Denial Is a River in Africa

No part of the journalism world is paying more attention to World AIDS Day than Africa's online media. And none is more disturbed. For many commentators on the continent hardest hit by the HIV/AIDS pandemic, about the only good news is that the bad news is not quite as bad as it used to be.

International politics plays a small role in the debate. Europe is subtly urging Africa to reject the Bush administration's "abstinence only" HIV/AIDS strategy, reports the Daily Mail & Guardian in South Africa. Zimbabwean President Robert Mugabe blames the British for a local shortage of anti-retroviral medicines. (The British blame the incompetence of the Mugabe government.)

But African attitudes are seen as a much bigger problem.

South Africans are "in denial" about the HIV pandemic, according to the M&G, despite the fact that HIV is now the country's number one killer of children under five. (Incidentally, the M&G special report on malaria, HIV/AIDS and tuberculosis is excellent.)

Zimbabwe, too, is a "nation in denial," says health worker Martin Tawakira in New Zimbabwe. One out of every four Zimbabwean is HIV positive, he says, "and 500 people die daily due to AIDS related illness."

East and West African countries are relatively better off than southern Africa.

In Kenya, The Standard reports that HIV/Aids prevalence "has dropped from 10.2 per cent in 2000 to 6.1 per cent this year." One reason: Women are taking over the AIDS fight at the grassroots.

The Nairobi daily says that because the burden of caring for AIDS orphans has invariably fallen on older women, "there has been a strong re-awakening among women to address the pandemic. ...  women are readily abandoning cultural norms to embrace modern prevention methodologies. ... they freely discuss matters related to sexuality, they are now engaging their spouses in dialogue on safe sex, and they have become increasingly vigilant over spousal infidelity."

But in Uganda, World AIDS Day, is "being marked under the heavy pall of the [HIV/AIDS] Global Fund scandal that saw the suspension of funds to Uganda over alleged financial impropriety and mismanagement," according The Monitor.

Ghana takes credit for bringing down the prevalence rate to 3.1 percent, according to the Ghanaian Chronicle. But columnist Lovelace Opoku-Agyemang worries about "attempts to make the HIV status of persons a pre-condition for accessing economic and social benefits like credits and marriages. ... Society as a whole must make conscious efforts to demystify the pandemic and extend a non-discriminatory hand of understanding. ... The tone of public education ought to be re-focused from doomsday scenarios to encourage more openness and hope."

That's hard to do when denial is often the order of the day.

washingtonpost.com's Kevin Dumouchelle provided research for this post.

By Jefferson Morley |  December 1, 2005; 2:48 PM ET  | Category:  Africa
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Comments

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A denial in Europe? What about the USA. The Bush administration has gutted AIDS funding across the country. It has witheld promised funding here and around the world if the programs do not promote the right-wing "Christian" philosophy of abstinence. If you want to talk about denial -- look at the White House

Posted by: John Perry | December 1, 2005 04:15 PM

Statistics can be deceiving: the decrease in HIV/AIDS prevalence in Kenya from 10.2% in 2000 to 6.1% in 2005 looks great until you realize what those numbers actually mean.

Prevalence refers to the proportion of people in the total population who have the infection/disease. Incidence, which measures the proportion of new cases in the population at risk, is a better indicator of successful education and prevention efforts.

Although eliminating transmission of HIV/AIDS from mother to fetus could help decrease prevalence (fewer new cases in growing population), in general, effective prevention merely keeps prevalence from rising. A decrease suggests that people were either cured or died. Currently there is no cure for HIV/AIDS.

Here is a breakdown of the statistics for Kenya:

Total population in 2000 = 30,339,770
(http://www.photius.com/wfb2000/countries/kenya/kenya_people.html)
Prevalence in 2000 = 10.2%
Number of Kenyans with HIV/AIDS in 2000 = about 3.1 million

Total population in 2000 = 33,829,590
(http://www.odci.gov/cia/publications/factbook/print/ke.html)
Prevalence in 2000 = 6.1%
Number of Kenyans with HIV/AIDS in 2000 = about 2.1 million

What happened to 1 million Kenyans with HIV/AIDS between 2000 and 2005? They weren't cured. If they received treatment, it didn't help enough.

And that doesn't include the number of new cases that were diagnosed between 2000 and 2005.

Posted by: Epidemiology Student | December 1, 2005 06:42 PM

Sorry. Corrections to the dates on the stats below. . .

Total population in 2000 = 30,339,770
(http://www.photius.com/wfb2000/countries/kenya/kenya_people.html)
Prevalence in 2000 = 10.2%
Number of Kenyans with HIV/AIDS in 2000 = about 3.1 million

Total population in 2005 = 33,829,590
(http://www.odci.gov/cia/publications/factbook/print/ke.html)
Prevalence in 2005 = 6.1%
Number of Kenyans with HIV/AIDS in 2005 = about 2.1 million

Posted by: Epidemiology Student | December 1, 2005 06:47 PM

So much for the separation of Church and State, if you listen to one religious lobbying group you listen to all. This is not a country with Justice for all, justice is only for those who can pay. America has a huge PR problem internationally. Being black in America is to be ignored and neglected, as we see historically with slavery, lynchings that the Supreme court refused to speak out about, to Katrena. It is no mistake, that the U.S. refuses to help desperate blacks who are not in lock step with the bullies half a world away. The U.S. is much happier supporting their local pharmaceutical companies who refuse to sell anti Aids drugs unless they can make huge profits. Blacks in Africa, show Bush the money or the oil, then maybe he will act.

Posted by: Gael | December 2, 2005 10:11 AM

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