Lifestyle as well as poverty affect the spread of HIV/AIDS, says Dr Yaw Adu-Sarkodie from Ghana, a consultant for the World Health Organisation.
A leading African AIDS doctor stressed the link between poverty and HIV/AIDS, as well as the link between personal lifestyle and the spread of the pandemic, when he gave a Greencoat Forum lecture on 'Tackling the AIDS crisis in Africa' at the IofC centre in London, 14 October.
Dr Yaw Adu-Sarkodie from Ghana, a consultant for the World Health Organisation who is doing research into AIDS at the London School of Hygiene and Tropical Medicine, said that 'structural adjustment' programmes imposed by the IMF and World Bank had led to rural poverty and the collapse of local markets in several African countries. Mothers, desperate to earn an income, had been forced into prostitution in the cities and this guaranteed the spread of the disease. He told of one African mother who had said, 'It will take me 10 years to die of the disease. My children will die next week if I don't feed them.'
'We owe it to the whole world to create a level [economic] playing field,' commented Dr Adu-Sarkodie.
He stressed that the cost of drugs, which has fallen dramatically since 1990, was still too expensive for Africa. As a result, only 50,000 Africans out of the millions of sufferers have access to the drugs. India had produced generic drugs but was forbidden to export them to Africa under World Trade Organisation rules. 'Cheap drugs are still not allowed,' he said. Yet only one per cent of the profits of the big pharmaceutical companies came from AIDS drugs sold to Africa. He deplored the fact that the world could find $200 billion to prosecute a war against terrorism 'but we can't find $20 billion for [UN Secretary General] Kofi Annan', needed to tackle HIV/AIDS.
Dr Adu-Sarkodie also stressed the need for sexual abstinence and fidelity as part of the 'ABC of AIDS control'. While 'protected' sex was universally advocated, 'people do not seem to see abstinence as effective,' he said. 'This is not hammered on. I believe abstinence has a crucial role—the tradition of remaining a virgin till married life.'
Dr Adu-Sarkodie outlined the reasons why Africa was particularly hit by HIV/AIDS, where 29.4 million people are sufferers in Sub-Saharan Africa alone. These included polygamy, a lack of mass education, impoverished health systems and 'poor political leadership' with some politicians stigmatising sufferers. President Mbeki of South Africa had been late to acknowledge the impact of the disease. But President Musevani of Uganda had admitted the crisis 'without worrying about the impact on tourism'. There, 'it is a fiat from the President that all ministers speak openly about AIDS'. The resultant AIDS awareness meant that Uganda's graph of infections was beginning to decline. Senegal, a Muslim country, had comparatively low infection rates, and Dr Adu-Sarkodie attributed this to the prevailing attitude of the population towards fidelity.
Dr Adu-Sarkodie stressed the social and economic consequences of the disease, including a decline in average life expectancy to 35 years in Sierra Leone and less than 50 years in Botswana. There was a serious loss of manpower and productivity, including on farms which led to food shortages. Some schools in Kenya had no teachers. And in some countries up to 40 per cent of the military were HIV positive, leading to 'huge national and global security issues'. A quarter of all working days lost in Africa were due to HIV/AIDS, which also account for over 25 per cent of all disease-related deaths. There was now an 'orphan generation' with children as young as 12 having to take family decisions.
He stressed an urgent need for a massive programme of education, particularly among the pre-teens, who are largely unaffected. 'The bottom line is that prevention is better than treatment,' he said.
Elisabeth Madden, from the external relations division of Anglo-American mining corporation, spelt out the multinational's social policy towards its 125,000 employees in South Africa, 24 per cent of whom are HIV positive. This figure rose to nearly 40 per cent among diamond miners in Botswana. The company was providing voluntary, life-long, anti-retroviral treatment to employees--the first multinational in South Africa to do so--though the take up was slow due to the stigma associated with the disease. The company had just announced a partnership with Lovelife charity to extend treatment in public health clinics. The company was doing all it could to address the humanitarian crisis, she said.