ’’Apart from South Africa, most African countries do not have manufacturing capacity. The pharmaceutical industries in Europe or America don’t feel the need to produce mass drugs for Africa. Unless we move fast, we are going to lose a lot of lives,’’ Idogho warned. He said the cost of ARVs has dropped from 2000 dollars in 1998 to 30 dollars in 2004 per month. ’’This is a major benefit to Africa,’’ he said.

But this amount is still too high for Africa where 350 million, or half the continent’s population, lives below the poverty line of one dollar a day, according to the World Bank. Worldwide only seven percent of the five to six million people needing HIV treatment had access to ARVs by the end of 2003, according to UNAIDS. Without access to treatment and if current infection rates continue, 60 percent of today’s 15 million year olds in Africa will not reach their 60th birthday, the U.N. agency warned.

This challenge will fall on civil society to provide leadership and pressure their respective governments to roll-out drugs to reduce the rate of infections in southern Africa. So far, most southern African governments insist on the so- called ABC --’Abstinence’, ’Be faithful’ and if you can’t, then use ’Condom’ philosophy.
Campaigners say this is not practical, as no one will willingly abstain from sex.

Another challenge facing campaigners is the growing number of AIDS orphans. In Africa, an estimated 12.3 million children have been orphaned by AIDS, with the majority of them in southern Africa, according to UNAIDS. Most of the orphans are looked after by grandparents. ’’Extended family’s capacity is overstretched. If parents’ lives are extended - through ARVs - the issue of orphans will diminish,’’ said Caroline Sande-Mukulira, who is in charge of the HIV/AIDS programme for southern Africa at Action Aid.

But Idogho - who interprets the acronym AIDS as ’Africa is Destined to Survive’ - urged the continent not to lose hope. ’’AIDS is going to wake us up. It’s going to strengthen us. And as a continent it’s going to move us forward.’’ He added: ’’AIDS has made Africa to look at gender issues. AIDS is also making us to challenge patriarchal system. Without AIDS all these wouldn’t have happened.’’

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