Africa: AIDS Updates, 1/2, 07/06/02

UNIVERSITY OF PENNSYLVANIA - AFRICAN STUDIES CENTER

Africa: AIDS Updates, 1 Date distributed (ymd): 020706 Document reposted by Africa Action

Africa Policy Electronic Distribution List: an information service provided by AFRICA ACTION (incorporating the Africa Policy Information Center, The Africa Fund, and the American Committee on Africa). Find more information for action for Africa at http://www.africaaction.org

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Region: Continent-Wide Issue Areas: +gender/women+ +health+ +economy/development+

SUMMARY CONTENTS:

The XIV International AIDS Conference begins in Barcelona, Spain, on July 7. Today's two postings include several related articles. The official conference web site is: http://www.aids2002.com. Daily coverage of the week-long conference is available at http://www.kaisernetwork.org/aids2002

This posting contains a speech by Stephen Lewis at a UN Press conference last week, and selections from the Kaiser Daily HIV/AIDS Report summarizing other recent developments. A related posting today contains excerpts from a speech by Zwelinzima Vavi, General Secretary of the Congress of South African Trade Unions, and from a UNICEF press release.

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Statement by Stephen Lewis, the Secretary-General's UN Envoy on HIV/AIDS in Africa, at the noon briefing of UN media, July 3, 2002.

[excerpts: full text available at

http://allafrica.com/stories/200207030681.html]

This media briefing is driven, of course, by the publication yesterday of the two new startling reports on HIV/AIDS. For ease of reference, I'll refer to the omnibus Global document as the UNAIDS report, and the document relating specifically to youth as the UNICEF report. ...

Rather, I want to draw attention to two particular aspects, which flow from the reports, and which relate directly to Africa. ...

First: amidst the unrelenting catalogue of horrors --- the prediction of a possible 68 million additional deaths world-wide, 55 million of them in Africa by the year 2020; the ghastly finding that the pandemic has not yet begun to level off in Africa, even in the highest prevalence countries; the bracing public assertion by Dr. Piot that the pandemic is still in its early stages overall --- to this catalogue of horrors, there must be added, in the case of Africa, that the pandemic is now, conclusively and irreversibly, a ferocious assault on women and girls.

We all understood that the percentages were rising. We all understood that women were particularly vulnerable. We all understood that the pandemic was feasting on gender inequality. I'm not sure, however, that any of us understood until now, the full magnitude of the accelerating catastrophe for women. That's where these two reports are indelibly interlinked.

The figures, carefully extracted from the various tables, tell the story. And I make no apologies for using the figures: somehow the world has to be made to understand what's happening.

According to the UNAIDS report, of the 26 million infected adults in SubSaharan Africa (that is between the ages of 15 and 49), women now constitute 15 million, or 58%. That figure is distressing enough, but look what happens when it's linked to the data from the UNICEF report. At the very outset of that document, there is a breakdown of the numbers of young people (defined as 15 to 24) living with AIDS in various regions of the world. For Sub-Saharan Africa, the total is 8.8 million, two-thirds of whom, that is to say 67% of whom, are young women. The ratio, young women to young men, is an explicit two to one.

Put in the context that more than half the new infections now occur among young people --- 6,000 a day --- and you can see what is in prospect for Africa. I'm not a statistician, but if the present reality is 58%, and the future reality is 67%, we're talking about the unthinkable ... a looming cataclysm for the women of Africa.

There are, in both reports, endless pieces of evidence to confirm the pattern. If you cull the tables at the back of the UNICEF document (confirmed in the UNAIDS document), it's hard to believe what emerges. There is a category on the percentages of young people living with AIDS at the end of 2001. The category provides a low range and a high range. For comparison purposes, I'll use the high end because that's where we appear to be heading, given the projections of the UNAIDS report.

On that basis, in Botswana, the percentage of young women living with AIDS is 45%; the comparable figure for young men is 19%. In Lesotho, young women are at 51%, young men at 23%. In South Africa, the numbers are 31% as compared to 13%. In Swaziland, 47% to 18%. In Zambia, 25% to 10%. In Zimbabwe, 40% to 15%. In Namibia, 29% to 8%. In Malawi, 18% to 8%. In Cameroon, 15% to 6%. In Central African Republic, 16% to 7%. In Rwanda, 13% to 6%. The pattern is comparable for all African countries.

Please note that in every single country, the young HIV positive women represent two to three times - or more ---- the infection rates of young men. I despair of the numbing recitation of statistics, but they reveal a relentlessy grim picture. ...

