African AIDS epidemic vastly overrated
I thought I would share this little piece of optimism with you, not so that you will go on an African Love Frenzy (the risks are still severe), but so that you can travel without being overly paranoid about getting infected, or overly dismal about the percieved suffering arround you. Don't get me wrong, the situation is still bad as hell, just not as bad as first thought, and also getting better. Its gotta be good fpr something, right?
I sourced the following information from the Norwegian newspaper Dagbladet. I've taken the liberty to edit out the stuff of less interest/relevance, and translate it in my own lingo. If you want to read it in its original form and don't understand Norwegian, take a course ;)
A fresh study financed by USAID and other corganisations, undertaken by ORC Marco, concludes that previous UN and WHO repports vastly exaggerated the African AIDS problem, mainly because of studies using poor data collection methods, leading to studies with poor reliability and validity (this new study is supposedly muh more reliable and valid, but what do I know.The findings of the new study is supported by numerous other independant experts and organisations, so I won't argue against it).
The UN and WHO have been blaimed for excagerating the situation to get more money flowing. Washington Post refers to the study and writes that UNAIDS denies having had any politial or financial motives behind the inaccurate repports. The UN has repportedly used only small and limited population samples for entire countries, with pessimistic conclusions about the extent of the epidemic. Several independant studies have been performed, indicating that the UN numbers were way off. The new study makes a closer examination of 16 countries and conlude that the UN numbers are too high.
AIDS in Africa has never been as Galopping as first thought, and have never reached the astronomical proportions often believed. In fact, several studies in East Africa indicates that the epidemic is on a decline, and never reahed the estimates UNAIDS had for the region. In adition, the UN have to adjust its numbers for its core area, namely central Africa.
The study finds that there are vast differences. The study shows that the epidemic is more closely tied to urbanised areas than previously thought, and that lack of data from the rural areas, have led to wrong numbers. Also, tests of pregnant women were commonly used as a source of data, leading to highly unrepresentative and exaggurated data (over representation of young sexual active women).
Population studies performed with a representative selection of the population indicate vastly different infection rates. A study in Kenya indiates 8% and not the 15% calculated from the use of pregnant women. In line with the National studies, the number was reduced to 6.7% in 2004. In Burkina Faso the UN meant that 6.5% was infected, while the new studies indicates 1.8%. For Sierra Leone the gap was 7% in 2002 and only 0,9% in the new figures.
The Boston Globe repported in 2004 that the number of AIDS infeted may be exagurated as much as 25-40%
In Uganda, Zambia and Zimbabwe, the numbers have gone down.
Southern Africa and more specifically Botswana and Namibia have the highest infection rates in the world. The official Namibian prevelance rate is 23% but then considering the number of unreported deaths and the fact that MOST deaths are attributed to TB or menengitis to avoid the family suffering the stigma of having Aids in their family; who knows what the actually figure it.
Some other stats:
- 40% of deaths in SA were aids related in 2000
- 1 in 5 teachers in South Afrcia are infected with HIV/Aids (What happens to a country when it's education system collapses)
- Cases of Aids deaths in SA Prisons has increased by 750%
- but there are signs that the infection rate has decreased compared to the 90's
This coming from a country where the President first said that Aids doesn't exist and the vice president said taking a shower after having sex with an infected person will prevent you front contracting Aids.
Europe better watch out because with the massive influx or foreign worker and immagrants there is going to be a marked increase in HIV infections (has already). Considering the high number of STD cases amongst teens in the UK it's going to have a devastating effect.
Arguing about fractions of percentages is irrelevant. The fact is that aids is a highly effective killer that has already had significant effects on the Southern African and Asian populations and economies. Everyone has been talking about it for decades but have only recently started taking it seriousyl but there is still a long way to go.
HIV/AIDS is decimating souhern africa and to suggest otherwise is dumb.
What are you getting at here Wheelie?
cancel your trip, Wheelie, and go and live for a year in an east african village, preferably within eye sight of the local health centre.
I don't think you'd be posting such crap after that experience.
Hey, hey, easy now... don't shoot the messenger.
I am only refering to a newspaper article refering to reports that says that all numbers are not nearly as bad as some numbers repported by the UN and WHO, which even the UN and WHO has had to agree to having been too high. This is not the same as saying that things are still not horrendously bad, which the obviously are just not as super insanly bad as first thought, which I find is good, which was my only point. Nor is this any post trying to say that everything is nice and peacy and in anything close to good order. I'm sorry if my post was percieved to have any such connotations, which was never my intention. As my post was not a direct citation, I understand that one could easily mistake the words of others for my words, such as "vastly overrated"... clumsy of me...
