Africans open up on Aids

Peter Piot, executive director of UNAIDS, said he it was pleasing to note that more people in Africa were now going public on their HIV-positive status, a key to reversing the social stigma that continues to be one of the deadliest elements of the continent’s Aids crisis.

During his visit to Malawi this week, where an estimated 10 people die of Aids everyday, Piot told journalists that Africa must maintain the attitude of openness if they are to score meaningful success against HIV/Aids.

Piot was on a three-day ‘fact-finding’ mission to Malawi. He was accompanied by Britain Department for International Development (DFID) Permanent Secretary Suma Chakrabarti.

Piot said: “I have met people opening up and living positively with HIV not only in Malawi, but in Tanzania and Mozambique. This was not the case two years ago and this means that we are making progress.”

Reversing stigma has been a major goal of international Aids control efforts, but has met with limited success in Africa where the illness was until very recently still considered an automatic death sentence.

In South Africa, where some 5,5 million people are infected with HIV, only a tiny handful of public figures have come forward about their HIV status while in other African countries many people hide their infection for fear of retribution.

Malawi, an impoverished country of 12 million people, lies close to the heart of southern Africa’s HIV/Aids epidemic and has already lost an estimated million lives to the disease.

Piot said that along with showing increasing openness about Aids, Malawi was also demonstrating that even poor countries can ramp up programmes for both prevention and treatment that yield real results.

Malawi’s HIV prevalence rate, which was about 16 percent two years ago, has now stabilised at 14 percent while the number of people on life-saving antiretroviral drugs (ARVs) has shot up from 4 000 in 2004 to 48 000 now – although still well short of the 187 000 estimated to need treatment.

Malawi’s aggressive HIV/Aids information campaign has also dramatically boosted the number of people going for voluntary testing, the first defense against the disease’s further spread.

“We are at a turning point in HIV response in Africa and we are starting to see results. Countries in East Africa are reporting good results due to access to testing and treatment,” Piot said.

“Malawi is not yet there but all the signs of getting their are evident,” Piot said.

He said the apparent leveling off of Malawi’s HIV prevalence numbers was not good enough, noting the country still saw about 90 000 new infections last year – reflecting a troubling trend across Africa.

“Of course it has stabilised because it is not moving up but still the number is unacceptable and more work needs to be done,” Piot said.

The UNAids chief visited Dedza, a poor district about 100km from the capital Lilongwe, which has one doctor serving a population of 624 000 but where local residents have taken the initiative to form support groups that are often a crucial part of a community HIV/Aids response.

On his part, Chakrabarti said, “there is a lot done and a lot to do still”. He said there was need for authorities to incorporate HIV/Aids issues in national economic programmes.

“We don’t have to take HIV as a ghetto issue but as an integral part of the country’s economic growth,” he said.

Chakrabarti said DFID has made long-term financial and technical commitment towards the fight against HIV/AIDS in Malawi and called upon other donors to follow suit.

Piot and Chakrabarti visited a community of people living with HIV in the central highland district of Dedza and later met with President Bingu wa Mutharika in the capital, Lilongwe.

National Aids Commission (NAC) Executive Director Bizwick Mwale said because of lack of resources Malawi cannot afford to put all those living with HIV on ARVs.

He said out of the one million Malawians living with HIV/Aids only 50 000 were on ARVs.

“It’s not that all the one million require ARVs but based on World Health Organisation criteria 10 to 15 percent of those will require ARVs,” he said.

Mwale said NAC estimates indicate that around 170 000 people in Malawi need ARVs today but out of that figure “we have got about 50 000 that have been registered”.

“We still have a long way to go; the job is still on,” he said.

Mutharika’s Secretary for HIV and Nutrition, Mary Shaba, said the president has declared that the fight against HIV and Aids “must be put among the priorities in Malawi’s Millennium Development Goals strategies”.

She said Malawi sets aside US$2 million annually in the budget for the fight against the pandemic.

“Added to that we ensure that 2 percent of all ministries’ budgets be dedicated to the fight against HIV/Aids,” she said.

Since the first HIV case was discovered in Malawi in 1985 the country’s life expectancy has been drastically reduced to 36 years, according to the UN Development Programme.

July 2006
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