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Aids in South Africa

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AIDS in South Africa
Acquired Immunodeficiency Syndrome or AIDS is the most deadly disease known to man. More than 25 million people have died of AIDS worldwide since the first cases were reported in 1981 and 33.4 million are currently living with HIV/AIDS. According to Advert, an international HIV and AIDS charity, almost 70% of the people in the world who are infected with AIDS live in Sub Saharan Africa. And in Sub Saharan Africa, South Africa is believed to have more people with HIV/AIDS than any other country in the world. Yet with all of this, the greatest tragedy yet may be the ignorance of AIDS. The large majority of Africans believe strongly that you can get rid of AIDS one of two ways; showering after intercourse with an infected person or having intercourse with a virgin. The latter is a major cause in the number of rapes that take place in Africa, especially child rapes. Even the current president of South Africa, Jacob Gedleyihlekisa Zuma, is not exempt from this statistic. In December of 2005 he was charged with the rape of a woman who he knew to be HIV positive, in an interview he stated that he took a shower afterward to reduce the chance of infection. What is even more shocking about this is that Zuma, at the time was also the head of the National AIDS Council for South Africa.
The groundbreaking article released at the end of 2002 by the Medical Research Council of South Africa, the “Impact of HIV/Aids on adult mortality in South Africa” report is the first comprehensive examination of mortality statistics from the AIDS era. In a strongly worded introduction to the report, Dr. Makgoba states that as a consequence of early beliefs that AIDS was a disease exclusively due to homosexuality and that “many Africans promoted the notion that homosexual practices were ‘unAfrican’, thus sowing the seeds for denial to justify why AIDS would not be prevalent in their communities”. He believes that “this denial was compounded by stigmatization, chauvinism, the distortion of scientific evidence, and ignorance”. The report shows data proving that AIDS is the biggest killer in South Africa—with an estimated 40% of adult deaths during 2010 were caused by AIDS. According to the researchers of the ‘Impact of HIV/AIDS on Adult Mortality in South Africa’, AIDS will continue to be a growing problem in South Africa. The statistics show that one in nine South Africans, and one in four adult South Africans has the dreaded disease and because of that statistic it is estimated that the average life expectancy is only 47 years of age, instead of 66, as it would be if AIDS were not a factor. In addition to this report, Dr. Makgoba believes that “there is no precedent for this in our history. We have a situation where the younger females, who are supposed to be healthy and productive, are dying in greater numbers than their mothers” which doesn’t bode well for the future of South Africa.

The Joint United Nations Program on HIV/AIDS, known as UNAIDS, recently estimated that the minimum amount of resources necessary to help curb the spread of AIDS in low and middle income countries is between seven and ten billion dollars per year. This global fund called for by United Nations Secretary General Kofi Annan has at present attracted almost $1,500,000,000 in pledges. The World Bank offered major loans in 2002 and 2003 for HIV/Aids, with a grant equivalency of over $400,000,000 per year and in 2000 began a 15 year commitment to curbing the epidemic. All the while, more countries are boosting their national budget allocations towards AIDS responses. Some of the most under developed countries of the world have received, or are due to receive, some sort of national debt relief that could help them increase their spending on HIV/AIDS. Thus, the only apparent challenge should have been moving from commitment to actions, showing that it’s not easier said than done.
A part of the trouble has been being proactive in this matter, or even acknowledging there was a problem. For a few months at the beginning of 2001 it looked as if the South African Government had finally come to realize and treat the AIDS epidemic with the seriousness it deserves. After years of ignoring—then underestimating—the dilemma surrounding AIDS, a new sense of urgency seemed to be taking effect within the South African government. Money that had been poured into Virodene, the ‘miracle cure’ that turned out to be nothing more than an industrial solvent, seemed to have been better allocated to more beneficial programs. Just when things appeared to be on the rise, everything took a major turn for the worse thanks to one person. Even with statistics that prove that some 40% percent of the population is presently infected with AIDS, former South African President Thabo Mbeki was adamant that the AIDS ‘epidemic’ was by no means a crisis in his country.

Mbeki’s antics brought a storm of protest when he questioned the Medical Research Council’s report that found AIDS to be the single biggest killer of South Africans. He used an outdated study by the World Health Organization to argue that AIDS is only the 12th leading killer in South Africa. Mr. Mbeki then proceeded to ask health officials to reassess their budget according to this World Health Organization report, thus making the budget reassessments as outdated as the report.

Mbeki clung to his much-criticized stance of denying a direct link between HIV and AIDS in an interview with Time magazine shortly thereafter. “No, I am saying that you cannot attribute immune deficiency solely and exclusively to a virus,” he responded when asked whether he was prepared to acknowledge that there was a link between HIV and AIDS. He later appointed scientists to government panels who share his foolish mindset that HIV does not have a role in the cause of AIDS. His doubts about this link presented much confusion within the South African public. Doctors and Trade Unionists had to deal with all sorts of questions from patients and members who are convinced that they no longer need to use condoms. According to a doctor at Baragwanath Hospital, “a few irresponsible remarks have undermined years of hard work”.

