AIDS IN SUBSAHARAN AFRICA

Sub-Saharan Africa is the region most severely affected by HIV/AIDS, with almost two-thirds of the world's adults and children living with the virus coming from this region.

Last year alone, AIDS killed 2.2 million Africans and an estimated three million people were newly infected with HIV, bringing the total number of people in sub-Saharan Africa living with HIV/AIDS to 25 million.

Women are increasingly becoming the biggest victims, with 13 infected women for every 10 infected men (up from 12 in 2002). That difference is even more pronounced among 15 to 24-year-olds.

In Kenya and Mali, there are 45 women living with HIV from this age group for every 10 men living with the virus.


 

HIGH RATE OF HIV CASES

HIV prevalence rates in some African countries are already at alarming levels. Seven countries in sub-Saharan Africa have adult prevalence rates of more than 17%, with rates exceeding 35% in Botswana (37.3%) and Swaziland (38.8%). In West Africa, prevalence rates tend to vary between one and five per cent, while in East and Central Africa the rates vary from four per cent to 15%However, there is some cause for hope.

There is evidence that HIV prevalence rates are declining in countries that have aggressively introduced education and awareness campaigns. For instance, in South Africa, HIV prevalence rates for pregnant women under 20, fell to 15.4% in 2001, down from 21% in 1998.

A decline in HIV prevalence has also been detected among young inner-city women in Addis Ababa, Ethiopia's capital, and Uganda.

 

AFRICAN AIDS VICTIMS' SITUATION

• 315 million people – one in two people in Sub Saharan Africa survive on less than one dollar per day.
• 184 million people – 33% of the African population – suffer from malnutrition.
• During the 1990s the average income per capita decreased in 20 African countries .
• Less than 50% of Africa’s population has access to hospitals or doctors. In 2000, 300 million Africans did not have access to safe water.
   
• The average life expectancy in Africa is 41 years.
  Only 57% of African children are enrolled in primary education, and only one of three children do no complete school.
  
• One in six children die before the age of 5. This number is 25 times higher in sub-Saharan Africa than in the OECD countries.
  
• Children account for half of all civilian casualties in wars in Africa.
   

HIV/AIDS IN AFRICAN COUNTRIES

By the year 2010, crude death rates in Cameroon will have more than doubled as result of HIV/AIDS.

An estimated 340,000 people in Ghana are currently living with HIV.
he prevalence rate among adults in Ethiopia and Kenya has reached double-digit figures and continues to rise.
 

HIV-positive patients have occupied 39% of the beds in Kenyatta National Hospital in Nairobi, Kenya , and 70% of the beds in the Prince Regent Hospital in Bujumbura, Burundi.
 

HIV INFECTION RATES AND PREVALENCE

Infection rates in young African women are far higher than in young men, with rates in teenage girls in some countries five times higher than in teenage boys. Among young people in their early 20s, the rates were three times higher in women.

In Africa, women’s peak infection rates occur at earlier ages than men’s. This helps explain why there are an estimated 12 women living with HIV for every 10 men in this region.

Infection rates in East Africa, once the highest on the continent, hover above those in West Africa but have been exceeded by the rates now being seen in the southern cone.

In four Southern African countries, national adult HIV prevalence has risen higher than thought possible, exceeding 30%: Botswana (38.8%), Lesotho (31%), Swaziland (33.4%) and Zimbabwe (33.7%).

 

But AIDS in Africa is more than an epidemic; it is a massive development catastrophe. (See below). Most infectious diseases kill off the weak – the very young and the very old. HIV targets people in the prime of their working and parenting lives. Around half of all people who acquire HIV become infected before they turn 25. Typically, they develop and finally die of the illnesses called "AIDS" before their 35th birthday. This age factor makes AIDS uniquely threatening to families, communities and economies.

Contributing to this critical situation is a conspiracy of shame and silence. Though the African epidemic is over two decades old, a stigma still clings to AIDS in many places. Arising from irrational fears of contamination and from the association of AIDS with sex and death, AIDS stigma not only leads to cruel rejection of people known to have HIV but chills discussion about the epidemic.

And without discussion, there is no way for communities to become aware of, or take seriously the threat of an all-but-invisible virus that can be spread, unknowingly, by people who feel and look perfectly healthy. Indeed, according to conservative UNAIDS estimates, nine-tenths of those living with HIV do not know they are infected.

AN EXAMPLE OF HIV'S PROBLEM

Pepile is seven years old and very ill. Her father and younger brother died of Aids, her mother is HIV positive. So is Pepile.

She is one of 23 million Africans who are living with HIV and Aids, just one young life in a disaster which has been called the greatest catastrophe to hit the African continent since slaveryTwo more Aids orphans to join the 10 million already trying to survive in Africa.

According to one recent estimate, one quarter of the population of southern Africa may die of Aids. Businesses are losing their workers, schools are losing their teachers, farms are losing their labourers

DISASTER

The theme is "Break the Silence" - because for millions of Africans, the stigma of living with HIV/Aids is still too great, and they suffer alone and in silence.

Slowly, governments in Africa and elsewhere are waking up to the scale of the disaster, but many more millions will die before this 21st century catastrophe has been beaten
 

AIDS DEATHS

Aids kills some 6,000 people each day in Africa - more than wars, famines and floods. Millions of children are orphans, many more live with HIV or Aids.

"...Young people are at the centre of the HIV/AIDS epidemic," says Carol Bellamy, Executive Director of UNICEF. "They are both the hardest hit by the disease and also the key to overcoming it. Yet despite this, strategies for responding to the epidemic generally disregard young people."
 

