Monday, October 27, 2008

HIV/AIDS in South Africa: Past, Present, and Future

Welcome to this installment of The AIDS Pandemic, a podcast hosted by Dr. David Wessner from the Department of Biology at Davidson College. I’m Kara Earle.

Since the diagnosis of the first case of HIV in 1982, infection rates in South Africa have skyrocketed. It is currently estimated that one in five South Africans, or approximately 5.7 million people, are living with HIV. In addition, there are nearly 1,000 AIDS-related deaths occurring daily. Many AIDS experts around the world blame the South African government for their lack of appropriate response to this nationwide epidemic. Until 2003, South Africans using the public health system could only receive treatment for the opportunistic infections acquired as a result of being HIV positive, but not the antiretroviral drugs that fight the virus itself. As a result of slow government action, the HIV prevalence rate among pregnant women in South Africa increased from 0.8% in 1990 to 29.1% in 2006.

Since the end of Apartheid in 1993, South Africa has been governed by a popularly elected President. Beginning in April 1994, the African National Congress, or ANC, has consistently won a majority of votes to become the governing party, with the President of the ANC serving as President of South Africa. Thabo Mbeki was elected following Nelson Mandela in June 1999, and was forced to resign by the ANC September 24th, 2008, a mere 6 months before the end of his second term in office. With the election of Jacob Zuma as ANC President in December 2007, it is likely that when new national elections are held in April of 2009, the ANC will again be the victorious party and Zuma the new South African president. Until then, the South African Parliament has chosen Kgalema Motlanthe to lead the country.

Kgalema Motlanthe

As Deputy President under Nelson Mandela, Mbeki initially acknowledged widely-held views about the spread of HIV/AIDS in South Africa. However, shortly after his election to the presidency, Mbeki increasingly cited poverty, not HIV, as the primary cause of AIDS. He began to side with dissident scientists and did not believe antiretroviral drugs could help in the treatment of AIDS; rather, he believed the commonly used drugs were toxic. His beliefs were shared by the South African Minister of Health, Dr. Manto Tshabalala-Msimang, who advocated good general nutrition and a combination of lemon juice, garlic, and alcohol as treatment for HIV/AIDS. In 2001, the South African government, independent of President Mbeki, declared that AIDS is in fact caused by HIV and shortly thereafter the High Court ordered the government to make antiretroviral drugs available publicly. Even so, it is estimated that only 28% of South Africans who need treatment for HIV/AIDS are actually receiving the drugs.

President Mbeki was forced to resign due to allegations that he had interfered in a corruption case against ANC President Jacob Zuma. Since taking office September 25, 2008, President Motlanthe has replaced Health Minister Tshabalala-Msimang with Barbara Hogan, an advocate for the treatment of HIV/AIDS. In combination with increased awareness and involvement by the government in recent years, this change is seen as a step in the right direction for the HIV epidemic in South Africa. However, the expected next President, Jacob Zuma, arrives with a considerable amount of controversy. In addition to the recent corruption case brought against him, Zuma was tried in 2006 for raping an HIV positive family friend. He was acquitted of the charges by explaining that the victim was wearing a short skirt and sitting provocatively. He also told the court that he reduced the risk of HIV infection by showering afterwards. Despite these previous comments, he seems to address the HIV/AIDS epidemic in a reasonable manner.

It is impossible to know what changes the next six months will bring in South Africa as a result of the sudden change in government. In recent years, the country has shown a desire to take on the HIV epidemic through both prevention and treatment methods, regardless of the beliefs held by its President. It is widely believed that a country with as much wealth as South Africa should be able to provide antiretroviral drugs to all who need them, and not merely the 28% who are currently receiving them. In order to slow this epidemic, the incoming administration will need to devote significant time and funding to the development of prevention and treatment programs throughout South Africa.

I’m Kara Earle, thanks for listening.

Wednesday, October 15, 2008

Blog Action Day 2008: Poverty and HIV/AIDS

Today is Blog Action Day 2008, a day in which bloggers throughout the world are blogging about a single issue - poverty. It is the hope of the organizers that this concerted effort will raise awareness about this important issue, lead to increased donations to groups combating poverty, and, ultimately, lead to some real changes. I am happy to be a part of this year’s effort.

While many of us this week are concerned about our shrinking 401(k) accounts, the situation is much more dire for millions of people throughout the world. According to the U.S. Census Bureau, 37.3 million Americans were living in poverty in 2007 and over 45 million Americans lacked health insurance. Nearly 1 in 4 African Americans are living in poverty.

According to Global Issues, over 3 billion people worldwide live on less than $2.50 a day. Every day, the deaths of 25,000 to 30,000 children can be attributed to poverty.

Inadequate financial resources also contribute to the spread of HIV/AIDS. In the US, HIV/AIDS increasingly is becoming a disease of lower socio-economic classes. Throughout the world, women who are not economically independent or empowered are more likely to engage in survival sex, or the exchange of sex for food, clothing, or shelter. One study in North Carolina found that roughly 28% of street youths engaged in some form of survival sex. In some parts of the world, children in impoverished families may be forced into a marriage with an older man. In this situation, the girls or young women are not in a position to abstain from sex or practice safer sex. In these situations, the children and young women clearly have an increased risk of becoming infected with HIV.

So what can we do? Each of us can contribute to groups who advocate for the poor. Each of us can contact our elected representatives and urge them to support the Millenium Development Goals, a United Nations program to eliminate poverty by 2015. Each of us can write about this issue and talk about this issue. Each of us can help a neighbor in need.

To find out how other bloggers are addressing poverty, please visit the Blog Action Day web site.

Until next time, I'm Dave Wessner.