Break the trajectory of HIV/AIDS in Africa


Africa remains hostage to a killer disease without a cure. No other place on the planet has been worst affected by AIDS the way Africa has.  The disease is exterminating whole segments of the society, emptying schools, swallowing families, communities, and tearing social fabrics already tattered by generations of poverty and neglect.

Although AIDS-related deaths and HIV infections in Eastern and Southern Africa are falling dramatically, the current statistics should remind us that there is still a lot of work that needs to be done.

The Eastern and Southern Africa regions continue to be the epicenter of the HIV pandemic. The Southern Africa sub-continent, in particular, is the most severely affected with a third of all the people living with HIV globally residing in 10 of the countries in the region.

The World Health Organisation (WHO) indicates that nine of the Southern African countries, which include Botswana, Lesotho, Malawi, Mozambique, Namibia, South Africa, Swaziland, Zambia and Zimbabwe, have HIV prevalence rates among adults (15 to 49 years) of over 10 percent.

At an estimated 25.9 percent, Swaziland has the highest rate in the world, followed by Botswana with 24.8 percent and Lesotho 23.6 percent. With 5.6 million people infected, South Africa is home to the world’s largest population of people living with HIV and AIDS.

However, in 22 countries in Sub-Saharan Africa – new infections have dropped by more than 25 percent between 2001 and 2009, including in some of the countries with the largest epidemics such as Ethiopia, Zambia and Zimbabwe.

Zimbabwe was the first country in Southern Africa to record a significant, sustained decline in HIV infections from 29 percent in 1997 to 16 percent in 2007.  The annual HIV incidence in South Africa, though still high at 1.5 percent in 2009, dropped from 2.4 percent in 2001. 

Botswana, Namibia and Zambia HIV/AIDS incidence rates also appear to be declining while in Lesotho, Mozambique and Swaziland they seem to be levelling off. Angola’s relatively younger pandemic, on the other hand, appears to be growing.

Experts are of the opinion that much of the reduction comes as a result of changes towards safer behavioural patterns among young people, including delay of first sex, reduction in the number of partners and increased condom use.  Data from the UNAIDS shows that prevalence among 15 to 24 year olds has decreased by more than a third between 2001 and 2010. 

Nonetheless, in Swaziland, Botswana and Lesotho – between 8.5 and 11 percent of young people are living with HIV. HIV disproportionately affects girls and young women. Of the 2.7 million 15–24 year-olds living with HIV in the region, 70 percent are females. 

In east and southern Africa, prevalence rates among young women aged 15 to 24 years are almost two-and-a-half times higher than among men of the same age, with considerable variations between and within countries. Girls’ vulnerability to HIV infection not only stems from their greater physiological susceptibility to heterosexual transmission, but also from the severe social, legal and economic disadvantages they often confront.

Preventing new infections among young people, therefore, requires efforts that both tackle cultural and gender norms and also promote knowledge and life skills to help young people protect themselves and their partners from HIV.

In order to make great strides in stopping the spread of HIV/AIDS in Africa, I strongly believe that all stakeholders need to chip in. I still believe that political leadership can do more in the fight against HIV/AIDS by mobilising effective and strategic multi-sectoral responses.

Both sexes also need to be at the forefront of change, responsibility and leadership if this plague is to be contained. The public also needs to openly discuss HIV/AIDS rather than treating it as a taboo. With donor funding drying up for many community-based organisations, African governments must shoulder the responsibilities by financing local NGOs and supporting community leaders so as not to undo what has been achieved so far.

Governments also need to increase investment in health strategies and rural health-delivery systems for both prevention and care. This must include basic health needs such as clean water, nutritious food, sanitation and access to opportunist infection medication and anti-retroviral drugs.

September 2013
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