The ability to make an international telephone call or send a letter across the world is the direct result of long-established international agreements that set out rules for telephone traffic and postal systems. Since the end of World War II, international cooperation has played an increasingly important role in setting global rules for trade, dispute resolution, and technical compatibility. Globalisation is viewed by many as a threat to national identity, culture, and indigenous business. Yet more effective international cooperation may be the only hope for addressing the most critical problems the world faces today, including massive poverty, environmental degradation, and health crises. And these issues are inextricably tied up with socio-economic development on one level, and national security on another. The result is interdependence of national economies, and interconnectedness of national and international policy-making processes. All of this makes international policy more important than ever before.

Read the rest of this commentary by clicking on the link below. This is the beginning of a commentary that is part of the Collaboration on International ICT Policy for East and Southern Africa (CIPESA), a programme of bridges.org. This is one of a series intended to spark thinking and dialogue on important issues in the field. These short informative pieces give an overview of an international ICT policy issue relevant to African stakeholders, and stir discussion by presenting strong views and provocative questions. Readers are encouraged to respond to the points raised, via email or in the "comments" box under each commentary on the CIPESA website at www.cipesa.org/AfricansCareAboutICTPolicy.

Increased condom use and premature deaths from AIDS-related diseases might be playing more of a role in declining HIV prevalence in Uganda than abstinence and fidelity, according to a study presented at the 12th Conference on Retroviruses and Opportunistic Infections in Boston, US.

PAMBAZUKA NEWS No. 195’s Editorial on ‘HIV/AIDS - THE DILEMMA OF THE INEVITABLE’ by Kiiza Ngonzi, not only served as an ‘awaking bell’ for all of us Africans grappling with HIV/AIDS and its direct impact on our lives, but threw a real challenge to the strategies we are employing to combat a disease that is already devastating our populations.

Indeed, what a tragedy and an amazing puzzle it is that almost two and half decades since HIV/AIDS hit Africa, Africa continues to be devastated by this determined killer disease. In all our faces, HIV/AIDS is on the rampage, going about its business infecting and killing millions of Africans, old, young, pretty, ugly, big, small, rich, poor, educated, illiterate, urban, rural, professional, unprofessional at free will. To Africans HIV/AIDS seems so powerful that it has overcome our intellect and control, leaving us with our heads buried in the sand.

The impact of HIV/AIDS on our lives can hardly be over-estimated. By this time, there is hardly anyone in Sub Saharan Africa who has not been touched by HIV/AIDS. All of us know what it is to be afflicted by this dreadful disease, because if we have individually not been afflicted, we have had relatives, friends, or colleagues who have been directly or indirectly affected. We have seen it often enough since it killed its first victim in Uganda in 1979, and hospitalized its first patient in Zambia in 1982.

The impact on our social services is already real. Our hospitals are overwhelmed by the numbers of terminally sick and the dying, while our mortuaries and graveyards are littered with the dead.

The extent, magnitude, ravages and devastation of HIV/AIDS is best illustrated by the long term effects on our nations, reflected in the situation of African children. UNAIDS already estimates that there are as many as 11 million orphans in sub Saharan Africa, 1 million of whom are in Nigeria, 890,000 in Kenya and 780,000 in Zimbabwe. South Africa is expected to have up to 1.5 million orphaned children by 2010, while in Zambia 1.8 million children are increasingly vulnerable as HIV/AIDS continues to destroy the traditional family social safety net, causing massive school dropouts and chronic malnutrition.

The overall impact of HIV/AIDS on the African Continent is manifesting itself not only in reduced quality of human life, but dramatically reduced life spans, already believed to have dwindled to a low of 32-37 years of age, compared to an average of 57 in the post independence Africa of the mid 1970s, and 78 years of life in the Western World. This practically means that one has a period of 32 years in which to grow, acquire an education and life skills, develop a career, raise a family and contribute to national development before life terminates. How possible is this? Today, in most of our countries, every child born is assumed to have a significant chance of contracting HIV and dying of AIDS. HIV/AIDS has clearly become a national emergency in most of our countries

And yet HIV/AIDS is a behaviour disease and a human being can control its behavioral spread, and its infection. He/she can refuse to allow HIV into his/her body, and it will effectively stay away and if he/she is already infected, he/she can determine to live with it, hold a dialogue with it, talk to it, agree to accommodate it in his/her body, but ask it to give him/her time to live, to accomplish certain tasks, and together, they can plan to allow him/her to complete his/her career, plan for his/her children, build them a house. This is not possible with a motor or aircraft accident, heart disease, meningitis, cancer, TB, pneumonia, cholera, malaria, even child birth.

