AIDS it’s History and it’s impact in Africa
A paper from the Social Responsibly Committee about AIDS following a meeting with Dr James Bunn, a Consultant Paediatrician working in Liverpool in April 2004. Dr Bunn has a special interest in AIDS and has worked in Malawi. History of HIV/AIDS 1981 Epidemic of a rare pneumonia among the gay community in Los Angeles. 1982 Case definition of AIDS when symptoms could be described. 1983 Slim disease found in Uganda where healthy adults were wasting away. 1983 Isolation of HIV virus in France when the slim disease was recognised as being related to HIV. 1985 Blood test developed that could identify the virus 1987 World Health Organisation began a special programme on AIDS realising it was widespread and not confined to the gay community. 1989 Red Ribbon was launched. 1994 AZT was found to prevent MTCT (maternal to child transmission) if given in last weeks of pregnancy and during delivery. This has brought the risk of infection in this way down to less than 2% in the UK. 1995 It was found that a combination of drugs can work in adults to prolong life and its quality. 1995 Found that prevention of STI (sexually transmitted infections) can also prevent transmission of HIV. 1996 The Global vaccine initiative was launched. This has proved very difficult. 2000 UN Security Council held its first meeting on a health issue this was about the AIDS problem and the economic problems it was causing in Africa. 2002 Anti-retroviral drugs became available at subsidised prices for the poorest countries and are now produced in India, South Africa and Brazil. 2003 3 by 5 initiative was launched. This was to treat 3 million living with HIV in poor countries by 2005. This is seen as a good aim but unlikely to be achieved. How many people? World-wide there are approx 40 million people living with the virus. Of these 37 million are adults and 2.5 million are children under the age of 15. 5 Million people were newly infected with HIV in 2003, of these 4.2 were adults and 700,000 were children under 15. 3 million people died of AIDS deaths in 2003, of these 2.5 million were adults and 500,000 were children under 15 and of these 330,000 were children under 5. 90% of children who are HIV positive are infected from their mothers. Much of this mother to child transmission is preventable. Last year every pregnant woman in the UK was offered a test for HIV. Now most of the children infected with HIV in this country are children brought into the country as migrants. The situation world wide Numbers infected: - Sub-Saharan Africa 25-28.2 million people infected. SE Asia 4.6-8.2 million people infected. Latin America 1.3-1.9 million people infected. Western Europe - 520,000-680,000 people infected. North America 799,000-1.2 million people infected. Caribbean350,000-590,000 people infected. Eastern Europe and Central Asia 1.2-1.8 million people infected. New Zealand and Australia12,000-18,000 people infected. India and SE Asia are seen as sitting time bombs in terms of numbers and spread of HIV but they do not seem to be addressing the problems they will face. Many countries do not declare their figures for HIV for political reasons because they feel people will not invest in countries that have a problem. In some countries the numbers with HIV are hidden because of social pressures eg in Cuba they used to imprison people who were HIV positive so there was a reluctance by people to be tested. The Situation in Africa In Botswana 40% of pregnant women are HIV positive. In Zambia the women get HIV 10 years younger than men do. This is because many young girls marry older men who have had several partners. There is also a prevalence of sugar-daddies who have several girls that they keep for sex. There is also an issue of abuse and rape. Urban areas have larger prevalence than rural areas. It has also been found it is more common on trucking routes where the drivers take sexual favours on the route and then they take the infection back to their wives. In the mining areas of South Africa where the men live in mining communities and only go home to their wives once or twice a year there is a greater chance of infection because they tend to use prostitutes and their wives back home find other partners. However in Kampala, Uganda the numbers of people infected with HIV is declining. This may be because the President spoke about one of his relatives dying from AIDS. This brought the problem out into the open and people realised that if it could happen to their President's family, it could happen to them. It made them realise no-one was immune. Cost to the Health Services In Nairobi 39% of hospital beds are occupied by HIV patients. In Zimbabwe 25% of all health spending goes on HIV. In Rwanda 66% of all health spending goes on HIV. Cost to Society Employers in the sugar plantations of Kenya have found health care costs for their employees rose by 10 times in the period of 1989-1997. Absenteeism from work is increasing as families attend more funerals and this is an added financial burden to families. Families are facing the loss of young adults and the loss of mothers which creates a large number of orphans. The young adult may also be the money earner for the family so there is an increase in poverty. Life expectancy is decreasing. In Southern Africa life expectancy was 44 in the mid 1950s, 59 in the 1990s and is expected to be down to the mid 40s again by 2010. 