Where Aids stigma is worse than death

The tragedy of Lilongwe’s miserable hospital, where 10 patients are crammed into the stench-filled rooms designed for three, is repeated across the continent from Cape Town to Cairo.

AIDS has brought untold misery to Africa, destroyed nearly 50 years of development and raised fears that peace and security could be threatened by unprecedented population losses and economic upheaval. Since the disease gripped the poverty-stricken continent, 12 million Africans have died of AIDS. Over 23 million people in sub-Saharan Africa are estimated to have HIV, some two-thirds of the world’s HIV-positive population. By 2005, more people in sub-Saharan Africa will have died than in both World Wars combined, according to the United Nations High Commission for Human Rights.

Equally alarming is the prospect that in the three most badly hit countries of Botswana, South Africa and Zimbabwe populations will for the first time actually shrink by the end of this decade. One in five people in seven regional states, including economic powerhouse South Africa and neighbouring Zimbabwe, are already HIV-positive and there are few signs of optimism. Health system is on the verge of breakdown, labour forces are being decimated, and millions of children will be orphaned due to the AIDS disaster.

Life expectancy is dropping by 10 to 20 years, reaching as low as 30 years old. Alarmed United Nations officials and health workers have called for a marshall plan, similar to that to resurrect post-war Europe, to rescue Africa from the abyss. Without a change in sexual behaviour, backed by a programme to educate the young and increase the availability of anti-AIDS drugs, Africa faces a cataclysm unmatched in modern history, experts say. “We don’t have a handle on the epidemic…We may be losing the fight unless our efforts are redoubled,” said UNAIDS Zambia head Kenneth Ofosu-Barko.

Malawi’s predominantly rural social fabric is being destroyed by the disease while neighbouring Zambia faces losing one in five of its economically active adult population. Anti-AIDS drugs are beyond the reach of all. Up to 80 percent of hospital beds in Zimbabwe, Zambia, Kenya and Cote D’Ivoire hold HIV patients, according to the World Bank. “We’re seeing more deaths than ever before…There are orphans just a few months old with HIV,” said Ben Njobvu, research coordinator at the Chikankata hospital, 125 km south of the Zambian capital Lusaka.

AIDS experts working in the region say too often, well-intentioned small-scale efforts by NGOs are uncoordinated and, by their very size, unequal to the task facing them. “Political leaders have their heads in the sand. There is no hope, it’s a crime against humanity that so many have been allowed to die,” said a senior UN official.