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The Problem of AIDS in Africa

   HIV first emerged in Africa during the early 1970’s but did not garner much concern or attention until around the early 1990s when global health care communities and agencies became alarmed at the explosion in the incidence rate of infected individuals and as well, the related mortality rates that rapidly followed. Due to a high illiteracy prevalent in these countries, the efforts of local agencies in the health sector to educate inhabitants on the topic of AIDS failed miserably. Governmental officials took a passive stance and were persistent in their denials that the disease existed counter-arguing instead that AIDS was but a mere fiction, a fabrication on the part of global organizations to interfere with the politics and governing of its countries.

   The combined illiteracy of locals and ineffectual or non-existent efforts of most African governments to intervene have contributed to the ease with which AIDS have continue its trajectory of infection throughout much of Africa. The disease progressed swiftly throughout the 52 countries of its mother continent to infect mothers and fathers, sons and daughters and, sisters and brothers. Tracking its way easily through the pathways of illiteracy, ineffectual health system, poverty and poor governmental intervention, AIDS infected (and killed) hundreds of thousands of the African population within a relatively short timeline.

AIDS IN AFRICA: A POLITICAL ECONOMY
Much blame has been cast on African people for the global spread of AIDS in much the same way as gays and homosexual individuals were and still are blamed for its emergence in the Western hemisphere of the world.
The earliest verified HIV case was diagnosed on 1959 in Kinhshasa, Congo; African blood samples before this time were essentially free of the virus. Similar to influenza and rabies, AIDS is a disease that is transmitted from animals to humans; the closest relatives of HIV are SIVs which are viruses carried by apes and monkeys. HIV-1 is a strain of HIV that most resembles a chimpanzee SIV, which is commonly found in rain forests of coastal West Africa. HIV-2, a milder West African virus, is nearly identical to a monkey SIV. These viruses have lived in their natural hosts for millions of years and don't make them sick. The currently favored idea of how the viruses jumped into humans is that people hunted chimps and monkeys for meat, and cut themselves while butchering (Williams).

   Up until the late 19th century, most Africans were farmers and lived in rural villages. In colonial Africa, forced labor was the rule. For example, copper mines in Katanga (Congo) rounded up Africans from Zambia, Rwanda, Angola and Mozambique to work in their underground mines and millions more were drafted by colonial armies during both world wars. During the 1930's, the French built a railroad through coastal West Africa, drafting (once again) hundreds of thousands of African laborers from distant locations and marching them through the rain forest under appalling conditions of near-starvation. According to one theory, it is here that Africans first were exposed to SIVs, as workers made desperate by starvation had to hunt apes as foods.
Since the emergence of the first AIDS-diagnosed case, the Joint United Nations Programme on HIV/AIDS (UNAIDS) estimates that at the end of year 2003, over 20 million people worldwide had died of AIDS with Africa, having the highest percentage of deaths. At present, about 42 million people are infected with the virus HIV; of this estimate, 70 per cent of the world’s HIV-positive people live south of the Sahara desert that is, in Africa (Guest).

   The 13th International AIDS Conference, held in Africa in 2000, described an unreal and unimaginable ‘natural’ genocide of Africans. Reports estimated that approximately fifteen million Africans have already died and that thirty-four million are HIV-infected, including 25 million in sub-Saharan Africa. In addition, it is estimated that HIV/AIDS will kill 67% of teenagers in some African countries. It was found that women are twice as likely as men to become infected and it was predicted that over thirty million African children will become orphans by year 2010 with life expectancies dropping from 70 years to 30 in some countries.

   An extremely high ratio of 1:3 adults (defined as being between the ages of 15 to 49) is said to be infected with Botswana being the hardest hit country having over 38 percent of its adult population infected (Guest).
While these numbers are staggeringly high, more alarming are claims by international health organizations such as the UNAIDS and WHO that declare that these estimates may in fact, be below the real and actual figures. Some (African) countries gather no data regarding HIV/AIDS prevalence while others may simply extrapolate national statistics from alternate sources of data such as surveys of HIV prevalence amongst pregnant women antenatal clinics.