But perhaps it is not far fetched to say that the on-going status of HIV/AIDS in Africa is an indicator of a bigger and far deeper problem. As the saying goes, ‘the way you define a problem determines your ability to confront it’. The question is, ‘has Africa defined HIV/AIDS adequately enough to confront it head-on?’

Recently, ten 16-29-year old community outreach volunteers, comprising four females and six males with educational backgrounds of 6th to 12th Grades, spent two weeks walking about markets, schools, churches, streets, bars, taverns and restaurants of Mtendere Compound, one of Lusaka’s largest townships, trying to find out what ordinary community people thought and brought these findings:

1) Whereas most people talked to knew that HIV/AIDS is a killer disease that still has no cure, they had difficulty with its identity, its name, ‘HIV/AIDS’ (Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome), which they felt was in itself a contributing factor to its un-halted spread since it is too scientific and therefore, too complicated for the majority of ordinary people to understand.

This was believed to be the reason for a variety of configured nicknames such as Uganda’s ‘Slim Disease’, and Zambia’s ‘Long Illness’ or ‘Kangundende’, which sounded like mockery and ridicule and served to increase stigma. Many said that whereas they could clearly identify other diseases with symptoms specific to them, such as coughing blood in TB or sores on the genitals in syphilis, there were no specific symptoms for HIV/AIDS apart from a variety of so-called ‘opportunistic infections’. Consequently, a lot of people were confused and resort to associating HIV/AIDS with witchcraft, while many others have given up even trying, and resolved to leave ‘HIV/AIDS as a disease like any other, made and sent by God and that if God has determined that one will die from it, it will happen’; while others still said, ‘every one on earth has AIDS; if it is your day it is!’

2) The team further found that our current popular prevention and mitigation strategies against the spread and impact of HIV/AIDS such as ABC (Abstain, Be faithful, and Condomize) and VTC (Voluntary Testing and Counseling) were themselves greatly challenged since a lot of youths strongly believe that:

i) Sex has become just like a game among young people, ‘if you don’t practice sex, then you are left out with this world’;

ii) Condoms cause cancer;
iii) HIV/AIDS test accuracy is questionable. As one 19-year old woman expressed, ‘my brother tested positive at one testing center after testing negative twice at another centre.’;

iv) Rampant/indiscriminate alcohol abuse among the youth does not facilitate abstinence or safe sex;

v) Economic difficulties take far more precedence over a disease.

3) Some cultural/traditional beliefs/practices, many embedded in male supremacy, continue to hamper ordinary people from freely and openly discussing sex with their sex partners. There was no or little evidence to show that society had come to terms with the nature and transmission of this life destroying disease.

4) Some concerned parents and elderly people be-moaned HIV/AIDS sensitization teams which come into communities, talk about the disease and are never seen checking to see if what they preached was being practiced; while yet others blamed the escalating rates of HIV/AIDS infections on indiscriminate distribution of condoms among young people, which was giving them false trust in the power of the condom and eroding and corrupting their morals.

Clearly, HIV/AIDS remains too mysterious for ordinary Africans to understand and to relate to. There is absolutely no reason whatsoever for a disease which is destroying life in the millions, hampers people’s ability to dream of the future, and dramatically reduces life spans, to be given tantalizing baptismal or beautiful nick names which only serve to confuse local community people, and limit their ability and efforts to combat the disease.

Indeed, we at MAPODE strongly believe that if Africa is to combat this horror disease, there is absolutely no need for people to be apologetic about it. A disease that, unlike its potential victims has no fear (is brave), is not embarrassed, not hidden, not ashamed, not shy, and has already rendered human sex a ‘life and death’ affair deserves no gentility. Therefore, Trust in love is no longer enough! There is a need to be absolutely sure of safety before one commits themselves to engage in the sex. Authentic safety is a must.

