Eighty-three percent of all AIDS-related deaths have occurred in sub-Saharan Africa, with 2 million deaths and nearly 4 million new HIV infections in 1998 alone. Africa must fight AIDS, but Africa cannot fight AIDS alone.
The annual health budget in most African countries is less than $6 per citizen -- ridiculously far below the $12,000-a-year price tag of the protease inhibitors used to fight the AIDS virus. Yet, according to a recent U.N. report, international donor spending on the fight against AIDS leveled off in 1990 even as AIDS infections continued to rise at alarming rates. The report estimates that wealthy nations now spend less than one percent of their annual development assistance budgets for AIDS programs in developing countries.
The Clinton administration recently unveiled a $100 million initiative to fight HIV/AIDS in Africa. The money will be directed to prevention (through education and counseling), health care for those currently infected with AIDS, and care for children orphaned by AIDS.
Now it is time for the rest of the international community to open its eyes to the devastating toll AIDS has taken in Africa and to work for and alongside the African people to bring this epidemic to an end. We must realize that increased funding for AIDS prevention and patient care is not simply a humanitarian gesture -- just as AIDS in Africa is not just a continent-wide health issue in search of a cure. The devastating loss of lives and livelihoods, families and futures, also has lasting effects on the countries as a whole -- significantly reducing the work force, exacerbating poverty and leaving more than 4 million children without parents.
A study conducted by USAID reports that 19 sub-Saharan countries will likely have 40 million orphans by 2010 due to AIDS, and the life expectancy in 10 sub-Saharan countries will drop by 20 years. These are strains on the economy and infrastructure of countries that will take decades to mend. Our commitment to ending the AIDS crisis in Africa now is an investment in the future of the continent and its people.
But increased funding must be spent wisely. We certainly cannot expect to treat every AIDS patient in Africa with protease inhibitors. Nor can we place all of our hopes in the so-called cheaper drugs such as AZT. The answer to fighting the AIDS epidemic in Africa is prevention.
To date, the proposed solution on the part of many international humanitarian and aid organizations has been to distribute condoms, teach safe sex and hope for the best. But Africa is not America. In many African cultures, any discussion of a sexual nature is taboo, and discussion of the causes of death is equally avoided. In some countries the words "AIDS" has yet to be translated into the local language. Approximately 90 percent of those who are HIV-positive do not even know they are infected. And those who are aware of their plight shield themselves in shame and humiliation, telling no one and seeking no treatment for fear of alienation and discrimination, and causing the disease to creep silently across the human landscape.
Uganda has been fighting the discrimination and stigmatization of AIDS with aggressive education campaigns geared toward the country's young people. Although Uganda was one of the hardest hit with the AIDS epidemic (with nearly 10 percent of the population infected), the country has seen a notable drop in the proportion of infections since it began its campaign. Officials also note that young people are delaying sex and having fewer partners, further indications that the education is working. Indeed, Peter Piot, the director of the United Nations program on AIDS, noted that Uganda's focus on values -- not sex education or safe sex -- was enough to delay the average sexual experience by at least two years.
Catholic Relief Services initiated its first AIDS project in Uganda in 1989, combining psychological, spiritual and material support to HIV/AIDS patients and their families and working with Ugandan officials to empower communities to prevent its spread. Uganda now serves as a model for other African countries on how to combat the disease with openness and understanding.
The status of women in many countries in sub-Saharan Africa is also a factor in the spread of AIDS. Even when women remain faithful and careful, they are not in a position to demand fidelity. The men often carry the disease from one partner to the next, HIV-positive mothers give birth to HIV-positive children, and the cycle continues.
Providing funds for treatments of AIDS-related infections, or to decrease or prevent mother-child transmission is a Band-Aid on this problem. It does not heal the wound.
Sister Ann Duggan is the AIDS response coordinator for Catholic Relief Services.