Australian Nursing Journal states that there are many effects that the AIDS epidemic has on people in Africa, but there are some strategies that work best in containing it. AIDS has devastated lives of people across the continent of Africa. This epidemic has left eight million children as orphans, and UNICEF says it is crushing the rate of child survival. The Australian Nursing Journal states that a whopping 48% of the world’s population with AIDS is in eastern and southern Africa. “This virus has overtaken war as the number one killer in the region.” (AIDS destroys children’s lives in Africa, 1999, pg. 17) The orphans, especially the girls, were left to take on adult responsibilities. They take care of younger brothers and sisters, and are more vulnerable to abuse. These young women never had a chance to be children. They are raped and infected before they are even old enough to understand about AIDS. Our children are our future, and we need to protect them. (AIDS destroys children’s lives in Africa, 1999, pg.17)
The HIV/AIDS epidemic has become a serious public health problem because no cure or vaccine exists and infection almost always leads to death. “Infection is followed by years of slow destruction of the immune system, rendering carriers increasingly vulnerable to fatal opportunistic infections such as pneumonia and cancer.” (Bongaarts, 1996, pg. 21) Why has the HIV/AIDS epidemic affected some regions and countries much more than others? John Bongaarts says that there are two factors are widely accepted as at least partially responsible. First, the timing of the onset of the spread of HIV differs considerably among regions, from the late 70s in sub-Saharan Africa, North America, and Western Europe, to the mid 80s in Asia. This difference no doubt contributed to large variations in the size of the epidemic in the mid 80s because in some countries the epidemics were by then already a decade old, while in others they had just begun. A second cause of differences is the nature and size of a populations high risk groups. (Bongaarts, 1996, pg. 24)
Ethiopia is one of the main regions that are affected by AIDS. An estimated 2.2 to 3.0 million people in Ethiopia are infected with HIV, and 1.2 million children are AIDS orphans. (HIV/AIDS in Ethiopia, 2000, pg. 13) AIDS is a threat to Ethiopia’s development. The HIV/AIDS in Ethiopia article states that Ethiopia’s future depends on being able to respond to AIDS forcefully. The first infections were found here in Ethiopia in 1984. It came later than most Sub-Saharan countries. The transmission is largely through heterosexual contact then through mother-to-child transmission. Among the factors contributing to the rapid spread of HIV are (1) seasonal migration of workers in search of employment and better economic conditions that tend to increase sexual contacts, (2) dislocation of many people due to the civil war, (3) high STD rates in both high-risk groups and the general population, (4) increasing sexual activity among youth, and (5) high unemployment rates. (HIV/AIDS in Ethiopia, 2000, pg. 17) A World Bank Study says that AIDS is causing a one percent annual reduction in economic growth in Ethiopia. This is making it harder to reduce poverty. In 2000, the Ethiopian government implemented the comprehensive Multisectoral HIV/AIDS Five-Year Strategic Plan and established a National AIDS Council responsible for its implementation. (HIV/AIDS in Ethiopia, 2000, pg 2) They looked at this plan, but no studies were done to see if it worked. AIDS in Ethiopia is proving to be difficult to control. Conditions in rural areas, however, are conductive to further spread the disease unless current socioeconomic trends and risk behavior are reversed and unless the decentralization and poverty reduction programs bring about the changes required for an effective response to the epidemic. (HIV/AIDS in Ethiopia, 2000, pg17) Ethiopia is not the only African country affected. It stands out more because of the devastating numbers of the people who have this epidemic.
“The Joint United Nations Program on HIV/AIDS estimates that 95% of people living with AIDS are in developing countries. Sub-Saharan Africa is one of the hardest hit.” (Barnard, 2002 pg. 159) Barnard says that in South Africa, there are more than four million adults and children who have AIDS. This is the biggest population of people living with HIV/AIDS than any other country in the world. People in South Africa die from AIDS with a rate of 250,000 people per year. This number is just horrendous and so discouraging. They have twice as many people die a year than we have in the population of Texarkana. United Nations estimates that fewer than fifty percent of South Africans who are alive now will even reach the age of sixty. Barnard’s article says that there are four factors that appear to be responsible for the spread of AIDS.