Indeed, we at MAPODE concur with Kiiza Ngozi that if Africa is to combat this horror disease, HIV/AIDS messages need to be communicated in a language best and easily understandable to us Africans who are its hardest hit victims, a task we cannot leave to others to do for us. It is high time we woke up to the truth that HIV/AIDS has also become a source of huge profits for big trans/multi-national industries, and is creating un-precedented employment opportunities for multi-lateral agencies. Therefore, left this way, chances of finding a practical solution within the near future will remain as remote as a pipe dream, a likely replica of our economies already brought to their knees by inappropriate experimental external policies. It is for this reason that we strongly feel that Africa, through its political and community leadership, working together with traditional elders, scientists, spiritual leaders and teachers, are all challenged to demystify and simplify HIV/AIDS so that our people can individually and collectively deal with it head-on rather than continuing to use kid-glove methods. Unless we are content to wait for another two decades!

* Merab Kambamu Kiremire (Mrs.), a Development Worker/Researcher is the Initiator/Director of MAPODE (Movement of Community Action for the Prevention and Protection of Young People Against Poverty, Destitution, Diseases and Exploitation), a Community-based Youth-at-Risk focused Non Governmental Organization (NGO) that implements child/youth prevention and protection programmes in Zambia and Uganda. She was one of the 6 University of Cape Town (UCT)’s African Gender Institute Rockefeller 2004 Associates. Please visit:

The overall aims of this discussion is to share experiences and raise awareness about the issues of mobile populations and HIV/AIDS, particularly in the Southern African region. This discussion will take place on the AF-AIDS eForum between February and June 2005. To join the eForum, send an email to: [email protected]

A mass polio immunisation campaign began on Friday across Africa, targeting 100 million children, the UN Children's Fund (UNICEF) reported. The 22-nation synchronised campaign, dubbed the Coast-to-Coast Polio Drive, comes as reports from Ethiopia indicated that a child there had contracted polio, the first case in the country in four years.

Experts from southern Africa have gathered in Namibia to discuss critical reproductive health challenges in the sub-region and formulate strategies to address them. About 200 delegates will carve out a comprehensive reproductive health component, to be incorporated into the New Partnership for Africa's Development (NEPAD) framework on related health issues.

I officially became an African when l visited Nigeria two weeks ago, so I was told. No one is ever considered one until you make this pilgrimage and you have to go there to understand what they mean. So it is in this same spirit that I defend Nigerians, although l never thought that it would ever come to this. The most shocking discovery was that it is the Nigerians who leave the country to pursue greener pastures that give it a bad name with their survival antics. Nigerians on the whole are actually very honest people, with a few rough edges, but honest and very hospitable people. Hard to believe if you have met and dealt with their representatives on the continent.

All this l discovered after chain locking my suitcases with all forms of intricate locks that it would have needed a seminar to unlock. As l tightly clutched my limited hand luggage whilst checking in at the airport l was taken aback by the politeness yet in your face approach. But l was certain l was not going to fall for the famous sleek tongues they use to ensnare their victims…l knew them! I had read up on them! Be aware and be very afraid! But you can only go on for so long until you make up your mind to remember to relax as long as you have your passport and return ticket, which I had to check on so very often to ensure that it was still there. I had spent the better part of the earlier days going through a morning ritual of leaving my room with everything secured back into its cases. But to be honest l came back with everything l was supposed to come back with and very safe and sane and with a deep respect for a people who are unique in their own right, very unique.

But this is not about extolling the virtues of Nigerians but a gaining of an in depth understanding of the impact of HIV/AIDS on this nation and how people relate it to their daily life. To date Africa is the region worst affected by HIV/AIDS, with 70% of the world’s 42 million infected people (29.4 million people).An estimated 25 million people are living with HIV in sub-Saharan Africa, despite the apparent stabilization in HIV prevalence rates, with a yearly infection rate of 3.2 million Africans – 8,700 Africans every minute! This means that it will take 250 years to wipe out 10% of the world’s population and the “dark continent” will be riddled with bush and veld! Breaking it down further in southern Africa all seven countries have prevalence rates above 17% with Botswana and Swaziland having prevalence above 35%. In West Africa, HIV prevalence is much lower with no country having prevalence above 10% and most having prevalence between 1% and 5%. Adult prevalence in countries in Central and East Africa falls between 4% and 13%. With such figures is there any hope? How come they seem so accurate and so scary yet people seem unmoved?

