AFRICAN AIDS BATTLE AFTER 30 YEARS

For Swaziland, the impact of AIDS was first felt in the late 1980s, though public acknowledgement of the epidemic took another decade to be realized.  For parts of Africa, however, the battle against AIDS has been ongoing for closer to 30 years.  Indeed, the epidemic had its origin in Africa, though it developed simultaneously throughout the world.
Now we find ourselves at a milestone.  A medical emergency is now measured by decades, with no end in sight.  But milestones have a way of drawing people’s attention to an issue.  Anniversaries call upon observers to note not just the past but the present situation and future prospects.
According to UNAIDS, every day on our continent 1,500 babies are born with HIV, and 6,500 Africans die from AIDS.  In Swaziland, the focus on prevention mother to child transmission of AIDS has reaped one of the great successes in the past decade.
UNAIDS also reports that last year there were nearly four million new HIV infections and a rising number of HIV and AIDS related deaths in Africa.
As the UN special envoy on AIDS in Africa, Stephen Lewis noted, “If the current situation continues like this there will be no Africa by the year 2040.”
Or rather, there will be an African devoid of Africans – in other words, a continent that is no longer one of nations and cultures but mere real estate.
This, of course, is the failure of the AIDS campaigns thus far, the inability to prevent the spread of the disease. “Behavioural change” is the buzz word bandied about at many a conference and workshop, but either it is a word divorced from meaningful action or the users are clueless on how to achieve this goal.
Preventing AIDS has been achieved in varying degrees throughout the continent, most notably in Uganda for a stretch of years earlier this decade.  Here, various possibilities have been raised that might explain people’s reluctance to use condoms, engage in responsible sex or be abstinent or monogamous have been raised, but even with these identified the transition from identifying culprits to actually overcoming these barriers has not been done.
No one doubts the goodwill of hundreds of incoming medical and social welfare organizations that have arrived to lend a hand since the late 1980s.  No one can credit them with a lasting impact, or achieving any headway in reducing transmission and thus prevalence and ultimately the destruction of the epidemic. 
That is not to say that similar qualified and dedicated organization and individuals should not be welcomed.  Indeed, they must.  But this is a battle that is all tactics – and unorganized tactics at that – rather than strategy.  What is the overall “game plan” to reduce AIDS in Swaziland? 
At this week’s AIDS conference in Nairobi, commemorating the end of three decades of AIDS in Africa, calls for a renewed “game plan” were raised.
This comes at the dawn of our continent’s fourth decade facing an incurable disease, when we find that 90 percent of people living with AIDS do not know their status and 70 percent of people who need treatment do not receive it.
Most of the 32 nations attending the Nairobi conference were African, and have been beneficiaries of billions of dollars of aid directed at the disease.  Although there has been some inefficient use of funding, most aid has been used as intended.  That is good news.  However, that has not dented the advance of AIDS.
Part of the problem, according to delegates from governmental and medical sectors, was that for the first decades AIDS was a subject of denial rather than firm action. 
Given “donor fatigue” and limited funds from donors who are still enthused, the time has come for meaningful action – action that produces tangible results – to be displayed.  Otherwise, the cause might well be given up as hopeless. 
This was the conclusion of delegates at this week’s Nairobi conference.
As one report summarized, “In the face of increasing donor fatigue and other issues from the global financial crisis to climate change and emerging epidemics like swine flu, fears are that the AIDS pandemic risks slipping off the international agenda.”
In the face of a seemingly overwhelming challenge, it is natural for persons and even governments to fall into a state of paralysis, and through inaction acknowledge their helplessness. 
However, with a disease that can be prevented by simply slipping on a tube of latex rubber, helplessness is hardly an issue.  On an individual basis, AIDS is easily conquered.  On a society-wide scale, the goal still remains how to convince individuals to save themselves.  30 years into the AIDS crisis, why is denial still preferable to death?