- widespread poverty and economic marginalization
- Employment and migration patterns in South Africa
- Large – scale female unemployment and prostitution
- Government responses to HIV/AIDS has not been dealt with continuously
“Each day Africa buries nearly 6,000 men, women, and children as a result of AIDS, and that count will double in the next few years. (Thurman, 2000, 191) People may think badly on women who are prostitutes that get AIDS, but what they do not realize is that these women most of the time do not have a choice. Their children are starving, and because of poor land and resources they are left with the difficult decision to sell themselves to save their children. Thurman says that by the next ten years, 40 million children will lose one or both parents to AIDS. If something is not done now, these numbers will continue to climb. AIDS is hurting the economy of Africa by infecting the skilled workers. Without these workers, the work will not get done and the economy will fall. It is a lose lose situation. AIDS hurts the richest man all the way down to the poorest man.
Barnard also discusses another important controversy that AIDS has which is the cost of the drugs. South Africa needs three main types:
(1) drugs such as nevirapine that have been proven capable of reducing mother-to-infant transmission of HIV by up to fifty percent
(2) combination antiretroviral therapy that can reduce viral loads and prolong productive, symptom – free survival
(3) antifungal and antibacterial agents to reduce morbidity and mortality from opportunistic infections. (Barnard, 2002, pg. 161) Nevirapine is still under trial in Uganda, but if used could cut mother-to-child transmission rates by up to 50%. The cost would be $6.22 for the full treatment. Such drugs such as AZT are far too expensive for South Africans. The South African government has yet to declare a national emergency. This is puzzling to me. Why would they not say that this epidemic is cause for emergency? Millions of people are falling victim to this, yet no one is looking hard enough at these drugs. “Without more decisive action, the epidemic will threaten structures of governance and even the very viability of the state in some African countries.” (Bermejo, 2004, pg. 164) South Africa and Ethiopia are only two parts of Africa that are affected by this epidemic. Africa has many more countries that are as deeply affected. Ethiopia and South Africa stand out more because of their population size. South Africa is far more devastated than Ethiopia because over half its population is infected with HIV. More than 2 million children have AIDS in South Africa whereas in Ethiopia only has 1.2 children infected. Even though the numbers are different; they are still devastating and hard to deal with.
Alvero Bermejo states that the funding that is now available for AIDS in Africa comes in many different forms and with strings attached. He also says that the multitude of funding mechanisms for HIV/AIDS, with their differing policy and programming priorities, mean that African governments have to grapple with complex and competing choices as they strive to meet national health and development objectives while at the same time pleasing their donors. (Bermejo, 2004, pg. 165)
The World Bank launched its AIDS program in the year 2000. This program has produced one billion dollars for HIV/AIDS efforts. There is also the U.S President’s Emergency Plan for AIDS Relief. This plan covers 15 countries. Twelve of these are in Africa alone. This is the largest funding in the AIDS epidemics history. It aims to have 15 billion dollars in the next five years. 2.4 billion Of this will be spent in 2004 for HIV/AIDS prevention, care, treatment, and the mitigation of the impact of the epidemic through help for orphans and other children. ( Bermejo, 2004, pg. 165) It is important that all people have access to treatment for all kinds of different reasons. Treatment does help in preventing others from contracting the disease. Having access to treatment can educate the individuals who have HIV or AIDS. It also states in Bermejo’s article that there are 26 million people living in South Africa with AIDS, yet only 50,000 receive treatment. Africa needs a different approach to prevention and treatment. In order to effectively link HIV prevention with HIV treatment and care, people living with HIV need access t education and information to facilitate risk reduction, reproductive health and safe pregnancy services, sexual health information and care, and even counseling. (Bermejo, 2004, pg. 168) But, I believe this can be improved through the help of mankind. Everyone, including those who have the disease, need to be more aware of the effects AIDS has on mankind.