In background papers, prepared by UNAIDS, it is said that one-third to almost one-half of new mothers in the worst-affected countries, could die of AIDS.

And then as if all of this isn't bad enough, we have the UNICEF document, based, I would emphasize, on more than 60 new national surveys --- the most up-to-date definitive material now available --- which shows, in alarming page after page, the astonishing lack of knowledge about AIDS, and transmission, and prevention and sexuality among the young people surveyed.

In the course of those pages, there are the following representative glimpses of reality: in Cameroon, Central African Republic, Equatorial Guinea, Lesotho and Sierra Leone, more than 80% of young women, ages 15 to 24, do not have good knowledge about sex; in Nigeria, 95% of girls, age 15 to 19, perceive their risk of contracting AIDS to be minimal or non-existent; in Nigeria again, 61% of unmarried sexually active young men, 15 to 24, did not use a condom at the last episode of sexual intercourse, and, incredibly enough, 93% of these young men felt no risk or a small risk of contracting HIV; in a large number of African countries, specifically, Somalia, Burundi, Comoros, Uganda, Zimbabwe, Rwanda, Tanzania, Sierra Leone, Chad, Niger, Mauritania, Cote d'Ivoire, Guinea-Bissau, Senegal, Central African Republic, Sao Tome and Principe, Gambia, Togo, a majority of the girls surveyed did not know where to get tested; and in corroboration of what I have already noted, 17% to 22% of girls age 15 to 19 in major urban areas of East and Southern Africa are already infected. In Ethiopia, 14% of young women surveyed, said that they had had sex before the age of 15; in Nigeria the figure is 17%. These two countries, with a combined population of nearly two hundred million, stand at the very precipice of an explosion in the pandemic.

The report also chronicles the sexual violence, the predatory sexual behaviour of older men, the girls pulled out of school to care for sick and dying parents, the complicating malevolence of the sex trade, the growth of the orphan population, and much more. It is a true and full compendium.

If it can be said, as it can, that by the year 2020, the number of deaths from AIDS in Africa will approximate the number of deaths, military and civilian combined, in both world wars of the 20th century, then it should also be said that a pronounced majority of those deaths will be women and girls. The toll on women and girls is beyond human imagining; it presents Africa and the world with a practical and moral challenge which places gender at the centre of the human condition. The practice of ignoring a gender analysis has turned out to be lethal.

And that brings me to the second point I want to make, albeit far more briefly. I listened carefully yesterday to Peter Piot and to Jeffrey Sachs, advisor to the Secretary-General, both of them speaking to the high-level session of the Economic and Social Council. They both made the same unanswerable points: AIDS is wrecking human havoc in every sector of a steadily-increasing number of African countries; we have all the knowledge we need to turn the pandemic around, but to do it, there must be a huge quantum leap in financial resources.

On those truths, there seems to be an international consensus. At the recent G8 Summit, the New Partnership for African Development, or NEPAD, included a strong paragraph which said, unequivocally, that unless the communicable diseases are defeated (and by that they meant primarily AIDS), economic and social development in Africa would be an "impossible hope".

In the formal G8 response to NEPAD, called the Africa Action Plan, under the section titled "Improving Health and Confronting HIV/AIDS", there appears this language: "To this burden (meaning other communicable diseases) has been added the devastating personal and societal costs resulting from AIDS, the consequences of which stand to undermine all efforts to promote development in Africa ... Therefore, recognizing that HIV/AIDS affects all aspects of Africa's future development and should therefore be a factor in all aspects of our support for Africa, we commit to ...". And then there follows a series of predictable commitments which resonate with goodwill and purpose.

What has not yet resonated are the dollars to meet the commitment. The shortfall is staggering: billions and billions of dollars meant to prolong and save human life in Africa over the next generation. The Global Fund is desperately underfunded. The Secretary-General has asked for $7 to $10 billion a year to fight the pandemic. This year the Fund has roughly $800 million. Peter Piot uses the figure of $10 billion overall from all sources. Everyone agrees on that range or higher. This year we're closing in on $3 billion.

Jeffrey Sachs says the necessary money is readily available; it's a simple matter of arithmetic. He argues, as the MacroEconomic Commission on Health argues, that to reach the Millenium Goals for Health would require setting aside, annually, one penny of every ten dollars of income in the rich countries ($25 billion required out of a $25 trillion pot). But the penny won't drop.

