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02.03.2006 Health

HIV/AIDS: Africa’s Waterloo

By P.Y. Tsikata

The debate about the origin of HIV/AIDS is still very controversial. The majoritarian view, hold by some heavyweight scientists with undisputable reputations such as Dr Alan Cantwell, Jakob Segal and the Green Belt Revolutionist and the Nobel peace Prize Laureate, Wangari Maathai, among other prominent scientists, is still profoundly anchored on a conspiracy theorem. They argue that it is a man-made attempt by Western scientists to wipe out a certain segment of the world's population in bio warfare. In the tangle over its origin is The South African President, Thabo Mbeki, along with members of his government who attribute natural causal agents such as poverty, chronic diseases, malnutrition and other environmental factors. But whatever the genesis of this plague, the scientific revelations, based on available statistics and trends, are that Africa is completely overwhelmed by the disease and may not recover from this epidemic anytime soon.

When doctors identified the first cases of what has become 'AFRICA'S WATERLOO' in New York and San Francisco two decades ago, its proximity, as it were, seemed thousands of miles away and infeasible to reaching our shores. Two decades on, it has spread and affected many lives on the African continent than anywhere else in the world. The trends suggest that by the close of this decade, whole communities may be wiped out in certain parts of the continent.

Finding cure has eluded human adroitness making prevention the only way forward. Although the discovery of life prolonging drugs and other prophylactic agents, for example Zidovudine (AZT), with the capacity to reduce and prevent mother-child transmission in babes, have brought some relief and hope to mankind, the economic debates surrounding the availability of these drugs are still raging on unabated. This, in effect, makes the availability of these drugs to a horde of PLWA in Sub-Saharan Africa on commonly accessible basis impracticable.

Whilst some countries with very high rates of infection may have more resources both at the national levels and individual levels to combat its spread, the fight to contain the disease has not been an easy road to paradise. It is still a long stretch from stemming the tides. Evidently, South Africa and Botswana with per capita GDP of $11,000 and $10,000 respectively are definitely overwhelmed by the spread of the disease which now stands at 21.50% and 37.30% in the individual countries.

Comparatively, the infection rates in Ghana and Nigeria are still considered relatively low. In the case of the latter, though the prevalence rates are much lower than in the aforementioned Southern African countries, the size of her population means that it has the largest number of PLWA in the world after South Africa and India. For the former, her 3.1% should not make her complacent as still waters run very deep.

For Ghana and Nigeria, GDP per capita earnings--$2,500 and $1,000 respectively-- are very low in a region identified as the poorest in the world. Indeed, the deployment of national and individual resources in the two countries, and for that matter, the whole of West Africa in fighting the disease may greatly hamper other attempts to reduce poverty in the region. The long term implications for these economies will be very explosive than we are currently witnessing in some countries with very high infection rates.

But if unprotected sexual intercourse still remains largely the most susceptible form of transmission accounting for 85% of infections, then we may be running behind time in trying to avert a disaster in the waiting in these countries.

Clearly, research has shown that the age of puberty has been reducing by four months in every decade for the past century. This implies that the age at which young people become sexually active has concomitantly been affected, and if the appearance of pubic hair and the development of breast and other signs of the sort signify the 'capability' of the young person, then we should wake up to the realities of the time: THEY ARE ENGAGING IN SEX MUCH YOUNGER THAN IN OUR DAYS.

This capability manifests itself in the sex-drive (libido) or the natural desire for a sexual activity. Therefore, even against the advice of parents, peers and religious teachings, the individual, who in most cases is adventurous around this age, may try to experiment it irrespective of the dangers it holds in store.

Recent reports and articles, (STDs Now High Among Ghanaian Teenagers, 6 Feb. 2006, SSS Girls Sacked for Engaging in Gang Sex, 17 Feb. 2006) including my own commentaries and a host of articles, are cloudless indications that our young boys and girls have become easy pickings for both foreigners and locals who are exploiting them left and right. If our young footballers as young as 12 years are already having 'AKPO KE TWO' and cases of STDs, hitherto found among adults, are now being reported in children as young as 13 years, then we must redouble our efforts in the fight in combating the disease since presence of STDs increase the risk of transmissions.

The wider picture is not too different from what these young ones are exhibiting. Incontrovertibly, gay relationships, cunnilingus, fellatio, one-night stand or casual sex, extra-marital affairs, fornication, paedophilia and a host of other sexual aberrations, some of which may be regarded as foreign to our society, are all taking place on our soil now. The parallels are no different from what the Christian may consider as a replica of the Biblical Sodom and Gomorrah.

The worrying aspect of the infection is that it takes a long time in some individuals for the symptoms to start showing. This particular aspect of the disease makes it very onerous to combat as there are a lot of people living with the disease who might not know for years to come. Consider the fact that in most parts of the continent, people attend hospital only when they are sick and the only way to be sure of one's status is through testing, which is not even 100% is guaranty.

The ABC of sex-Abstinence, Be Faithful and the use of Condom- for sometime now has dominated our approach towards preventing the spread of the disease. But recent developments, with the voting of US$15 billion and with religious groups getting chunk of it, are indicative of a shift in paradigm with the emphasis being greatly placed on abstinence. This message was re-echoed by the US first lady on her recent visit to Ghana.

Whilst it is the surest way to prevent transmission, we need to be careful not to deemphasize, through our inattention to the other equally important preventive mechanism such as the use of condoms.

Indeed, religion forms an integral part of African society. Ghana's statistics on religion suggest that Ghana's population is made up of 63% Christians, 16% Muslims and 21% indigenous Traditional religions. Closer looks at the religious precepts of all three religions demonstrate that they prohibit sex before marriage, encourage non-promiscuous relationships and even forbid sex (abstinence for that matter) among their adherents in certain periods of the year. Therefore, the message of abstinence tends to rehash these fundamental religious tenets in order to save mankind.

But the questions for us to be asking now are: first of all, if 16% of our population are believers in indigenous religions who are equally susceptible to HIV/AIDS infections but do not have any formally recognized structures, how do we reach out to them to benefit from these funds? Two, with the current tension between Moslems around the globe and Western countries, is it possible for these faith groups to access these funds wherever they located? Three, if the churches, the mosque and other shrines are the driving force in African society, why then do we have this huge infection rates on the continent?

The situation on the continent is so critical that policies need to be constantly reviewed and updated to engage with the realities of the situation. The over reliance on abstinence will remove the safety net which is provided by the use of condoms and expose many individuals who may not be able to resist the temptations of the flesh.

There are also many out there who are so gullible that they are convinced by the good looks of someone who may repent overnight and become part of the faith group and without any careful investigation, medically or otherwise, get engrossed with these individuals even into marriage. So let's be careful not to over rely on abstinence to the neglect of the other approaches.

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