President Mbeki then further squandered his image and brought about a barrage of criticism when he exaggerated the toxicity of Nevirapine, the only anti-retroviral known to stunt the spread and transferal abilities of HIV/AIDS. “There exists a large volume of scientific literature alleging, among other things, the toxicity of this drug is such that it is in fact a danger to health,” he told the National Council of the Provinces, Parliament’s second chamber. His plans for the future were thus based upon this theory and so he “has therefore asked the Minister of Health to go into all these matters so that we ourselves, including our country's medical authorities, are certain of where the truth lies.” He continued by warning Parliament that anti-retro-virals are “as dangerous as the disease they are meant to treat”.

Even after being President of one of Africa’s top countries for 9 years there are many times when the rest of the country questions decisions made by Mbeki. Although for the most part those questionable decisions did not turn out to be as deadly as his blunder over the AIDS crisis. It is possible to think that being president; he is after all still human, and thus bound to make mistakes. But having as many right-hand men as he does and being as informed as he could be, his dubious decisions seem unforgivable.

Mbeki’s road to become the head political figure in the country was not an easy one. He only found himself at the top after a lifetime of fighting the oppressive white rule of apartheid in South Africa. Former president Mbeki’s misunderstanding of the seriousness of the situation has been reportedly rooted in defensiveness about race. He has been quoted as saying that those advocating AIDS treatment viewed black people as “germ carriers and humans of a lower order”. His views, therefore, seem to be based on a retaliation of the Apartheid Era; and he seemed to be trying to show that he will determine the major decisions and won’t be influenced by the majority of white doctors and scientists. It is difficult to imagine a more immoral inequality than apartheid, but AIDS has already built up a higher death toll. And the South African government seemed to have no immediate plans to make anti retro-viral drugs available, using arguments that they are toxic, that there is a lack of infrastructure in the country to ensure correct administration and monitoring of the drug, and that they are simply too expensive. The extremely high mortality rate was thought to continue to unbearable heights, however, since 2005 the numbers have plateaued. Today 1.9 million South Africans are under the ARV treatment, ten times more than in 2005.

Former president of South Africa, and Nobel Peace Prize winner, Nelson Mandela continually called for an end to the debate on the link between HIV and AIDS within his former political party, the African National Congress (ANC). It has on many a time caused rifts from within the delegation that could pose greater problems for the unity of both the ANC and South Africa. Mandela has said that the government and South Africans should focus on fighting the ‘war’ against the disease, according and article in the Sunday Times, a national weekly newspaper in South Africa. In an interview with the newspaper, Mandela issued a strong attack on the government’s lack of urgency in the fight against AIDS. Mandela stated: “This is a war. It has killed more people than has been the case in all previous wars and in all previous natural disasters. We must not continue to be debating, to be arguing, when people are dying”. The report said that while stopping short of directly criticizing President Thabo Mbeki and the African National Congress, Mandela said he was talking to the ruling party about its position on AIDS and believed it would listen to sound advice. “I have no doubt that we have a reasonable and intelligent government, and that if we intensify this debate inside, they will be able to resolve it.” He said it was only when he had done “everything in [his] power” and exhausted all channels within the African National Congress to reach an understanding that he could and would “come out and criticize them”.

In reaction to Mbeki’s seemingly unintelligent thoughts on the AIDS epidemic, Mandela believed that “doctors and sick people should be the ones to decide on the anti retro-viral drugs, not the politicians.” He was very supportive of the idea to move forward on the treatment of AIDS but also remained very involved in South African politics and the African National Congress itself. Therefore, he was rather sensitive to the insecurities in the Mbeki camp. On the eve of President Mbeki's State of the Nation address in April 2003, Mandela stressed the importance of preventing mother-to-child transmission of AIDS by allowing the anti retro-viral drugs to be dispersed and used “beyond argument or doubt.” He said that the debate on this killer disease “unfortunately continues to rage in manners that detract attention from what needs to be our core concern”.

“This is war,” according to Mandela, “it has killed more people than has been the case in all previous wars and all previous natural disasters. We must not continue to be debating, to be arguing, when people are dying.” With this in mind, one glimmer of hope came through the words of Trevor Manuel, South Africa’s finance minister addressing parliament, who acknowledged the extent of the mortality of AIDS. He publicized that an “extra R357, 000,000 ($55,000,000) would be spent over the next three years on the fight against AIDS.” He conveyed his thoughts that “the budget contains significant measures to strengthen the national HIV/AIDS program.” In addition to this monetary assignment, R86,000,000 ($13,000,000) is to be allocated, during the next financial year, for the distribution of condoms throughout South Africa. Also, there will be an increased effort on forming the basis of the AIDS education and counseling programs, and the care of AIDS sufferers and pregnant women with AIDS.