These two reports make as eloquent an argument as we're ever likely to hear for the world to come to its senses. For the African continent, it means economic and social survival. For the women and girls of Africa, it's a matter of life or death.

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KAISER DAILY HIV/AIDS REPORT A free service of kaisernetwork.org http://www.kaisernetwork.org/dailyreports/hiv

Excerpts from issue of July 5, 2002

GLOBAL CHALLENGES

1. $27 Billion Boost for HIV Prevention Programs Could Avert Majority of Projected HIV Infections Worldwide

Nearly two-thirds of the HIV infections projected to occur worldwide by 2010 could be prevented if an additional $27 billion were allocated to HIV prevention programs, according to two studies released yesterday, the Boston Globe reports (Donnelly, Boston Globe, 7/5). In the first study -- published in the July 6

issue of the Lancet -- epidemiologists, demographers and mathematicians from UNAIDS, the World Health Organization, the U.S. Census Bureau and the private organization The Futures Group International created a model to predict the future of the epidemic and how new infections could be averted. The researchers

predict that an additional 45 million people worldwide will become infected with HIV by 2010 but add that 29 million of these infections could be prevented if HIV prevention efforts are rapidly expanded or instituted. Such efforts include advertising campaigns, school and workplace education, condom distribution and

needle-exchange programs, the study states.

According to the study, while the majority of HIV infections could be averted if fully expanded programs were in place by 2005, half of the projected benefit would be lost if the projects were not in place until 2008 (Brown, Washington Post, 7/5). The researchers project that the cost of such a "concerted, global campaign" would require a quadrupling of current spending on HIV prevention. "These deaths are not inevitable. We can actually do something which can substantially decrease this epidemic," WHO

epidemiologist and study co-author Dr. Bernhard Schwartlander said (Garrett, Newsday, 7/5).

The model did not take treatment into account because the researchers said that there is "no research to quantify how the use of antiretroviral drugs changes population-wide transmission of HIV" (Washington Post, 7/5) Schwartlander said that "prevention and treatment efforts are intertwined, and there should not be a debate of funding one over the other."

Prevention Plan Outlined

A separate study released yesterday outlined a plan for expanding current HIV prevention programs and creating new ones. The study was drafted by the Global HIV Prevention Working Group, an independent panel of 40 "leading HIV prevention specialists" that was assembled by the Bill & Melinda Gates Foundation and the Kaiser Family Foundation (Boston Globe, 7/5). The group convened to evaluate the projections made in the other study and "determine what an all-out global HIV prevention campaign would take," Newsday reports (Newsday, 7/5). The group proposes a number of initiatives, including allowing countries to set their own priorities for funding, boosting health system infrastructure, expanding successful prevention programs, mobilizing political leadership, improving HIV surveillance and "dramatically" increasing access to treatment. To successfully achieve these goals would require an additional $4.8 billion annually by 2005 and a total of $27 billion in funding by 2010. Helene Gayle, co-chair of the working group and an official with the Gates foundation, said, "We are going to continue to face devastation if we don't as a world community wake up to this and put in the resources that we need to make the difference. By presenting some practical solutions, and some things we know are doable, it's not just saying 'Give us the money and trust us.' It's 'Give us the money ... and there are solutions available today'" (Boston Globe, 7/5). ...

2. Debate Over Funding for Treatment, Prevention to Be 'Centerpiece' of XIV International AIDS Conference

The debate over how to divide funds between prevention and treatment efforts will be the "centerpiece" of the XIV International AIDS Conference that begins on Sunday in Barcelona, the Wall Street Journal reports. While those favoring prevention programs and those favoring treatment programs agree that the $2 billion in the Global Fund to Fight AIDS, Tuberculosis and Malaria is "paltry," the "clash" between the two groups will "profoundly affect" the distribution of the funds.

At next week's conference, treatment advocates, doctors and people

with HIV/AIDS plan to present research supporting funding for HIV/AIDS treatment programs and stage "massive" protests, the Journal reports. Treatment Action Campaign Chair Zackie Achmat said those treatment advocates also are planning a "new pan-African treatment movement, demanding everything from vitamins to antiretrovirals."