With this as the backdrop, my visit was to the University of Abuja, to explore young minds and educate them on HIV/AIDS and its impact on their lives directly and indirectly. I also wanted to demystify the raging misconception about the spread of the disease, where they believed that it is those south of the equator that are dying and they were still safe.

I came at them double barrelled and used my experience as an example to give them a visual perception of how a person directly affected by the disease dealt with the emotional as well as financial challenges that go with HIV/AIDS. Personally I had come to the conclusion that the issue of HIV/AIDS is not in its entirety all about death. People die and will continue to die for one reason or the other. But it seems like l have been around AIDS all my adult life. I have watched my friends die, schoolmates wither and disappear for some concocted reason, and my friends’ parents fall sick, become incapacitated, die and be buried. I have played my role in fighting AIDS, worked with organizations with strong HIV/AIDS policies and community HIV/AIDS interventions programs. I have attended HIV/AIDS seminars, workshops on AIDS andlistened to the most moving experiences by victims and activists.

In spite of all this preparation there is nothing that prepares you when AIDS comes home. All l can say is that there’s an aura of hopelessness that settles around your entire being. You know that no matter what you do and will try to do the certainty of losing this person “soon” is written in stone and whatever you do is to just allay the inevitable. I have lost five members of my family within a space of 5 years; siblings aged between 30-45 years who have left behind 12 orphans between them and a series of financial dilemmas in their wake. To top it all,, our mother, who had parents’ worst nightmare of burying their own children, died of it too. If I did not know better I would think it is in the family genes but l will not go into that.

Without going into the details l believed my story represented all the facets of the impact of HIV/AIDS on an individual, a family and a community - both in the short term and the long term. In addition to being a woman, I represent the quota of HIV/AIDS that is affected and afflicted quantitatively and qualitatively by the epidemic. I played and provided the palliative care and in the end lost 5 key people in the family, all in their prime, and was left with the responsibility of looking after orphans. I highlighted the frustrations, accessibility to treatment and services, and this was in Uganda where the level of awareness and palliative care is quite high and l was well placed and privileged.

I then went ahead to create a picture of what the 5% prevalence rate attributed to Nigeria represented. Every time HIV/AIDS was discussed it was in the context of East, Central and Southern Africa, the sub Sahara Africa, which from their understanding, had to a certain extent created a belief that West Africa, the ECOWAS region, was safer. After all they only had to deal with 5% prevalence rates while “sub Saharan Africa” was dealing with 30-40% in the cases of South Africa and Botswana and 10-20 % in the cases of East and Central Africa.

Suffice to say that when it came to unpacking the 5% of 120 million Nigerian people we discovered that these 6 millionHIV positive cases were 5 times more than the 40% HIV/ADS cases attributed to Botswana who according to their total population represented about 400,000.

The aim of my story was to create a wider thinking and the need for a concerted effort and understanding of what the epidemic meant. I wanted these young people to understand that HIV/AIDS is not an issue of promiscuity or homosexuality, or who is sleeping with whom, but an issue that is affecting the very nature of societal progression. I needed them to visualise what would happen in Nigeria in relation to what had happened in South Africa. This was not very far off if they continued to assume and adhere to the current line of interpretation of the information at hand. What l had not counted on was the empathy that resulted from the talk, which was appreciated - but then it defeats the purposes because when people start pitying you they forget that the message was for them.

But my hope was not daunted and I decided to explore the environment of this august academic institution and see where these academic giants resided. What met me were mountainous rubbish heaps teeming with flies, broken sanitation systems and living conditions that defied definition. When it comes to HIV/AIDS, its heterosexually transmittal implications and disproportionate impact on women, the direct association to their living conditions was unfathomable.

It was after this that I realised that we are dealing with a situation beyond our comprehension. We came with pre-packaged information and hoped that these backward people would be grateful that “sons and daughters of the soil” had returned to save them from their lot in life. Here the priorities were very different and way beyond what HIV/AIDS connoted. They believed that it was the duty of the “government” to ensure that they had what they needed. The concept of harnessing their environment and seeing how they could survive with what they had was something they had not considered because they could not do anything about it and after all it was up to the “government” to sort these things out.