INSTRUCTION ABOUT HIV/AIDS

When a young person learns how to have an open dialogue about sexuality, s/he develops self-confidence, becomes more aware of his/her core values, practices invaluable relationship skills, and discovers how to access further knowledge about sexual health.

When a young person learns how to respond to peer pressure and how to recognize risk factors for HIV, s/he can also decide how to make healthy choices about his or her future.

 

THINKING ABOUT AIDS

When a young person practices scripting, storyboarding, using video equipment, and directing a crew, s/he practices creative self-expression, important leadership skills, and essential job skills -- teamwork, decision-making, critical thinking, project management, and problem solving. These skills are the basis for social and economic independence.

When a young person learns how to present his or her knowledge to others through peer leadership presentations, s/he is practicing an ethic of civic duty and creating an educated and empowered community. S/he learns the power of having a voice.
 

HOW MANY PEOPLE HAVE CONTRACTED AIDS IN AFRICA?

AIDS has claimed nearly 12 million lives since the early 1980s. Experts estimate some 40 million people will be infected with HIV by 2000.
Ten million people have contracted HIV since the 11th World AIDS Conference met in Vancouver in 1996. Worldwide, 30.6 million people are known to have contracted HIV, or full-blown AIDS; 21 million of them live in Africa.


 

WHO IS RECEIVING TREATMENT FOR HIV AND AIDS?

But only 12 percent of those who need treatment are receiving it. Effective prevention programs, counseling and testing services are the exception to the rule and drugs still cost too much, the report said.

And despite the many programs and money spent, the epidemic has not been reversed. The 4.9 million infections and 3.1 million AIDS deaths in 2004 were the highest to date, Annan said.

Some of the worst predictions have come to pass. Nearly half of the estimated 39.4 million people living with HIV, the virus that causes AIDS, are women and girls, whether married or single, promiscuous or faithful.

 

AIDS TRENDS

The trend is that more young women are being infected than young men," Thoraya Obeid, the head of the U.N. Population Fund, told a news conference on Wednesday.

"If they are married, they can't abstain. They are faithful but the husband is not faithful," Obeid said.

Women, she said, need information, including how to use a female condom to protect themselves.

Men and women between 15 and 24 years old are the hardest hit by the pandemic. Obeid released a survey done by young people in a dozen countries, most of whom said they had no voice in their nation's AIDS policies.

Worldwide, the U.N. report says, some $8 billion will be available in 2005 to implement programs in 135 low- and middle-income countries, a dramatic 23 percent increase over the previous year.

Of this amount, rich countries have contributed some $6.7 billion, six times greater than the world spent in 2001.

 

HOW MANY NEW INFECTIONS OF HIV?

Sub-Saharan Africa is more heavily affected by HIV and AIDS than any other region of the world. An estimated 24.5 million people were living with HIV at the end of 2005 and approximately 2.7 million new infections occurred during that year.1 In just the past year the epidemic has claimed the lives of an estimated 2 million people in this region. More than twelve million children have been orphaned by AIDS.


Child at Nsanje district hospital in Malawi, HIV+

The extent of the epidemic is only now becoming clear in many African countries, as increasing numbers of people with HIV are becoming ill. In the absence of massively expanded prevention, treatment and care efforts, it is expected that the AIDS death toll on the continent will continue to rise.

This means that the epidemic's impact on these societies will be felt most strongly in the course of the next ten years and beyond. Its social and economic consequences are already widely felt, not only in the health sector but also in education, industry, agriculture, transport, human resources and the economy in general.

How are different countries in Africa are affected?

HIV prevalence rates vary greatly between African countries. In Somalia and Senegal the prevalence is under 1% of the adult population, whereas in South Africa and Zambia around 15-20% of adults are infected.

In four southern African countries, the national adult HIV prevalence rate has risen higher than was thought possible and now exceeds 20%. These countries are Botswana (24.1%), Lesotho (23.2%), Swaziland (33.4%) and Zimbabwe (20.1%).

West Africa has been less affected by HIV, but the prevalence rates in some countries are creeping up. Prevalence is estimated to exceed 5% in Cameroon (5.4%), Côte d'Ivoire (7.1%) and Gabon (7.9%).

Until recently the national prevalence rate has remained relatively low in Nigeria, the most populous country in Sub-Saharan Africa. The rate has grown slowly from below 2% in 1993 to 3.9% in 2005. But some states in Nigeria are already experiencing HIV infection rates as high as those now found in Cameroon. Already around 2.9 million Nigerians are estimated to be living with HIV.

Adult HIV prevalence in East Africa exceeds 6% in Uganda, Kenya and Tanzania.

Trends in the epidemic

Large variations exist between the patterns of the epidemic in individual countries. In some places, the HIV prevalence is still growing. In others it appears to have stabilised and in a few African nations - such as Kenya and Zimbabwe - declines appear to be underway, probably in part due to effective prevention campaigns. Others countries face a growing danger of explosive growth. The sharp rise in HIV prevalence among pregnant women in Cameroon (more than doubling to over 11% among those aged 20-24 between 1998 and 2000) shows how suddenly the epidemic can surge.

Overall, rates of new HIV infections in Sub-Saharan Africa appear to have peaked in the late 1990s, and HIV prevalence seems to be levelling off, albeit at an extremely high level. Stabilisation of HIV prevalence occurs when the rate of new infections is equalled by the death rate among the infected population. This means that a country with a stable but very high prevalence must be suffering a very high number of AIDS deaths each year. Although prevalence remains stable, the actual number of Africans living with HIV is rising due to general population growth.
 