Prevention Has 'Long-Term Impact'

The Bill & Melinda Gates Foundation's new HIV/AIDS and tuberculosis prevention taskforce, which is focused "almost solely" on prevention, also will "tak[e] center stage" at the conference, the Journal reports. The group, led by AIDS prevention expert Dr. Helene Gayle, advocates HIV/AIDS prevention through condom use, voluntary HIV testing, behavioral changes, needle-exchange programs and research of microbicides and HIV vaccines. The taskforce focuses on prevention "because it has the best long-term impact," according to Gayle. "It's relatively simple to say dollar for dollar that prevention is more cost effective," AIDS Vaccine Advocacy Coalition Director Chris Collins said, adding, "The more complex point is what happens in societies where one in five or one in three people in the professional class are wiped out."

Shifting Focus

Although the South African government has focused almost exclusively on prevention, the HIV infection rate there has continued to rise, according to Achmat, who advocates a Medicins San Frontieres program that links prevention and treatment to fight HIV/AIDS. But economists say that such programs are "expensive" and "take many years" to implement. Meanwhile, pharmaceutical companies are "relieved" that the debate over prevention and treatment efforts has "shift[ed] focus" away from the debate over the high cost of AIDS drugs, the Journal reports (Zimmerman/Schoofs, Wall Street Journal, 7/3).

4. Constitutional Court Denies South African Government's Right to Appeal High Court Ruling on Nevirapine Distribution

South Africa's Constitutional Court today denied the government's right to appeal the Pretoria High Court's December ruling that the government must provide nevirapine to HIV-positive pregnant women in state hospitals to reduce the risk of mother-to-child HIV transmission, SAPA/SABCnews.com reports (SAPA/SABCnews.com, 7/5).

The court's ruling -- a "victory" for HIV/AIDS activists, including the advocacy group Treatment Action Campaign, which originally filed the suit against the government -- "removes the last obstacle put up by the government" for universal distribution of the drug, according to Reuters/Lexington Herald-Leader.

Chief Justice Arthur Chaskalson said that the government's restriction of the drug's distribution to 18 pilot sites "fell short of its constitutional obligation to offer the best treatment available." He added, "Government is ordered without delay to remove the restrictions that prevent nevirapine from being made available for the purpose of reducing risk of mother-to-child transmission of HIV at public hospitals and clinics that are not research and training sites" (Chege, Reuters/Lexington Herald-Leader, 7/5). TAC leader Zackie Achmat, who is HIV-positive but refuses to take antiretroviral drugs until the government makes them available to all South Africans, "welcomed" today's decision and said that the court's ruling "gave him hope that the government would change its position on making antiretroviral drugs available as therapeutic treatment for all HIV-positive people, not just for mother-to-child transmission prevention" (SAPA/SABCnews.com, 7/5). According to Patricia Lambert, special adviser to Health Minister Manto Tshabalala-Msimang, the government planned to "study the decision" before releasing a statement. The universal provision of nevirapine, which can reduce vertical HIV transmission rates "by up to half," could prevent at least 30,000 infants from contracting HIV from their mothers each year in South Africa (Reuters/Lexington Herald-Leader, 7/5).

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Africa: AIDS Updates, 2 Date distributed (ymd): 020706 Document reposted by Africa Action

+++++++++++++++++++++Document Profile+++++++++++++++++++++

Region: Continent-Wide Issue Areas: +gender/women+ +health+ +economy/development+

SUMMARY CONTENTS:

This posting contains excerpts from a speech by Zwelinzima Vavi, General Secretary of the Congress of South African Trade Unions, and from a UNICEF press release. A related posting today contains. a speech by Stephen Lewis at a UN Press conference last week, and selections from the Kaiser Daily HIV/AIDS Report summarizing other recent developments.

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Address by COSATU General Secretary, Zwelinzima Vavi, in Durban National Treatment Conference on HIV/Aids

27 June, 2002

[excerpts: full text at: http://www.cosatu.org.za/speeches/2002/zv020627.htm]

Chairperson, President Willy Madisha Comrades and Friends, Ladies and Gentlemen

The conference takes place at an opportune moment in our history - a time when the dark clouds that have surrounded debates on HIV/AIDS are receding. We must all congratulate the government for its 17 April pronouncements on HIV/AIDS. This closes a chapter of ugly time consuming and counterproductive debate and ushers a new era of a genuine partnership and unity in action between the government and the civil society formations. The time is now to stop acting from different sides of the fence - it's a luxury we cannot afford while the pandemic disease decimates our people.

We stand at a crucial period in our history - we either move forward together or perish. The time for action is now - we have to act to fight the pandemic before it consumes all of us. As workers, students, youth, doctors, nurses, hospital staff and professional, government leaders, as well as every citizen of the Southern Hemisphere - Africa, we are presented with the most daunting challenge in our lifetime. ...

