”How can the world stand back and watch millions of Africans die of Aids?” asks United Nations Special Envoy for HIV/Aids in Africa, Stephen Lewis.
”What is it about Africa that allows the world to write off so many people — to make people expendable — when all the money needed is found for war on Iraq? Is it so overwhelming? Have wealthy countries simply washed their hands of Africa? Is it too far away? Is it subterranean racism?” he asks in an interview with the Mail & Guardian.
Whatever the reason, Lewis is convinced that there is no time to lose in confronting HIV/Aids and that the continent urgently needs funding to avoid the collapse of critical sectors under the weight of the pandemic.
”Suddenly [it] is upon us and the toll is dreadful. Essentially families and communities are disintegrating in a way that is unparalleled, unprecedented. There has never been such a desolating assault on a continent, there has never been such a catastrophe.”
The death of seven million agricultural workers in 25 countries since 1985 has devastated the sector, leading to famine in Southern Africa, and is a harbinger of what could happen in areas such as education and security, says Lewis.
”There is the possibility of education falling apart in country after country. Of whole sectors disintegrating.
”If it happens in agriculture, why not in education? Schools are losing teachers and cannot replace them. They are under siege. Children are taken out of school because of the drought and to care for sick and dying parents. What happens when the education system breaks down?”
Recent reports found that four to five of every 10 children of primary-school age are not in school. In Mozambique 17% of teachers are expected to die of Aids by 2010.
Lewis says the pandemic poses an extreme risk to the population in conflict areas such as Sierra Leone, the Democratic Republic of Congo and Angola. ”Angolan women took me aside [at a recent conference at Cape Verde] and said there are thousands of soldiers about to be demobilised, whose HIV levels are twice as high as in the villages.”
He is concerned about the vulnerability of women to HIV/Aids. ”Normally the world responds to vulnerable women, but it hasn’t. The implication in human terms is overwhelming. Women do 60% to 80% of the agricultural work. Children won’t have mothers.
”Many countries have about a million orphans and the extended family system is in tatters … We have sibling families with young girls forced into survival sex and young boys into grievous forms of child labour.”
The political leadership of the continent is also concerned about the orphans, says Lewis, and the havoc they might wreak if they turn into delinquents with nothing to lose.
”There must be a vigorous campaign to get every child into school and for the school to become an anchor in children’s lives, where they get a meal, self-worth and peer relationships.”
Lewis says there are successful initiatives across Africa confronting the problems of Aids, but they lack funding to be expanded to scale. ”UNAids said at the last meeting in October it could use $6,5-billion just for Aids without any changes in capacity and infrastructure.”
He believes the continent must deal with the pandemic or it will not deliver on the economic growth and opportunities envisaged by the New Partnership for Africa’s Development (Nepad). ”Unless Africa deals with communicable diseases, Nepad will be a pipe dream.
”All [previous economic] assumptions have been wrong in the face of Aids. The idea that if the economy grows enough, money will trickle down for health [is wrong]. The disease burden is so great that unless countries deal with it, they will never achieve economic growth. They are putting at risk the very designs for African development itself.”
On Wednesday Lewis began a three-week trip to five countries in Southern Africa to look at the effect of the food crisis and Aids on the region.
He says: ”I spoke to [HIV-positive] mothers recently in Arusha [Tanzania] and the first thing mothers always say is they need food … Next, they want education for their children so they have prospects after they die. Then they ask for drugs. That is always the order.”
Lewis will report to UN Secretary General Kofi Annan on his return and continue to rally support for dealing with the humanitarian crisis in Africa.
Currently the UN’s Global Fund to Fight Aids, Tuberculosis and Malaria has collected only $2,1-billion of the $10-billion it needs, and will run out of resources by next year unless donor countries fulfil their promises.
Grim findings
Two-thirds of the 10-million people with HIV/Aids in sub-Saharan Africa are women and girls between the ages of 15 and 24 who are going to die, says United Nations Special Envoy for HIV/Aids in Africa, Stephen Lewis, reviewing the latest figures on HIV/Aids by the UN and the World Health Organisation.
Lewis told journalists in Johannesburg on Wednesday that Aids was depopulating parts of the continent of women. He described the pandemic as an assault on women.
The Aids Epidemic Update, released this week, shows that 19,2-million of 42-million people with HIV/Aids in the world are women and 3,2-million of them are children under the age of 15. Two million of the five million people infected with HIV this year were women and 800 000 were children. Of the 3,1-million people who died of Aids this year, 1,2-million were women and 610 000 were children.
A regional analysis of sub-Saharan Africa showed it had the highest number of adults between the ages of 15 and 49 with HIV/Aids, at 29,4-million, as well as the highest percentage of HIV-positive women, at 58%.
But within these grim findings are signs of hope. For example, in South Africa HIV-prevalence rates among pregnant women under 20 have fallen from 21% in 1998 to 15,4% last year. Prevalence among young urban women in Ethiopia’s capital, Addis Ababa, has also dropped and Uganda is proof that ”the epidemic does yield to human intervention”, the report said.
But in Botswana, Lesotho, Swaziland and Zimbabwe HIV-infection rates have rocketed to more than 30% of the adult population — ”higher than thought possible”.
There is no end in sight to the rising toll on the continent, Lewis warned. ”The worst years are yet to come. We are still on the threshold.”