A rchive Date
[ 16-07-2000 ]
Category
[ International Relations ]
sub-Categoy
[ Africa ]
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[Africa being ravaged by AIDS pandemic
By ERIC MARGOLIS Contributing Foreign Editor
July 16, 2000
BASEL, Switzerland -- Last week's AIDS conference in Durban, South Africa reminded me of two eerie premonitions I had of the dreaded HIV epidemic.
Back in 1978, when I was living in New York's West Village, community newspapers kept reporting mysterious ailments among homosexual men, notably never-before-seen fungal infections, respiratory disorders and skin lesions. The victims would waste away, then die. The only common thread at the time was that many of the sufferers had visited male prostitutes in brothels in Haiti, or had numerous sexual partners each day. It wasn't until 1981 that these symptoms were recognized as a new scourge - AIDS.
Eight years later, I was flying over remote southern Angola with South African intelligence officers. They pointed out to me abandoned villages that were being swallowed up by the advancing bush. The villagers had died of AIDS. Entire regions of Angola were being depopulated. Cuban troops sent to fight in Angola brought HIV back to their island.
Fourteen years later, the AIDS epidemic continues unabated. According to figures made available here in Switzerland by the World Health Organization (WHO), in some parts of black Africa 25% of the population has been infected by HIV through heterosexual sex. Thirty million people have been infected worldwide, says WHO. Seventy percent, or 21 million, are in sub-Saharan black Africa. Certain African states - Zambia, Botswana, South Africa and Zimbabwe - are particularly afflicted. Four million Indians are also infected, though this represents only 1% of India's huge population.
AIDS, the conference reported, is now a pandemic rivaling the medieval Black Death that killed 20 million people in Europe, and the post-World War I influenza epidemics that killed 28 million worldwide. AIDS is also rivaling the principal killer diseases, malaria, infantile diarrhea, and tuberculosis - all endemic in Africa.
While many forms of HIV can now be arrested or suppressed by very expensive drug cocktails, such treatment is unaffordable for Africans. The conference reported no progress in arresting the lethal spread of HIV.
Condoms refused
The main reason? The anti-HIV campaign is based on promoting use of latex condoms. Many African men simply refuse to use them. So, in truth, do many men around the world who say using a condom reduces sexual pleasure.
The simplest answer to HIV is not more wildly expensive drugs, but improved, thinner condoms made from a film polymer that can be sprayed on the male, or applied as a gel by the woman in foreplay, providing barrier protection with minimal loss of sensation. Condom technology has advanced little in recent years. Why not invest in condom research instead of drugs?
The Durban meeting also confirmed a fascinating theory that has been discussed for years: circumcised men appear far less susceptible to HIV than uncircumcised men.
In Muslim parts of Africa, where men are circumcised, the AIDS rate is below 1%; in non-Muslim regions where circumcision is not practised, the AIDS rate is 10-20 times higher.
Circumcised men also have a far lower rate of other sexually transmitted diseases.
Interestingly, the AIDS rate in Arab Africa north of the Sahara is below .5%. Strict mores against pre- or extra-marital sex in Muslim societies likely play a role in lower HIV transmission. Haiti, curiously, shows the same sexual disease profile as Africa, suggesting that genetics may play an important, but as yet unknown, role in HIV susceptibility.
Here in Europe, young people are being scared silly by terrifying warnings they will catch AIDS if they have unprotected sex - or any kind of sex, for that matter. Small wonder Europe's birth rates are plummeting.
Intravenous drug use, not heterosexual sex, is the main vector for AIDS in Europe and the former USSR.
In North America, deaths from AIDS were under 25,000 last year, hardly an epidemic on a continent of over 300 million people, but still very worrisome. Many victims were intravenous drug users or poor. Alarmist predictions of a few years ago that HIV would explode into the heterosexual mainstream in North America proved to be hot air - as are some of the current dire predictions about the globe being engulfed by HIV.
Among all the hand-wringing over Africa's plight, few have stopped to consider: 1) no one paid any attention to Africa's public health until recently. People there routinely died in their 30s. My own view is that AIDS was probably always present in sub-Saharan Africa, just not recognized; 2) Many Africans are so debilitated by chronic parasitic infections, fungi, malaria and nutritional deficiencies that HIV provides the coup de grace, carrying off the weakest.
For Africa, better rural medical clinics, better nutrition and thinner condoms are faster and more realistic answers to the HIV plague than magic bullet vaccines that have yet to be invented.
Eric can be reached by e-mail at margolis@foreigncorrespondent.com
 World Fact Book (CIA)]
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