We all know why we have to unite to stop the AIDS epidemic. Even if you are not yourself living with HIV, you surely have a friend or relative who has the virus. All of us have been to too many funerals in recent years. All of us know children who have been orphaned by AIDS; many of us are looking after them. No one can deny any longer that, unless we act together, AIDS will have a devastating impact on our society, our communities and our families. ...

For COSATU, the central strategy for stopping AIDS is solidarity - solidarity with people with HIV and AIDS, solidarity to exert pressure on pharmaceutical companies to reduce the price of the drugs that can help us treat the diseases, solidarity to exert pressure on the private sector to play its role, develop workplace policies and release resource for prevention and treatment, solidarity where necessary to exert pressure on government to release more resources to fight the epidemic, and solidarity to stop the virus from spreading in our societies. That is why we support the slogan: AIDS - A New Struggle! Against this oppressor, as against the apartheid regime before 1994, solidarity is our only hope. Divided we will surely fail.

Solidarity forms the basis for ensuring openness about AIDS, which is the only way to make education and prevention a reality on a broad scale. Only if people know they will not be discriminated against and treated as polecats, only when they will not be subjected to inhumane treatment by their own families, friends and colleagues in the unions and workplaces can they be open about their HIV status. Only if we can talk openly about this threat can we ensure the widespread use of preventive measures. And only if people can be open about HIV can we develop broad-based and explicit education campaigns.

Solidarity is also critical for caring for people with HIV and AIDS. This is not about charity, but about maintaining the integrity and cohesion of our society. We need consciously to develop support systems for our people, at work, in our communities and in our families. It should no longer be possible for parents to let their children die in silence, without even seeking treatment, because of their fear of this disease and the neighbours' reaction. It should no longer be possible for husbands to throw their wives out of the house when they find out they have HIV. As workers, as members of families and communities, we have to stand fast against this kind of barbaric behaviour. Only when we turn the tide so that those who discriminate end being the ones facing the wrath of the communities.

The state has a key role to play in building solidarity. So is the trade union movement, the churches and the rest of the civil society.

Government has the resources for mass-based educational programmes. We at COSATU can help through our own media; other organisations in civil society also do their best. But the government has far more resources and expertise, as well as access to the schools.

Unemployment and poverty contributes immensely in killing those infected faster than it would on the rich. Government and a more socially responsible private sector have a unique role to play in this regard. The state can provide treatment and ensure that through its programmes poverty and unemployment is eliminated. The provision of the basic services such as clean running water, access to health care, education and electricity are important ingredients in a fight against HIV/AIDS. ...

Most of our people are already poor, and AIDS pushes them into destitution. They end up dying because they cannot afford the medication they need - and their children can end up as orphans, with no means of support. The government has already made progress in improving its treatment and strengthening the welfare system to address these problems; we need here to discuss how to improve on the existing measures. We need to participate in the campaign to ensure we register as many children to receive child grants as possible

This conference must help us express our solidarity with people with HIV in practical ways. It must help us find ways to end discrimination against people with HIV, including in employment. We need a campaign to ensure that every union member, every student, every activist and public servant supports people with HIV in their workplaces, their communities and their families. More: we need to develop strategies to ensure that the Press stops sensationalising HIV and reports openly, accurately and soberly on ways to cope with it.

Together with government, we need to establish pro-active campaigns to help people with HIV and AIDS and their families through home-based care, support and counselling. We need to improve the welfare net for people with AIDS, and ensure that our retirement funds make provision for people with AIDS and for AIDS orphans. We must develop a campaign against discriminatory practices of the insurance industry and ensure equal access to insurance for all South Africans including those living with HIV/AIDS.

We need to develop mass education and prevention campaigns. Education on HIV must be integrated in all life skills programmes, from the schools to ABET to sectoral and workplace plans. It must be integrated into our media and cultural productions, which today do more to replicate stereotypes than to ensure rational responses to the epidemic.

Our education programmes must emphasise that safe sex is the only real protection. It must teach our children how to negotiate safe sex. It must be linked to respect for women's rights, including the ability to refuse sex and demand that their partners wear condom. Quite clearly as long we still have a patriarchal society that undermines gender equality we are far from defeating HIV/AIDS. Statistics bears testimony to this unequal relationship between men and women. ...