What is the effect of these levels of infections?

Over and above the personal suffering that accompanies HIV infection, the epidemic in Sub-Saharan Africa threatens to devastate whole communities, rolling back decades of development progress.

Sub-Saharan Africa faces a triple challenge of colossal proportions:

Providing health care, support and solidarity to a growing population of people with HIV-related illness, and providing them with treatment.
Reducing the annual toll of new infections by enabling individuals to protect themselves and others.
Coping with the cumulative impact of over 20 million AIDS deaths on orphans and other survivors, on communities, and on national development.

AIDS orphans die on the grave of their parents

In many countries of Sub-Saharan Africa, AIDS is erasing decades of progress made in extending life expectancy. Millions of adults are dying young or in early middle age. Average life expectancy in Sub-Saharan Africa is now 47 years, when it could have been 62 without AIDS.
The effect of the epidemic on households can be very severe. Many families are losing their income earners. In other cases, income earners are forced to stay at home to care for relatives who are ill from AIDS. Many of those dying have surviving partners who are themselves infected and in need of care. They leave behind children grieving and struggling to survive without a parent's care. See our AIDS orphans page for more about the effect of the epidemic on children.
In all affected countries, the HIV/AIDS epidemic is putting strain on the health sector. As the epidemic develops, the demand for care for those living with HIV rises, as does the number of health workers affected.
Schools are heavily affected by HIV/AIDS. This a major concern, because schools can play a vital role in reducing the impact of the epidemic, through education and support. See our HIV, AIDS and schools page for more.

HIV prevention in Africa

AIDS awareness billboard in Lundazi, Zambia
A continued rise in the number of Africans living with HIV is not inevitable. There is growing evidence that prevention efforts can be effective, and this includes initiatives in some of the most heavily affected countries.

In some countries there have been early and sustained prevention efforts. For example, effective prevention campaigns have been carried out in Senegal, which is still reflected in the relatively low adult prevalence rate of 0.9%. Also, the experience of Uganda shows that a widespread epidemic can be brought under control. HIV prevalence in Uganda fell from around 15% in the early 1990s to around 5% by 2001. This change is thought to be largely due to intensive HIV prevention campaigns.

More recently, similar declines have been seen in Kenya, Zimbabwe and urban areas of Zambia and Burkina Faso. However, the extremely severe epidemics in South Africa, Swaziland and Mozambique continue to grow.

Overall a massive expansion in prevention efforts is needed, and although there is no single or immediate tool to prevent new infections, the major components of a successful prevention programme are now known.

 

Condom Use In The AIDS Problem

Do condoms play a role in preventing HIV infection? In Sub-Saharan Africa, most countries have seen an increase in condom use in recent years. In studies carried out between 2001 and 2005, eight out of eleven countries in Sub-Saharan Africa reported an increase in condom use. But look at the rise in infection!

The distribution of condoms to countries in Sub-Saharan Africa has also increased: in 2004 the number of condoms provided to this region by donors was equivalent to 10 for every man,4 compared to 4.6 for every man in 2001.5 In most countries, though, many more condoms are still needed. For instance, in Uganda between 120 and 150 million condoms are required annually, but less than 40 million were provided in 2005.

In the context of stable partnerships where pregnancy is desired, or where it may be difficult for one partner to suddenly suggest condom use, this option may not be practical.

 

Mother-to-child transmission of AIDS

Around 2 million children in Sub-Saharan Africa were living with HIV at the end of 2005. They represent more than 85% of all children living with HIV worldwide.7 The vast majority of these children will have become infected with HIV during pregnancy or through breastfeeding when they are babies, as a result of their mother being HIV-positive.

Mother-to-child transmission (MTCT) of HIV is not inevitable. Without interventions, there is a 20-45% chance that a HIV-positive mother will pass infection on to her child. If a woman is supplied with antiretroviral drugs, though, this risk can be reduced significantly.

Before these measures can be taken the mother must be aware of her HIV-positive status, so testing also plays a vital role in the prevention of MTCT.

In many developed countries, these steps have helped to virtually eliminate MTCT. Yet Sub-Saharan Africa continues to be severely affected by the problem, due to a lack of drugs, services and information. The shortage of testing facilities in many areas is also contributing.

Fewer than 6% of pregnant women in Sub-Saharan Africa were offered services to prevent MTCT in 2005.8 Given the scale of the MTCT crisis in Africa, it is remarkable that more is not being done (by both the international community and domestic governments) to prevent the rising numbers of children becoming infected.

 

What needs to be done to make a difference in Africa?

International support

One of the most important ways in which the situation in Africa can be improved is through increased funding. More money would help to improve both prevention campaigns and the provision of treatment and care for those living with HIV.

Developed countries have increased funding for the fight against AIDS in Africa in recent years, perhaps most significantly through the Global Fund to fight AIDS, Tuberculosis and Malaria. The Global Fund was started in 2001 to co-ordinate international funding and has since approved grants totalling US $3.3 billion to fight HIV and AIDS in Africa.

Around 60% of the fund’s grants have been directed towards Africa and 60% has been put towards fighting AIDS.12 This funding is making a significant difference, but given the massive scale of the epidemic more money is still needed.

The US Government has shown a commitment to fighting AIDS in Africa through the President’s Emergency Plan For AIDS Relief (PEPFAR). Started in 2003, PEPFAR provides money to fight AIDS in numerous countries, including 15 focus countries, most of which are African.