   There are few cases of diagnosed HIV/AIDS due to a socio-cultural stigmatization of the disease; as a result, doctors are encouraged to either ‘mis’-diagnose AIDS-infected patients with other types of illnesses or to put alternative causes of death on patients’ death certificates. Studies revealed that Africans are sensitive about the topic of sexual relations outside marriage. Since AIDS is a sexually transmitted disease, the identification of a person as carrier or patient is often taken as an indication of promiscuity, despite the awareness that the disease can be transmitted in other ways. It is not uncommon for doctors to write up patients’ death as being caused by tuberculosis or pneumonia thereby contributing to a ‘silencing’ of the disease; author Vinh-kim Nguyen, in his article on Ties That Might Heal (Nguyen) attest to this phenomenon of denying and renouncing the existence of AIDS on the part of African societies and in so doing, create a ‘silent epidemic.’

   The high rate of infected cases didn’t happen overnight but its spread was insidiously invisible. African governments have done much too little, much too late. Most lacked monetary resources and the political will to improve sex education in schools or to hand out condoms. Efforts to provide health care have been insufficient; there are never enough clinics, nurses or drugs. The lack of political will to intervene manifested in the attitudes of most African governments who persisted in their claim that AIDS did not really exist. Eight years after the appearance and diagnosis of the first AIDS case in Africa, then Deputy Thabo Mbeki finally addressed the issue of AIDS in Africa. In 1998, he declared, ‘For too long we have closed our eyes as a nation, hoping the truth was not so real. For many years, we have allowed the HIV virus to spread, and at a rate in our country which is one of the fastest in the world.’

   Many Africans still do not know the facts of AIDS; such lack of knowledge cannot be blamed solely on ignorance. Many miss out on safe sex messages simply because they did not received enough schooling to be able to read leaflets or newspapers and the majority can ill afford a television or radio. Even in places where most people have heard of AIDS, it’s rarely talked or discussed about and in situations when it is vocalized, AIDS is spoken of in euphemisms like ‘this thing.’ As typical of human nature, there’s an attitude of immortality and invincibleness but in Africa, where endemic poverty exists, such concerns of HIV/AIDS fatality takes second (if not, lower) place to strategies for day-to-day living and survival. In Africa where poverty is rife, the issue of death and fatality surrounding AIDS evoked little anxiety and fear apprehension.

   There is little doubt that AIDS will impact on African’s lives to make the poor, poorer.
This in turn will affect the economies of households. AIDS rarely affect a single individual in African households; AIDS kills people at their productive peak, and often more than one person in the same family. Young children, especially girls, drop out of school to take over the role of breadwinner when one (or both) of their parents sicken and die. Health care and funeral costs drive these financially strapped households into further poverty, seducing the newly assigned breadwinner to undertake dangerous jobs at risk for HIV infection thus, sustaining this vicious circle of cyclical infection.

PATTERNS OF SEXUAL NETWORKING
The dispersion of any sexually transmitted disease is a culturally sensitive issue within any society because its cause is typically associated with a certain ‘perceived’ degree of either promiscuity or of unsafe and risky sexual practices and AIDS is no exception. For example, when one hears of a person infected with HIV, at best, one usually think of that person being infected because of unsafe sexual practices. Rarely does one claim, ‘Oh he/she must have had a contaminated blood transfusion.’ Unfortunately, these attitudes and beliefs are more often than not, grounded in truth because inherently, a disease such as AIDS are frequently transmitted via (unprotected) sexual relations.

   In Africa, patterns of sexual networking is complex with many factors underscoring the population’s attitudes and behavior regarding sexuality. A 2002 UNAIDS study conducted on African cohorts revealed that Africans tend to start having sex younger compared with cohorts in other countries and that African girls become sexually active at a much younger age than boys Kuate-Defo). The report alludes to issues of multiple partners, an overlapping of relationships and extra-marital relations as adding to the increased risk for HIV infections where in areas such as rural Kenya the number of pre-marital partners for men was nine and for women, three.

   In Africa, there is more sexual contact between people of different generations; there is a misplaced and misguided notion that young adolescent girls are less likely to be HIV-infected and as such, they are sought as sexual partners by older and middle-aged men who offer lavish gifts and monetary compensation. In a continent reputed to be the poorest, with the lowest gross national product and per capita income (Williams), many girls either give in by necessity or succumb by desire. By the time these girls marry, they are already infected with the virus and unknowingly infect their husbands (who engage in extra-marital sex) also pass the virus on to his younger mistresses.
In Europe and North America the relatively low prevalence of heterosexual transmission after a decade of HIV epidemic is still under maintained and dispersion is also relatively under control.

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