This experience informed my next visit to Funtua, Katsina State, Northern Nigeria, it very hot and with a very high Islamic influence. This time l was addressing 14-16 year old high school students and instead of talking at them I decided to have an open discussion. My message was that HIV/AIDS kills and devastates family livelihoods. We looked at its impact on an individual and how it affects his/her ability to do their work and provide for their families and how this translates to the family, the community and the region and the country as well. I kept away from the percentages and the regional subdivisions.

It yielded the same very practical results and intervention methods. In terms of content these children knew that HIV/AIDS was out there and in their communities and they were aware of the rumours. What they wanted to know then was what were they to do in the case of rape, or underage marriages, or access to preventive measures and counselling. All in all what was apparent was lack of access to information about personal hygiene, sexual reproductive health and its relationship with HIV/AIDS, sexual negotiation skills and the power relations within communities imbued with religious beliefs that promotes silence and considers certain topics taboo.

What is the problem? How are we sending out the message and is it getting to the right people? How do we create community ownership so as to overcome highly religious and cultural bottlenecks? How are we developing our communication strategies so as to identify target audiences that would have the ability and capacity to access information and respond to it effectively? One of the challenges has always been the language of communication particularly the use of statistics to explain the gravity of the situation and then using this same format to pass on this information to the affected target audiences. This is one feature that has resulted in the ineffective responses to HIV/AIDS programs. As you read the UNAIDS 2004 report it sounds like a research paper for an academic institution who are being asked to think through their parameters and see how “they” can come up with a course of action.

The dilemma we are finding ourselves in is where outsiders seem to be more concerned about our survival than we are. They seem to set the agenda and communicate it in a language comprehensible to only them. We, the so-called alleviators, are finding ourselves in places conceptually and geographically in our communities where HIV/AIDS is not considered an issue. The information is there, preventive methods there and primary curative remedies there that need to reach the people in need. We need to communicate in a language that is understandable to all so that our effort to save lives and give hope to the young is not wasted.

* Kiiza Ngonzi is HIV/AIDS Program Coordinator for Justice Africa. Justice Africa produces the Governance and AIDS Initiative Bimonthly Issues Brief, an
update on developments relevant to the issues of HIV/AIDS, democracy and
governance in Africa. Visit for more information.

* Please send comments to [email protected]

Under-nutrition seems to be inexplicable in a world where the food market ascends to the 11% of the global trade and food prices have declined over the last years. Nevertheless it is one of the most important causes of illness and death globally as well as a key factor in poverty reproduction. This is according to a chapter in the Global Health Watch 2005 report. The chapter looks at the underlying causes of under and over nourishment both in developing and developed countries as directly related to the globalisation and liberalisation processes that have been taken place in the last decades. You can read the newsletter of the Global Health Watch and find out how to subscribe through the link below.

Benin and Ghana have high maternal mortality rates. 'Near-misses', where mothers survive a potentially fatal crisis, are even more common. Research involving the London School of Hygiene and Tropical Medicine assesses the costs of such emergencies and reveals the important role played by households in financing obstetric services in both countries.

Between 1997 and 2002, according to a new report from Stats SA, South Africa's official statistics agency, the number of recorded deaths in the age group from 20 to 45 more than doubled, from a little over 100,000 to more than 200,000. Although most deaths likely to be linked to AIDS are officially recorded as due to associated diseases such as TB and pneumonia, the age and disease pattern provides strong evidence of the growing impact of AIDS. Other previous studies, such as those from South Africa's Medical Research Council, have provided similar indications. But the issue is still contentious, as AIDS denialists have used the relatively low numbers attributed directly to AIDS to claim that researchers are exaggerating the problem. The latest issue of the AfricaFocus Bulletin contains postings that examine the issues in detail.

Some 43 people have died and 13 others infected following an outbreak of pneumonic plague in the mining area of Zobia, in the region of Bas-Uele in Oriental Province, eastern Democratic Republic of Congo (DRC), an official in the Ministry of Health told IRIN on Monday. The ministry's director of epidemiology, Dr Benoit Kebele Ilunga, said the epidemic showed up three weeks ago in one of the mines in the diamond rich area.

Near hysterical media reports last week reported on a strain of HIV resistant to drugs from three main classes of antiretrovirals. But this article from HIV information site www.aidsmap.com says that perhaps the reason for the reaction to the case- reported in New York - and its reporting lies not in its medical significance, but in its importance to current US debates on comprehensive or abstinence-only HIV prevention. Visit the site to read the full article.