In Fiscal Year 2005, PEPFAR allocated US $1.1 billion to these African focus countries.13 The US Government is also the largest contributor to the Global Fund.

 

Domestic Commitment Against HIV/AIDS

More than money is needed if HIV prevention and treatment programmes are to be scaled up in Africa. In order to implement such programmes, a country’s health, education, communications and other infrastructures must be sufficiently developed.

In some African countries these systems are already under strain and are at risk of collapsing as a result of AIDS. Money can also only be used efficiently if there are sufficient human resources available, but there is an acute shortage of trained personnel in many parts of Africa.

In many cases, African countries also need more commitment from their governments. There are promising signs that some governments are starting to respond and becoming more involved, and this commitment needs to be sustained if the impact of the epidemic is to be reduced.

Reducing stigma and discrimination

HIV-related stigma and discrimination remains an enormous barrier to the fight against AIDS. Fear of discrimination often prevents people from getting tested, seeking treatment and admitting their HIV status publicly. Since laws and policies alone cannot reverse the stigma that surrounds HIV infection, more and better AIDS education is needed in Africa to combat the ignorance that causes people to discriminate. The fear and prejudice that lies at the core of the HIV/AIDS discrimination needs to be tackled at both community and national levels.

Helping women and girls Affected By AIDS

In many parts of Africa, as elsewhere in the world, the AIDS epidemic is aggravated by social and economic inequalities between men and women. Women and girls commonly face discrimination in terms of access to education, employment, credit, health care, land and inheritance. These factors can all put women in a position where they are particularly vulnerable to HIV infection. In Sub-Saharan Africa, around 59% of those living with HIV are female.

In many African countries, sexual relationships are dominated by men, meaning that women cannot always practice safe sex even when they know the risks involved. Attempts are currently being made to develop a microbicide – a cream or gel that can be applied to the vagina, preventing HIV infection – which could be a significant breakthrough in protecting women against HIV.

Women could apply such a microbicide without their partner even knowing. It is likely to be some time before a microbicide is ready for use, though, and even when it is, women will only use it if they have an awareness and understanding of HIV and AIDS. To promote this, a greater emphasis needs to be placed on educating women and girls and adapting education systems (which are currently male-dominated) to their needs.

The Way Out Of AIDS

Tackling the HIV and AIDS crisis in Africa is a long-term task that requires sustained effort and planning - both within African countries themselves and amongst the international community. One of the most important elements of the fight against HIV and AIDS is the prevention of new infections. Prevention campaigns that have been successful within African countries need to be highlighted and repeated.

The other main challenge is providing treatment and care to those living with HIV in Africa, in particular ARVs, which can allow people living with HIV to live long and healthy lives. Many African countries have made significant progress in their treatment programmes in recent years and it is likely that the next few years will see many more people receiving the drugs.  

AIDS IS AN EMERGENCY!

Aids-Africa brings together a multicultural community of Africans and other countries to raise and jointly address health-related issues, particularly HIV/AIDS in Africa. When 2,500,000 people in Africa will die of Aids this year, we are not talking about a “cause” — we are talking about an emergency, a global humanitarian emergency.

The facts about Aids blow your mind. They also break your heart. Imagine if a third of the kids at your local primary school were Aids orphans. That's a reality in Africa where the parents of 13 million children have been killed by Aids.

Across the continent these children wake up every day with no parents to look after them. And it will get worse. There will be 25 million kids without mums and dads by the end of this decade because of this disease.

Through discussion forums, Aids-Africa fosters independent, informed and constructive debate guided by principles of tolerance and respect. This forum is open to any interested party. Any individual may subscribe. By disseminating community-based knowledge and experiences, Aids Africa helps build collective consensus on HIV/AIDS - from local to international levels, in the countries most affected.


 

AWARENESS

Zimbabwe, the country that hosts Africa University, has one of the world's highest HIV-infection rates. Not less than 26.8 percent of young people and adults within the 15-49 age range, most of whom are women, are living with HIV/AIDS.

A very disturbing fact is that 90 percent of those infected are not aware of their status. Estimates of HIV-transmission rates from infected pregnant women to their children are about 33 percent. The Ministry of Health and Child Welfare estimates that more than 50,000 infants are born with HIV each year.

Recent data show that 70 percent of infant deaths are AIDS-related. The death rate from HIV/AIDS is high because of inadequate care, poor health infrastructure, lack of essential drugs for the treatment of opportunistic infections, and the unavailability of antiretroviral drugs (ARV) which, properly administered, have been shown to prolong and improve the quality of life for persons living with HIV/AIDS. It is currently estimated that more than one million orphans and vulnerable children live in Zimbabwe alone, most of whom have been orphaned by the HIV/AIDS epidemic.

PREVALENCE AND REACH OF AIDS AND HIV

Manicaland Province, within which Africa University is situated, has a high HIV prevalence. Life expectancy has fallen to 40 years or less. As stated by UNAIDS (2000), “HIV/AIDS pervades all spheres of life, be they physical, psychological, spiritual, economic, political, or cultural.

It is also more than just an individual problem, for it affects families, communities, nations, continents, indeed the whole world.” The pandemic, therefore, demands the attention of all disciplines, departments, governments, nongovernmental organizations, the private sector, faith-based organizations, and community-based organizations.