Also, I'm sure that you are right, that visiting an east african health centre would not be such an assuring experience. But, if the repports that this newspaper is refferring to holds any truth what so ever, there should be some comfort, that atleast in some areas, that things are not as bad as first thought, and that in other areas still, things are getting better, however marginal.
I did not write any of these repprots, and I can't warrant which ones hold the truth (many serious sciencetists and organisations do seem to support many of its findings). But, when accredited repports come along that show us a light in the end of the tunnel, I find that remarcably wonderful news, news which I very much welcome and hope to be true. I don't think this is posting crap.
At an end note, I am aware that this is a touchy subject, but there is still no need to get personal. Sound arguments, factual information, statistics, referenes to other sources, accreditations, or other comments which may either onverge or diverge from the original post are very welcome, and fruitful. But not bashing the attempts of others at contributing information, thought or insight, intended to be a positive contrubtion to the forum. I'm simply passing on info here...
My reccomendation, follow the suit of Bossies. Great post!
unless one forces the entire population to undergo a hiv test, the data collection and obtained results will be incomplete and wrong. Geography and cultural habits matter a lot, to name just two of many factors.
As I understand it, this is a forum and one is allowed to give his/her opinion on the postings of others, and vice versa. Reading the provocative title and the content of your post, I believe you have absolutely no idea of the impact of this disease, nor of the way the governements are (not) coping with it.
Sometimes it's usefull to call the things by their name.
Yes it is positive news that the percentages might have been overstated and it's also promising to hear that generally the rates are better than the 90's.
Anybody making a trip through Africa should go have a beer at a shebeen or kuka shop and ask the locals what effect Aids has had on their community. You will definelty notice the surprisingly large number of young kids on the streets. There are a lot more of them now than in past years. Most of them are Aids orphans. This is the most devastating consequence of the Aids pandemic. Thousands of kids, the future of Africa, all growing up as ferral children without any support or structured upbringing. Thankfully there are now many NGO's that are helping these children but it's a case of too little too late.
one could pull holes in many of the studies and statistics. eg "uganda's AIDS rate falls" is a great western headline, but unlikely to be a sound claim as the basis for measuring the rate has changed simply by having such a swathe of the population die off. I bet Musevengi milked in Kampala, too. POLITICS
tragically - as in any war - swathes of the population die or are orphaned. the role of the UN, then, is to prevent genocide, raise funds and provide help to those left behind. in this war, they have to raise funds and we in the west (including urbanised south africa) are fed a dubious diet of mangled statistics and news stories to justify spending taxes overseas.
more important than headlines, we need serious strategies and resources for providing support and education. sadly, education and politics don't sit well together as governments need paybacks within 2-5 years and education takes decades or generations to have an appreciable impact.
in Ethiopia in 2003, a local asked me what I thought about condoms - we were sat under a giant billboard exhorting their use. I said I thought they were a good means of reducing pregnancies and STD including AIDS. he said Ethiopians believe they are a western trap - they might stop babies, but not HIV because its too small, he reasoned. this was some months after the Vatican released a serious epidemiological study which indicated that condoms actually make the epidemic worse by changing the rate of infection and die-off. if AIDS was like ebola, it wouldn't spread so far because it kills too quickly.
in a health centre in Opuwo, Namibia, a Herero woman offered sex as we sat 2 metres from the sign about HIV/AIDS. she smiled and shrugged as I tried to ask her thoughts on the irony. her reality is that she was hoping for some money and that short-term survival outweighs the risk of disease and death. our "reality" in the west is that HIV/AIDS in avoidable and death is taboo. I met many, many people all over Africa who see HIV/AIDS WITHOUT stigma and as another way of meeting death. we shouldn't impose our western values on life and death, but try to help without promoting either corruption or dependence.
finally, a tale from Zimbabwe where a white farmer had a complete tantrum about me being a interfering European because, he said, Germans and Swedes kept sending food aid to Zimbabwe. as I'd travelled around, I'd noted the empty silos and abandoned fields. he had been driven off his farm along with his black farm hands by thugs who just wanted to steal the plant and sell it in south africa. he said the only way forward was for the blacks to get hungry and angry and evict Mugabe. he echoed tales that blacks had told me in Harare - blacks knowing they were being too polite in letting Mugabe stay despite the collapse of the economy. why doesn't the west do something? cos there is no trade to be gained or energy to be secured.
I worked as a doctor in East Africa for 2 months. I am absolutely sure that all the estimates of disease prevalence are very vague. There is simply no way to collect accurate data so some numbers will be higher than others. To me this doesn't matter a rats ass.
Your chances of getting infected as a traveller are low (unless you're very stupid), the problems in these countries are unimaginably huge. Everything else is just statistics.
