HIV/AIDS: 'Together we can do something about it'
Yesterday was World Aids Day. The previous week and the rest of this week is being used to focus global attention on the pandemic and what we all, rulers and subjects, victims and carers, local, national, regional and international actors can do to fight the scourge. Africa, as the continent with the largest number of infected people is rightly getting a lot of attention. 25 million people (almost half of the global total) across this continent are living with the killer disease which has not even peaked in some of the worst affected countries like Botswana, who have an almost 40% infection rate. The gender impact of the disease, the class burden and demographic distribution is even more devastating, with at least one in six children affected. Meanwhile the daily death rate is mounting.
Whatever one's view of statistics, its uses and abuses, the stark truth is that our peoples are dying and dying in great numbers and doomed to die in greater numbers and we have to (and can) do something, something very drastic, to arrest the situation. There is no point arguing about how the disease arrived or quarrel with the apocalyptic scenarios. While the arguments may be useful to historians of science and medicine and academics they do not address the problems at hand. Our people are dying.
The sad truth is that the situation is not hopeless; it is reversible. While there may not be a cure there is enough progress in science research and medicine to stem the rise, prolong the lives of infected people and provide even more information on various preventive measures. What is making Africa and Africans more vulnerable than other peoples is a combination of ignorance and poverty. The situation is not limited to Africans on the continent. There are alarming reports about the rapid spread of the disease among Africans in the diaspora, especially African-Americans and in particular African-American women.
It is not all bad news across Africa. A country like Uganda has a deserved image globally as a country which has shown openness and innovative local and national leadership in confronting the disease. But even Uganda's positive record for many years risks being undermined by complacency. If you have a winning formula why change it? This may be contributing to an atmosphere one concerned HIV/Aids activist described thus: “One hundred percent HIV/Aids awareness, Zero % Sex education.”
People who know enough (and some believe know too much ) about the disease take whatever care they can but in some sections of the population the law of diminishing returns may be setting in and even fatalistic attitudes (‘this thing will kill all of us’) may substantively drive the deadly curve up again. Thus more concerted efforts need to be continuously embarked upon to warn people that HIV/ADS remains real. Until there is a cure or effective vaccine everybody is still vulnerable. The fear about Uganda's continuing success in confronting the disease centres around more creative communication methods with vulnerable social groups (especially in rural areas, women and the Youth), prospects for universal access to cheap (if not free) anti retriovirals and relentless educational campaigns. There is also an unnecessary dilution of the message in the secondary argument imported from the neo-con religious right in America and other fundamentalists across the world about ‘abstention’ . The argument is not either or but effective education on all forms of preventive measures and safe sex including the active but culturally sensitive promotion of the use of condoms.
Many other African countries are unfortunately in various stages of denial. While every country now has one form of national campaign strategy or the other the full impact of the threat posed by HIV/AIDS is not generally appreciated, therefore the fundamental lifestyle and behavioural changes needed are not being addressed systematically. For instance, in many countries in the West African region the use of condoms is still resisted for many reasons including convenience, reactionary cultural attitudes and general ignorance.
Talking to educated people (who should, theoretically, know better) many of them in NGOs, academia, media, public institutions and local elite in their communities I discover an alarming mountain of ignorant complacency. Some of them have inverted tired racist arguments about the origins of AIDS by concluding that as long as they do not mess around with white partners they are safe! Yet I look in the newspapers and see death notices of many big people and the not so big who died ‘after a long illness’ or ‘heart attack’ or ‘high blood pressure’ or ‘pneumonia’ or ‘malaria’ or ‘short illness’ or ‘hypertension’ and my mind races back to similar coded messages in Uganda many years ago. And I wonder if all of these deaths are due to the stated public reasons or could be AIDS-related complications.
It took many years for even countries that are Uganda's neighbours to come out about HIV/AIDS. Kenya for instance thought admitting HIV/AIDS may affect its tourism trade. Actually, not so long ago a prominent politician who shall remain nameless died almost certainly of Aids-related illness. But both the public and high level political burial could not disclose the reason even though media speculation went close enough to suggest this was the case. Even in Uganda public disclosure about ‘big people’ is not common. There are many issues involved including stigma against the widows left behind, orphaned children and the right to privacy of affected peoples both living, dying and the dead.
The first task in confronting the disease is combating the mass ignorance that still surrounds the disease and associated social stigma that makes it extremely difficult for people suffering and living with the disease to admit it and seek necessary treatment. This will require both public and community leadership to raise general awareness that can turn the disease away from ‘death sentence’ to ‘can live longer’ hope. The second task is the poverty that makes poorer and marginalised peoples (especially Women, Youth and the majority of our peoples in rural areas) more vulnerable in terms of access to information and anti retriovirals and prevention programs. But addressing poverty and access issues alone will not deal with the problem fully. Even the relatively rich who have the money or middle classes who have easier access to the available medicines need the power that existing knowledge and available technology can afford them to appreciate that they need not ‘die of ignorance’. HIV/AIDS is real, knows no social boundaries and threatens all of us but together we can all do something about it.
* Dr Tajudeen Abdul-Raheem is General-Secretary of the Pan African Movement, Kampala (Uganda) and Co-Director of Justice Africa
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