Africa University has developed a number of community-outreach projects for HIV/AIDS prevention, care, and counseling of the infected and affected, and, an extensive impact-mitigation project with particular reference to orphans and vulnerable children, their families, and persons living with HIV/AIDS in Zimbabwe.

HEALTH SCIENCES SUPPORT FOR EPIDEMIC

The Faculty of Health Sciences was selected in 2004 to coordinate a major support project for orphans and vulnerable children. After visiting Zimbabwe and seeing the plight of the AIDS orphans, a United Methodist family donated $3 million to support ministries with AIDS orphans in Zimbabwe.

This project of the United Methodist Church in Zimbabwe, mediated by GBGM, provides educational support, health care, nutritional supplements, and psychosocial support for up to 3000 orphans and vulnerable children, most whom have been orphaned by the HIV/AIDS epidemic. Working closely with the pastors, headmasters of primary and secondary schools, and proprietors of day-care programs, the project-management team has identified more than its target of 3000 very needy children whose health and educational prospects are precarious and sometimes on the verge of collapse.

Child-headed households, aged grandmothers looking after more than seven grandchildren, and poor communities struggling to cope with the devastation and poverty caused by the epidemic were also identified and registered for support within the project. The families and communities in the project are receiving help to enable them to sustain the many orphans living in the communities.

This project, sad as its origins may have been, is destined to provide a valuable community outreach arena for undergraduate and graduate students of the Faculties of Health Sciences, Humanities and Social Sciences, and Management and Administration.

MOZAMIQUE AND AIDS/HIV

A beautiful country bordering the Indian Ocean, Mozambique has a population of 18.8 million. The United Methodist Church is alive and flourishing in every providence with a membership of 160,000 and growing. Unfortunately the HIV/AIDS pandemic is growing faster-1.3 million people are living with the disease.

The life expectancy of an infant born in Mozambique today is 37.1 years--37.8 for males and 36.3 for females.

In 2003, 110,000 people died of AIDS, leaving behind 470,000 orphans.

The latest figures suggest more than 14 percent of all Mozambicans ages 15 to 49 are HIV-positive. Poverty, inadequate health care and the lack of life-saving drugs means a large portion of Mozambique's population is sick and dying.

A recent report by Mozambique's Health Ministry estimates more than 200,000 people have reached the stage of the disease where they should start taking anti-retroviral drugs, which prolongs the lives of AIDS sufferers. Only 5,865 are receiving the drugs today.

Mozambique remains one of the poorest countries in the world with 70 percent living below the poverty line. The annual per capita income is $86. Education is a key part of fighting AIDS in Mozambique, yet the country's literacy rate among people age 15 and older is 47.8 percent.

United Methodist Bishop Joao Somane Machado says the culture of the country must be taken into consideration before any results will be seen. The United Methodist Church is on the frontlines of the AIDS crisis in Mozambique with orphanages, clinics, a hospital and education programs.

The 2004 United Methodist General Conference established a Global AIDS Fund in an effort to raise $8 million in the next four years. Contributions to Global HIV/AIDS Program may be sent through a local United Methodist church, annual conference or by mailing a check to: Advance GCFA, P.O. Box 9068, GPO, New York, NY 10087-9068. Write your check out to "Advance GCFA." Be sure to include Global HIV/AIDS Program, Advance #982345 on the check memo line. Call 1-888-252-6174 to give by credit card. For more information visit the Advance Web site http://www.gbgm-umc.org/advance.

AIDS INFECTIONS -- WHO IS GETTING THEM?

AIDS has become the biggest threat to the continent's development.

Sub-Saharan Africa is the region most severely affected by HIV/AIDS, with almost two-thirds of the world's adults and children living with the virus coming from this region.

Last year alone, AIDS killed 2.2 million Africans and an estimated three million people were newly infected with HIV, bringing the total number of people in sub-Saharan Africa living with HIV/AIDS to 25 million.

Women are increasingly becoming the biggest victims, with 13 infected women for every 10 infected men (up from 12 in 2002). That difference is even more pronounced among 15 to 24-year-olds. In Kenya and Mali, there are 45 women living with HIV from this age group for every 10 men living with the virus.

HIV prevalence rates in some African countries are already at alarming levels. Seven countries in sub-Saharan Africa have adult prevalence rates of more than 17%, with rates exceeding 35% in Botswana (37.3%) and Swaziland (38.8%). In West Africa, prevalence rates tend to vary between one and five per cent, while in East and Central Africa the rates vary from four per cent to 15%.

However, there is some cause for hope. There is evidence that HIV prevalence rates are declining in countries that have aggressively introduced education and awareness campaigns. For instance, in South Africa, HIV prevalence rates for pregnant women under 20, fell to 15.4% in 2001, down from 21% in 1998. A decline in HIV prevalence has also been detected among young inner-city women in Addis Ababa, Ethiopia's capital, and Uganda.

World Vision has been involved in HIV/AIDS issues for 10 years now, but it is statistics such as these that have caused us to substantially increase our efforts.

World Vision is currently analyzing our HIV/AIDS programs that are having the greatest impact, sharing these lessons and working toward replicating them in projects across Africa.

MALAWI

Elderly caregivers' crafty plan to raise money for orphans

February, 2003. The three women sitting on the ground have a combined age in excess of 200 years, and between them they are looking after eight children with no help, no social services, and no income.

That's the reality of life for increasing numbers of elderly here in Ntchisi, central Malawi - but also for millions of elderly people throughout Africa. It's the legacy of the AIDS pandemic, which is inexorably erasing a generation of parents, and leaving often frail elderly folk to look after a population that is now composed of more than half young people.