The South African HIV/AIDS advocacy group Treatment Action Campaign last Wednesday led about 2,000 people in a march outside the South African Parliament in Cape Town to demand that the government provide antiretroviral drugs at no cost to 200,000 HIV-positive people in the country by 2006. The South African Cabinet in November 2003 approved an HIV/AIDS treatment plan that aims to provide antiretroviral drugs to 1.2 million people - or about 25% of the country's HIV-positive population - at low or no cost by 2008.

Health and Development Networks (HDN) and the International Organization for Migration (IOM) Regional Office for Southern Africa are pleased to announce a forthcoming time-limited structured discussion on: HIV/AIDS AND MOBILE POPULATIONS IN SOUTHERN AFRICA. This discussion will take place on the AF-AIDS electronic discussion forum (eForum) between February - June 2005.

The Lancet, a leading international scientific journal, has lambasted the South African government for being defensive and urged it to “show backbone and courage to acknowledge and seriously tackle the HIV/AIDS crisis of its people”. The comments followed an editorial in this week’s Lancet on the findings of a Medical Research Council study that attempts to quantify misclassification of HIV/AIDS deaths concluded for the year 2000-01.

Aforthcoming time-limited structured discussion on: HIV/AIDS AND MOBILE POPULATIONS IN SOUTHERN AFRICA will take place on the AF-AIDS eForum between February - June 2005. The overall aims of this discussion are to share our experiences and raise awareness about the issues of mobile populations and HIV/AIDS, particularly in the Southern African region. Your contributions and comments on the following themes will be particularly encouraged: Topic 1: Migration and HIV/AIDS - How does migration and population mobility lead to increased HIV/AIDS vulnerabilities in Southern Africa? Topic 2: Migration and HIV/AIDS - How does HIV/AIDS affect migration and population mobility patterns? Topic 3: The brain drain of healthcare professionals from Southern Africa The discussion will begin soon, although we welcome your early contributions now. If you are already a member of the AF-AIDS eForum DO NOTHING, further information will be sent to you in the next few days. To join the eForum, send an email to: [email protected]

Health officials in New York say they have found a new strain of highly drug-resistant HIV in a city resident. The resident, a man in his mid-40s, is thought to have developed Aids much faster than usual after infection. The strain - known as 3-DCR HIV - has not been detected anywhere else in the world and is "difficult or impossible to treat", according to health experts.

The Voice of America, which reaches listeners in northern Nigeria through its Hausa language service, is officially launching a new Kano Reporting Center (KRC) on Feb. 16 2005, in conjunction with a health-reporting workshop for women journalists from Feb. 13-18 2005. The official opening coincides with a four-day workshop for female journalists to be led by Development Communications Network, the leading public health and science journalism training organization in Nigeria. More than a dozen Nigerian women journalists are participating in the workshop focusing on health reporting and covering issues including HIV/AIDS, polio, tuberculosis, leprosy, malaria and other epidemics.

Four organizations have been selected to receive a combined total of nearly $600,000 in grants over the next two years for HIV/AIDS projects under the U.S. Agency for International Development's Community REACH program. The selected projects will focus on providing service delivery to people living with HIV/AIDS (PLWHAs). The recipients, all local, nongovernmental organizations, were chosen from over 120 applicants in nine countries. The four Community REACH "Positive Prevention for PLWHAs" grant winners are: Dawn of Hope Ethiopia Association (DHEA), Ethiopia; Fondation Pour La Sante Reproductrice et l'Education Familiale (FOSREF), Haiti; Hodi, Zambia; Reseau Ivoirien Des PVVIH / The Network of Ivorians Living with HIV/AIDS (RIP+), Cote d'Ivoire.

Caravan of Life is a project that sensitises and mobilises the Angolan population on the need to take precautions against malaria. The project highlights the importance of malaria prevention and at the same time promotes the use of impregnated mosquito nets for pregnant women and children. The Caravan of Life programme is used to mobilise resources to assist in the delivery of malaria interventions. The project consists of a convoy of vehicles which transport medicine, mosquito nets, insecticides, computers, communication equipment and vehicles for the purpose of enabling the workers' in the malaria-affected areas to fight malaria.