I have a friend who farms in Swaziland , he calls AIDS " Africa's Slow Puncture ".
I visited 5 years ago when he employed 9 people on the farm .Only one of those is alive today .
It is true that AIDS is rarely reported as the cause of death .I was shocked to see the dozens of obituaries in the local newspaper and yet on the next page were witch doctors advertising spells to cure AIDS .
For a westerner it's very hard to understand the mindset of Swazis who have the facts at their disposal but chose not to heed the advice .
Swaziland is reputed to have the highest % infected in the world ,life expectancy for men is below 40 years.
There is no solution for these people ,except a complete turnaround in social behaviour and I don't believe that will happen .
Remember the words of Winston Churchill :
" There are lies and there are damnable lies ,
But the the most damnable lies of all -
- ARE STATISTICS !"
[ I hope I got that right ! but not to worry if I didn't because Churchill "borrowed" that quote from Disraeli anyway .]
why is AIDS a major health problem in Africa anyway?
Ok, this might not the proper forum to discuss it but, does anyone happen to know by any chance that, why especially those poor peoples of Africa suffer AIDS most on earth?? obviously, there souldn't be so much drug addicts there and apparently many children are born HIV positive?. Can we think prostitution ( or rapes because of civil wars etc.) is responsible ? or what? the very core of the thing i mean. there should be something more than being said? I would appreciate any knowledge on that-may be Fatboyfraser ( I am a doctor either) could give a hand; for he had been in the place for quite long and practiced. thanks .
I don't think there is an easy answer to your question...
From my experience in Uganda many factors play a role in increasing the problem:
Many cultural practises encourage the spread of HIV. Circumscisions with dirty, nonsterilised blades (120 in 1 hour). Inheriting the brothers wife (great for supporting the widow and family, if the new wife is serviced, great for spreading HIV). Witch Doctors offering cures. Having multiple wifes, Not using protection......
A tabu to speak about HIV/AIDS.
Social isolation if it is known publicly that someone is HIV positiv...
Low standards of education, especially for girls and women...
Availibility of testing...
Most African people are more promiscuous than Europeans anyway, and drugs are generally not available.
I guess the worst part is when presidents say that AIDS is gods punishment, or doesn't exist...see South Africa...
Uganda had good success in fighting HIV/AIDS with a massive public awareness campain. There are many support groups and educational groups everywhere and they managed to reduce the rate of infection from high 20s to just about 6% now. However, testing is not universally available, so people don't even know if they are positive or not...
The more you look at a society in terms of education, awareness, and culture the more reasons you can find why they suffer more than others.
Although the article you cited may make some good points (data collection in Africa is unreliable, and data published in the past may not be accurate), I think the general picture is pretty much unchanged - HIV infection is endemic in Africa, and probably will be for the rest of our lifetimes.
I have worked in Africa for 20 years now, as a pilot for various humanitarian organizations. I'm not a health care specialist, just an aircraft pilot, but very frequently I serve the health care people, meaning, the plane I fly is full of medical evacuations. It's not hard to tell when people are seriously ill, nor is it hard to spot the symptoms of the opportunistic diseases that often accompany the end stages of HIV infection.
I have also noticed that in many cases when I have returned to a country that I worked in for a long time (more than a year) after being away for 5 or 10 years, the majority of the local employees I knew when I was there before have died. It is possible that they died from other causes - Lord only knows that there are no shortage of diseases on that continent - but considering their demographic (typically between 20 and 35), my guess is that they probably died from the consequences of HIV infection.
I don't think that visitors to the continent have to be overly concerned about HIV, provided that they keep their clothes on. The risk of health problems from other causes - unclean water, insect bites, and so forth - is far greater than the risk that HIV presents to a visitor who is not sexually active.
Just my observations and HO
I lived and worked in Southern Africa for 2 + years, in a 9 month period a locally openned cemetery in Harare went from 15 odd graves to 10,000's - most of these people died from 'TB' 'Malaria', etc, they were in the main below the mormal age of death for the region/country - the vast percentage of these people died from the resultant effects of HIV/Aids.
To see the horrific growth rate in one small area of an African city was quite staggering - and this was before the land problems came about, so these were not affected by te shortage of fod etc.
After this we spent 6 months living in and around Livinstone/Vic Falls - the promiscuity am,ongst the locals and western travelers was quite astounding, and left me in no doubts about the causes of rhe spread of HIV/Aids in Africa and the risk that some westerns/travellers/tourists expose themselves to ad try to shrug off or ignore.
THe only answer if you are visiting this region is to avoid sexual contact for starters,and if participating in the giving of First Aid - wear gloves.
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