Here in Ntchisi an association of 15 elderly women with 34 orphans between them has decided to do something about the lack of income. They should be living in peaceful retirement, but they've gone back to work with a grim will. Employing traditional skills that many haven't had to use for decades, they are producing clay pots, wooden household items, woven seat covers - anything that can be sold to somebody.

"Although this is a poor area, they do manage to sell their items," says Mrs. Eleanor Chimwaiya, who chairs the self-help group. "We have sold 10 sets of the seat covers so far, mostly to people like doctors and teachers, who have some income. But other items can be bought, or exchanged for food, by almost anyone."

World Vision's Nthondo ADP has also stepped in to help the elderly folk of Ntchisi with maize seed for a collectively farmed plantation.

"It is always to encouraging to see people organise themselves and helping each other," says Nthondo's HIV/AIDS manager John Mbewa. "As they are doing so much for themselves, we wanted to do something to give them a chance to do more to feed the children who rely on them."

Life has been harder in southern Africa in the last year because of a widespread food emergency, but John believes the elderly self-help group will be able to produce its own maize seed for future years.
 

The Impact of AIDS in AfricaBetween 1999 and 2000 more people died of AIDS in Africa than in all the wars on the continent, as mentioned by the UN Secretary General, Kofi Annan.

The death toll is expected to have a severe impact on many economies in the region. In some nations, it is already being felt. Life expectencies in some nations is already decreasing rapidly, while mortality rates are increasing.

[2000] began with 24 million Africans infected with the virus. In the absence of a medical miracle, nearly all will die before 2010. Each day, 6,000 Africans die from AIDS. Each day, an additional 11,000 are infected.


Into 2005, UNAIDS estimates suggested that the situation did not look much better. In Sub-Saharan Africa, there were

25.8 million (out of 40 million worldwide) living with HIV
3.2 million (out of 4.9 million worldwide) new HIV infections
2.4 million (out of 3.1 million worlwide) AIDS deaths

Western Media Attention to AIDS in Africa

And what is also disturbing is how the situation in Sub-Saharan Africa has only become real western mainstream media news headlines around the time HIV and AIDS was declared a national security threat to the United States. As if it is now an important issue, whereas before it wasn’t.

Sure, it is more worrying to people of a particular nation if it is a real threat to them as well, but it is another example of the mainstream coverage and their priorities, especially when there is a lot to report in terms of western economic policies seen through the various international institutions that have increased poverty, an important factor in the spread of AIDS.

Western politicians were concerned about the plight of Kosovars leading up to the Kosovo crisis, but there was not a similar concern for people on the continent of Africa, where far more have died from AIDS (already in the millions—approximately 11 million people around the beginning of 1999—by the time concern for Kosovo was raised. This is not to belittle the situation in Kosovo, but to help put it in perspective).

A STORY OF AIDS/HIV

Smiling, excited children, ranging from toddlers to teens, stand on a sagging front porch singing at the top of their lungs as visitors arrive.

Two-year-old Pedro spies a woman in the group without a child in her arms. He quickly fixes that problem by tugging on her pants leg and holding up his little arms.

All the smiling faces and the lively chatter momentarily mask the reason the children are here. They are orphans whose parents have died because of the AIDS pandemic that has swept through Mozambique.

Teles Orphanage, supported by the United Methodist Women's Society of Mozambique, was originally established to shelter children left homeless by war.

Ten adults, led by director Amelia Titos Messane, care for the children. As she talks, Messane reaches down and picks up a small boy and holds him close. The child has been at the orphanage since he was one month old.

"Many of the children will stay here all their lives because they have no place else to go," she says. "They depend on the school and the school depends on the United Methodist Church."

NEW TROUBLES

After more than 30 years of war, peace finally came to Mozambique in 1992. But peace brought with it a new deadly enemy: AIDS.

After the peace agreement was signed ending the country's civil war, corridors opened into Mozambique from Zimbabwe, South Africa, Zambia and Malawi, says United Methodist Bishop Joao Somane Machado. "Those countries depend on our Indian Ocean to export and import, but the trade corridors also opened the door for HIV/AIDS to invade the country."

In Mozambique during 2003, AIDS killed 110,000 people, left 470,000 children orphans and found 520 new victims every day, according to the United Nations Children's Fund (UNICEF).

The United Methodist Church in Mozambique is working to overcome cultural barriers to bring information about the disease to people. With a membership of 160,000, the church is sadly outnumbered.

Despite huge sums of money flowing into the country from agencies around the world aimed at preventing the disease, Machado says the problem is growing.

"We have many, many organizations from outside of the country trying to come here to help us with this issue," Machado says. "But the number of AIDS cases is going up, not down. This is because they come with a system used somewhere else; they don't come and study the culture of Mozambique."

The first thing many of those organizations want to do is distribute condoms, he says.

Most Mozambicans live in rural areas. There are no shopping centers or places to buy things, Machado points out. "When I go there to visit, they ask me for salt because they have no salt for their food. How can you expect them to use condoms when they have no place to find them and do not even know what condoms are?

"You can't tell young girls they must be faithful to their husbands - they know that - yet many young women are dying and being infected," he says.

High unemployment in Mozambique forces many men to work in the mines in South Africa. The men are away from home for as long as 18 months, and while they are away, many of them become infected, Machado explains. When they return home, they pass the disease to their wives.

"Wives can't say no to their husband when he comes back, even when he is sick."