26% of all adult male deaths in South Africa are HIV related. 34% of all female deaths in South Africa are HIV related. 30% of all deaths in South Africa are HIV related. Age of death of AIDS victims is likely to be between 25 and 45 years. In Western Europe the numbers of deaths from AIDS declining although people are still being infected. This is because they are given three drugs which are changed periodically and may give people 20 or more years of active life. It is now hoped that children who are HIV positive will live to adulthood which means they may be able to work and be educated. They cannot be cured but they can live with the illness. Mother to child transmission Over 55% of those infected with HIV are women. In some areas 40% of antenatal mothers are HIV positive. Up to 45% of their infants will be infected. This could be halved with ante-retroviral drugs if administered at the right time. How to prevent infection a) Voluntary testing and counselling. b) Maternal treatment during pregnancy and delivery. c) Breastfeeding and infant feeding. In Africa when babies are totally breastfed for 3-6 months there is no greater chance of HIV infection than for those fed on formula milk. However there seems to be greater risk if they are fed with a mixture of breast and formula milk or are weaned before this time. This advice is different from advice given in the UK where mothers who are HIV positive would be advised to give formula milk. In Africa a baby would be 6 times more likely to be infected if not breastfed exclusively. There is a need for monitoring the drugs given to patients as these need to be changed regularly as the virus becomes resistant to them. This monitoring is not always available in Africa. There is also a reluctance on behalf of parents to give the drugs religiously every day to children especially when the child appears well. Prevention of infection in adolescents and adults a) Abstinence from sex before marriage. b) Be faithful to one partner c) Change your lifestyle or use condoms. Sometimes these are added: d) Do not discriminate against people living with AIDS e) Encourage people living with AIDS and give them hope. The use of condoms must be seen not just as a way of preventing HIV but also as a way of preventing all sexually transmitted diseases. There must be voluntary treatment and counselling available to all. Sterile needles must be used for injections and for body piercing. There must be safety in blood transfusions. Homosexuals must get advice on safe sex and behaviour. There must be post rape prophylaxis. This means administering drugs immediately following the incident which, hopefully, will prevent the transmission of the disease. In this country there is a great need to educate children and adolescents to say NO to casual sex and to know what constitutes abuse. Many adolescents still believe that HIV cannot happen to them. They seem unable to recognise the consequences of their behaviour. Adolescents can be very difficult to reach as they do not like being told what to do by adults so there is a need for counsellors of their own age and also they tend not to use the Health Service until they are very ill. Further reading Dr Bunn suggested two books for further information: The AIDS Handbook published by McMillan ISBN -0-333-94576 cost £3.50 Journeys of Faith Number 16 in a series called Strategies for Hope. This book has several stories in it of people who have worked among people suffering with HIV. There is also the Christian Medical Fellowship website: http://www.CMF.org.uk HIV seems no newsworthy in this country because people with the disease can be helped to live longer and to have a better quality of life. It also seems to have lost some of its stigma. However, as Christians, we must be concerned about the devastating effect that the illness is having on people everywhere and particularly in Africa where countries that are already poor are becoming poorer because most of the people who die of the illness are at or below working age. If people do not know that they have the disease they can not be helped so the British Province of the Moravian Church sends AIDS testing kits to Sikonge Hospital in Tanzania every month to help with this problem. It is now routine for pregnant women at Sikonge to be tested so that, if they have the disease, their unborn child can be protected. A prayer for those with HIV Hear our Prayer, O God of mercy and love, for all those who live with HIV or AIDS. Grant them loving companions who will support them in the midst of fear; give them hope for each day to come, that every day may be lived with courage and faith. Bless them with an abundance of your love, that they may live with concern for others. Pour on them the peace and wholeness which you alone can give. Through Jesus Christ our Saviour, who came to give abundant life. Amen. Prayer written by Vienna Cobb Anderson (diocese of teh Highveld, South Africa) Paper written up by Sr Kathryn Woolford and adapted by Sr Sarah Groves
The pages within this Social Resonsibility section represent the views of the committe and not necessarily that of the Moravian Church.