AIDS is a growing challenge. We must find ways to reduce this disease and help with the sufferings of others. Thurman says that at first, we must understand that, as a family of nations, our fate is linked. The AIDS epidemic in Africa and throughout the world is our shared experience and affects us all. Second, although the components of an effective HIV/AIDS strategy remain constant, how these strategies are implemented will differ greatly across the globe. Third, leadership, education, and the expansion of civil rights laws can help to bring AIDS into the light, where it can be seen and combated. Sandra Thurman says in her article that in the United States a family had their home burned to the ground because their children had AIDS. In South Africa, a mother was stoned to death by her neighbors for going public about her HIV status. In India, a young man was burned to death when it was discovered he was HIV – positive. If we are to make serious progress, we must learn to fight AIDS, not people with AIDS. Finally, we cannot win the battle against AIDS unless we deal with the basic vulnerabilities brought on by poverty and inequity. We must protect the dignity and human rights of people living with HIV and AIDS and anyone else who have a disability. (Thurman, pp.3) Even in schools children who have AIDS have the right to a free and appropriate public education. This is called FAPE. These children have the right to sit in the classroom with other children to learn. AIDS does not spread through the air. It is only accessible through blood or sexual intercourse.
For children, education may seem like an impossible dream. Every 14 seconds, another child is orphaned by AIDS, and by 2010, these children may number as many as 20 million in Africa alone, UNICEF says. “But a very affordable, and equally ambitious, effort can help these kids get a fresh start and begin to heal and grow: It starts with education.” (Tutu, 2004, pg.13) Tutu says that children who live in Africa must often pay a fee to attend school. School can be a refuge to some children. It provides them with a safe haven to be around others to share their experiences and confide in one another. Kenya abolished the fees and the schools enrollment jumped 22%, to 7.2 million from 5.9 million. Other regions in Africa would also like to abolish the fee to go to school, but has not come up with the money. If the funding was there, other countries could have this too. I believe this could happen. There is no denying that we need help, but we must find the strength and have hope to find a way to give these children a safe haven.
HIV/AIDS has not affected my life hands on, but it does affect me emotionally. I cannot imagine the suffering that the people in Africa have to endure. The children who are left as orphans are devastated with the loss of their parents. AIDS is forever growing and we must find a way to somehow contain it. There are a couple of safety precautions that people with this disease can take. People who want to be sexually active need to practice safer sex, and take precautions to becoming pregnant to lower the amount of children being born through mother-to-child transmission. While abstinence is appropriate for some people, in many African countries women and young people do not have the power over their own sexuality and person to say no to sex. (Bermejo, 2004, pg. 167) IN Bermejo’s article it says that in South Africa, one in three women’s first sexual experiences is forced. Some women who have abstained sex until marriage were infected by their husband. African women are at risk more than men. I do think that there is a cure out there. People thought that malaria would wipe mankind out, but we found a cure. There is no one answer, but all studies such as the ones on drugs should be looked at more closely to see if it will help the communities that are most in need. UNICEF needs to test these drugs such as nepirvine to see if it will slow down the chance of mother-to-child transmission. It was said by Barnard that more research needs to be done. Africa is a poor continent, so it will need the help of its neighbors. AIDS will one day be conquered, but as for now the human race must come together to find a way to contain it and protect the future generation.
- “AIDS destroys children’s lives in Africa.” Australian Nursing Journal. Oct. 99, Vol. 7, Issue 4, pp17.
- Barnard, David. “In the High Court of South Africa, Case No. 4138/98: The Global Politics of Access to Low Cost AIDS Drugs in Poor Countries.” Kennedy Institute of Ethics Journal. June 2002. Vol. 12. Number 2. pp. 159-174.
- Bermejo, Alvaro. “HIV/AIDS in Africa.” New Economy. Sep. 2004, Vol. 11 Issue 3, pp164-169.
- Bongaarts, John. “Global Trends in AIDS Mortality.” Population and Development Review. March 1996. Vol. 22, No.1. pp. 21-45.
- “HIV/AIDS in Ethiopia: AN Overview” Northeast African Studies. Vol. 7. Number 1, 2000. pp. 13-40.
- Thurman, Sandra L. “Joining Forces to Fight HIV and AIDS.” The Washington Quarterly. Vol. 24.
- Tutu, Mpho A. “Fight AIDS in Africa from classrooms, too.” USA Today. May 2004.
- Prescott Papers