AIDS EDUCATION

Groups visiting the country from Europe and the United States try their own methods for educating the people about HIV/AIDS.

"They try to put son-in-law and mother-in-law together and try to teach them. In our culture this is not possible," he says. In order for real conversations to happen, the culture of the people must be taken into consideration.

First, the people must recognize and accept the disease, Machado says. He says sorcery is often blamed for death, even when a medical doctor tells a family that a member has died of AIDS.

"They don't accept. They said, 'No, no, no. We know who killed him.'"

Center for peace

Machado is working with JustaPaz, a center for the study and transformation of conflict, and the Christian Council of Mozambique to train pastors and church leaders to educate the people about HIV/AIDS. The disease is a source of conflict in families, and the center is known for its ability to help people resolve all types of conflicts, he adds.

Before conversations and seminars were held, Machado says many of the churches were teaching people that HIV/AIDS "was a punishment from God."

"You cannot say those things from the pulpit," he says. "After many discussions with the Christian Council, they now understand that this is a simple disease that we need to deal with. We need to love the people."

Lucille Bonaventure with JustaPaz says working with the churches is an important way to reach the people.

Christians and AIDS: A Theological/Biblical Reflection in the Face of HIV/AIDS is a Bible study developed by the center with the cooperation of all the Christian denominations in Mozambique.

"The denominations all agreed on the text, and it is the first manual developed in Mozambique where cultural issues are addressed," Bonaventure says. The booklet uses Scripture to back up every point, reminding people that Jesus Christ cared for the lepers and those shunned by society.

This biblical approach helps pastors speak from the pulpit to raise awareness and erase the stigma associated with the disease, she says.

"Churches should be places where people take care of orphans and those who are sick," she says. The manual and Sunday school lessons, "Life in Abundance," are printed in Portuguese.

"The word of pastors in Mozambique is more respected than the word of politicians because of what we did bringing peace in Mozambique," Machado says. "They know the message of the church is true."

Teaching the people to love those who are infected with the disease and ways to prevent the disease from spreading is the role of the church, he says.

"In the pulpit we can say these things. We can appeal to the people. Those living with HIV/AIDS are still in our family - they need our love and support. This is the message we need to tell people."

The 2004 United Methodist General Conference established a Global AIDS Fund in an effort to raise $8 million in the next four years. Contributions to Global HIV/AIDS Program may be sent through a local United Methodist church, annual conference or by mailing a check to: Advance GCFA, P.O. Box 9068, GPO, New York, NY 10087-9068. Write your check out to "Advance GCFA." Be sure to include Global HIV/AIDS Program, Advance #982345 on the check memo line. Call 1-888-252-6174 to give by credit card. For more information visit the Advance Web site http://www.gbgm-umc.org/advance.  

AIDS, YEAR-BY-YEAR...

1981

This year's AIDS News from the New York Times

June 5. The CDC publishes in Morbidity and Mortality Weekly (MMWR) a report of five cases of Pneumocystis carinii pneumonia (PCP) among previously healthy gay young men in Los Angeles. Afterward additional cases were reported from New York City, San Francisco, and other cities. (MMWR, June 5, 1981 / Vol. 30/ No. 21)

July 5. The New York Times publishes its first article on AIDS, Rare Cancer Seen in 41 Homosexuals.

1982

This year's AIDS News from the New York Times

July 16. The CDC reports that it has recently received reports of three cases of Pneumocystis carinii pneumonia among patients with hemophilia . (MMWR, July 16, 1982 / 31(27);365-7)

November 5. The cause of Acquired Immunodeficiency Syndrome (AIDS) is still unknown. Scientists suspect that an "agent" is transmitted "most commonly to require intimate, direct contact involving mucosal surfaces, such as sexual contact among homosexual males, or through parenteral spread, such as occurs among intravenous drug abusers and possibly hemophilia patients using Factor VIII products. Airborne spread and interpersonal spread through casual contact do not seem likely." (MMWR, November 05, 1982 / 31(43);577-80 )

1983

This year's AIDS News from the New York Times

March 4. Scientists still not know how AIDS is transmitted . Recently "11 cases of unexplained, life-threatening opportunistic infections and cellular immune deficiency have been diagnosed in patients with hemophilia. Available data suggest that the severe disorder of immune regulation underlying AIDS is caused by a transmissible agent." (MMWR, March 04, 1983 / 32(8);101-3)

May 24. The New York Times reports "In many parts of the world there is anxiety, bafflement, a sense that something has to be done - although no one knows what - about this fatal disease whose full name is Acquired Immune Deficiency Syndrome and whose cause is still unknown." The World Health Organization (WHO) plans to convene a meeting of experts in Geneva from, November 22-25. (NYT, Concern Over AIDS Grows Internationally , May 24, 1983)

Ecumenical/Interfaith

June. Shanti Project in San Francisco sponsors an all-day religious forum, June 1, on the spiritual needs of people with AIDS. An idea of an AIDS interfaith network surfaces. Later that month, the Federation of AIDS Related Organizations, gathering for the second annual AIDS forum in Denver, CO, mandates the establishment of an AIDS Interfaith network.

July. Representatives from the religious community in San Francisco from the AIDS Interfaith Network of North America (AIN).
 

1984

This year's AIDS News from the New York Times

A heterosexual AIDS epidemic in Africa is revealed . For years, people on the continent have called it "Slim," because it caused slow wasting away of the body, making a person "slim," before death.