A German pharmaceutical Company, Boehringer – Ingelheim, has been offering, unsuccessfully until recently in South Africa, but successfully to all other developing countries since July 2000, its drug Nevirapine for the prevention of mother-to-child transmissions of HIV/AIDS. The drug prevents the newborn from being infected with HIV at birth in a high percentage of cases. “It was made for the world, as it still is now. Rejection won’t make us change that policy; we still would want to provide the medicine”.

In his closing remarks at the XIII International Aids Conference held in Durban, South Africa, Nelson Mandela reiterated the devastating impact HIV/AIDS is having on families, communities, societies and economies around the world. Decades have been chopped from life expectancies. AIDS is clearly a disaster. The most frightening thing is that all of these new infections and the human suffering could have been and many more still can be prevented. Something drastic needs to be done. Mandela then went on to tell the world what everyone should already know: “With nearly two decades of dealing with the epidemic, we should have some experience of what works. The challenge now is to move from rhetoric to action; action at an unprecedented intensity and scale. There is a need for us to focus on what we know works. We need to break the silence, banish stigma and discrimination, and ensure total inclusiveness within the struggle against AIDS; We need bold initiatives to prevent new infections among young people, and large- scale actions to prevent mother-to-child transmission, and at the same time we need to continue the international effort of searching for appropriate vaccines; We need to aggressively treat opportunistic infections; and We need to work with families and communities to care for children and young people to protect them from violence and abuse, and to ensure that they grow up in a safe and supportive environment”.

Mandela concluded by pleading for everyone’s help to combat this enemy. “For this we need to be focused, to act strategically, to mobilize all of our resources and alliances, and to sustain the effort until this war is won. We need, and there is increasing evidence of, African resolve to fight this war. Others will not save us if we do not primarily commit ourselves. Let us, however, not underestimate the resources required to conduct this battle. Partnership with the international community is vital. A constant theme in all of our messages has been that in this inter-dependent and globalized world, we have indeed again become the keepers of our brother and sister. That cannot be more graphically the case than in the common fight against HIV/AIDS”.

Works Cited
"AIDS." HIV &. N.p., n.d. Web. Dec. 2013.
"AllAfrica." AllAfrica.com: HIV-Aids and STDs. N.p., n.d. Web. Dec. 2013.
"Conflicts in Africa." - Global Issues. N.p., n.d. Web. Dec. 2013.
"DWAF: T Mbeki: State of the Nation Address, 21 May 2004." DWAF: T Mbeki: State of the Nation Address, 21 May 2004. N.p., n.d. Web. Dec. 2013.
"His Life and His Legacy." UNAIDS. N.p., n.d. Web. Dec. 2013.
"The Lancet IPad App: Articles in a New Light." TheLancet.com. N.p., n.d. Web. Dec. 2013.
"MBEKI: 13TH INTERNATIONAL AIDS CONFERENCE." MBEKI: 13TH INTERNATIONAL AIDS CONFERENCE. N.p., n.d. Web. Dec. 2013.
"Metropolitan Foundation | Red Ribbon | Live The Future." Metropolitan Foundation | Red Ribbon | Live The Future. N.p., n.d. Web. Dec. 2013.
Press, The Associated. "N.H.L. ROUNDUP; Flyers Win Their Third in a Row." The New York Times. The New York Times, 31 Dec. 2007. Web. Dec. 2013.
"SA Medical Research Council." SA Medical Research Council. N.p., n.d. Web. Dec. 2013.
"South Africa HIV & AIDS Statistics." HIV and AIDS Information and Resources. N.p., n.d. Web. Dec. 2013.

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The Impact of Hiv

...The impact of HIV & AIDS in Africa Two-thirds of all people infected with HIV live in sub-Saharan Africa, although this region contains little more than 10% of the world’s population.1 AIDS has caused immense human suffering in the continent. The most obvious effect of this crisis has been illness and death, but the impact of the epidemic has certainly not been confined to the health sector; households, schools, workplaces and economies have also been badly affected. During 2008 alone, an estimated 1.4 million adults and children died as a result of AIDS in sub-Saharan Africa.2 Since the beginning of the epidemic more than 15 million Africans have died from AIDS.3 Although access to antiretroviral treatment is starting to lessen the toll of AIDS, fewer than half of Africans who need treatment are receiving it.4 The impact of AIDS will remain severe for many years to come. The impact on the health sector In all heavily affected countries the AIDS epidemic is adding additional pressure on the health sector. As the epidemic matures, the demand for care for those living with HIV rises, as does the toll of AIDS on health workers. In sub-Saharan Africa, the direct medical costs of AIDS (excluding antiretroviral therapy) have been estimated at about US$30 per year for every person infected, at a time when overall public health spending is less than US$10 per year for most African countries.5 The effect on hospitals [pic] Nurses working on the HIV ward at Kisiizi Hospital in Uganda ...

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