The New York Times reports that "in the New England Journal of Medicine on 232 African AIDS cases, a team of Belgian doctors wrote: 'We are struck by the increasing number of patients who have come from Zaire or Ruanda during the past four years to seek medical care. We believe that AIDS is a new disease that is spreading in Central Africa." (NYT, AIDS in Africa: Disease Is Especially Alarming in Zaire, April 17, 1984)

April 24. U.S. researchers headed by Dr. Robert Gallo announce that they have isolated the cause of AIDS and call the virus HTLV-3 . American health officials say they believe the American and French viruses will turn out to be one in the same.

July 13. Evidence implicates a retrovirus as the etiologic agent of AIDS. (MMWR, July 13, 1984 / 33(27);377-9)

United Methodist

May. General Conference (UMC), meeting in Baltimore, MD, does not adopt any resolutions on AIDS. It refers a petition from the California-Nevada Annual Conference to the General Board of Church and Society. More....

October. Michael Collins, co-spokesperson for Affirmation: United Methodists for Lesbians/Gay Concerns dies in New York City, having been diagnosed in Fall of 1983. Formerly clergy of Oregon-Idaho Annual Conference, he was a member of Washington Square UMC in New York City. In his journal after his diagnosis, he wrote "I see myself as a new being--ready to move on--secure in the knowledge that I am to be loved forever."

October. At its annual meeting, the Health and Welfare Ministries of GBGM adopts a departmental position paper on "AIDS and the Compassionate Ministry of the Church," dealing with such areas as research and health education, local church ministries, and concern for human and civil rights. More....



 

1985-- This year's AIDS News from the New York Times

Film star Rock Hudson discloses that he has AIDS.

In the United States, the Food and Drug Administration (FDA) approves the first HIV antibody test and HIV screening of blood donations begins.

Ryan White , a 14-year-old seventh grader who is also a United Methodist, begins his successful fight to attend a public school in Kokomo, Indiana that had banned him because of fearful students and their parents. For months, he is forced get his lessons through a telephone hook-up at home. After he wins in court, he is harrassed by other students and vandals break windows in his family's house and slash the tires of their car.

Ecumenical

June 24. The magazine Christianity and Crisis publishes "Fear and Healing in the AIDS Crisis" by Lee Hancock, its first article on AIDS.

December 9. The New York City Council of Churches forms the Minority Task Force on AIDS to address the needs of ethnic minorities with AIDS.

United Methodist
January. New World Outlook, the UM mission magazine published by GBGM, publishes a story on AIDS ministry, "Growing in Compassion" by Nancy A. Carter.

June. California-Nevada, New York, North Georgia, and Rocky Mountain Annual Conferences adopt resolutions on AIDS.

1986
This year's AIDS News from the New York Times

Heterosexuals and AIDS: concern grows about transmission between men and women .

October 23. Surgeon General C. Everett Koop urges parents and schools to begin "frank, open discussions" with young children and teen-agers about the dangers of AIDS .

Ecumenical Efforts Against AIDS

January. The National Council of Churches (NCCC) forms an ecumenical AIDS Task Force staffed by Chris Cowap. Cathie Lyons, assistant general secretary of Health and Welfare Ministries, GBGM, is the convener the group.

June. A delegation from the NCCC task force, including Cathie Lyons, meet, at his invitation, with the U.S. Surgeon General, Dr. C. Everett Koop, for 80 minutes.

June. In response to requests from member churches and WHO, the World Council of Churches asks its units on Church and Society, Family Education, and the Christian Medical Commission (CMC) to study AIDS. The three groups call a consultation of AIDS, chaired by Dr. Kevin Gordon in Cartigny, Switzerland to discuss the challenge that AIDS poses for churches. Eighteen persons met, They were mainly from the U.S.A. and Europe but also included representatives from India, Zaire, and the West Indies. It draws up a statement "Aids and the Church as a Healing Community," which is later endorsed by the WCC Central Committee and sent to all of the member churches along with a call for activie involvement in prevention and compassionate ministry.

1988
This year's AIDS News from the New York Times

January. In London, health ministers from around the world meet for the first time to discuss the HIV/AIDS epidemic. World AIDS day is conceived and adopted unanimously by 140 countries meeting at the World Summit of Ministers of Health on AIDS. The day is envisaged as an opportunity for governments, national AIDS programmes, non-governmental and local organizations, as well as individuals everywhere, to demonstrate both the importance they attached to the fight against AIDS and their solidarity in this effort.

December 1. The first World AIDS Day is held. The theme: "A World United Against AIDS"

Ecumenical
April 11-13. The AIDS Interfaith Network (ANIN) holds its founding meeting in Rye, NY. Four members of the NCCC AIDS Task Force are elected to the governing board, Mary Ellen Haines, Dave Zuverink, Adele Resmer, and Ron Sunderland.

May. NCCC is one of seven national organizations invited to participate in the CDC's three regional Campaign Planning Workshops for AIDS Education held in Washington, Chicago, and San Francisco.

July 4. Christianity and Crisis magazine publishes a special issue on AIDS.

November. WCC calls its second consultation on AIDS.

United Methodist
April 20. The Council of Bishops of The United Methodist Church adopt "A Statement on Acquired Immune Deficiency Syndrome."

April 26-May 6. In St. Louis, General Conference adopts a resolution, AIDS and the Healing Ministry of the Church, and calls for creation of an Interagency AIDS Task Force which is to coordinate a network of AIDS ministries and develop and provide educational and interpretive materials to assist the church in an effective response to the AIDS epidemic both in the United States and around the world.