In addition to a massive general education campaign, we need special training programmes for public servants who work with people with HIV, especially teachers, nurses, correctional officers and police. This critical layer of workers, which is the arms and legs of the RDP must in particular ensure that it is a crying shoulder for those affected and infected instead of treating our people in an inhumane manner. Of course we recognise and pay tribute to the unequalled contribution made by many in the public service who go beyond the call of duty to provide counselling and support to our people.

In terms of prevention, it is critical that all our people, including the poor and those in rural areas and prisons, have easy access to condoms. Effective prevention also requires much more rapid roll out of Nevirapine, to stop the transmission to newborn babies; and a vast improvement in access to treatment for women who have been raped. ...

And of course we need to improve treatment. This conference will look at options for ensuring that all our people have access to affordable and effective treatment, including anti-retrovirals, treatment for opportunistic diseases and treatment for STDs. But we also need to look at how we can empower people to understand the treatment options and demand the care they need. Studies show that when people with AIDS have family and community support and know the possibilities, they will live longer and healthier lives.

We recognise that the pharmaceutical companies have mostly set exorbitant prices on the most effective AIDS treatments. This conference has to develop two kinds of strategies to deal with this problem.

First, we need to take into account the cost of not providing treatment, not just at the cost of the medicines themselves. That cost appears in human suffering, but also in the loss of productivity, the need to continuously replace trained people, and to look after millions of AIDS orphans. Given these costs, government should give AIDS treatment a higher prioritisation, even if it means relaxing some of our very tight fiscal targets or cutting back the military expenditure.

Second, we need to find ways to reduce the costs of medicines through use of generics as well as a worldwide campaign directed at the pharmaceutical companies. The WTO must legalise the import of generics, and not just production of them; and the South African government must move rapidly to begin to produce generic medications here, to supply all of the African continent if necessary. We should also look into the possibilities of improving community and home based care, which would relieve the burden on our hospitals. In short government must find a political willingness to utilise fully the weapons at its disposal that it acquired through the Medicines and Related Substances Amendment Act.

For far too long, we have focused on the role the government has to play and did not give enough tension to the private sector. Capital in this country in particular the mining industry and agriculture benefited directly from apartheid social engineering. The migrant labour system, the single sex hostel system, the pass laws and other influx control measures were policies designed by the apartheid masters to prop up the industries of South Africa. The migrant labour system and single sex contributes to the spread of HIV. Whist the situation has slightly changed in the recent years, for far too long the employers ignored the spread of the disease. Far too few companies have HIV/AIDS workplace policy that responds to the epidemic. Far too few companies contribute to the national effort to fight the scourge of the HIV/AIDS. The unions have so far not put enough pressure on the private sector to contribute the campaign. We cannot claim to have a comprehensive HIV/AIDS campaign if the private sector is left untouched.

This conference must also find ways to transform the health care system in South Africa. The current health care system is skewed toward private health care, which cares, only for a few. The public health system is under-funded, faces chronic shortage of essential staff and care for far too many people without adequate resources. Yet, it is the only hope for the working people, the aged, and the sick. An effective public health system is a key pillar of the strategy to combat HIV/ AIDS including opportunistic diseases.

It is for this reason that COSATU believe this conference should also focus on a broader treatment strategy to combat many curable diseases that are killing our people. We should take note of the resolutions of the government convened Health Conference and build on them as we continue to lay a foundation for a social consensus on health care delivery. Comrades, we have set high expectations for this conference. But we have no other choice. We cannot stand idly by and let our people suffer and die, when the remedy lies within our hands. We must unite in this new struggle to liberate our people from this new oppressor.

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UNICEF, UNAIDS, WHO Press Release

Major UN study finds alarming lack of knowledge about HIV/AIDS among young people

As They Begin Sexual Activity Most Don't Know How to Protect Themselves; Surveys Underscore Why Youth Are Central to Stemming Pandemic's Spread

[Excerpts: for full press release and full report see http://www.unicef.org/newsline/02pr42opportunity.htm]

NEW YORK / GENEVA, 2 July 2002 - In an alarming new finding, a United Nations report released today says the vast majority of the world's young people have no idea how HIV/AIDS is transmitted or how to protect themselves from the disease. Yet the study also shows that adolescence is the time when the majority of people become sexually active.

These trends, which highlight why HIV/AIDS continues to spread so rapidly, are part of a landmark report, Young People and HIV/AIDS: Opportunity in Crisis. Produced by UNICEF, UNAIDS and the World Health Organisation, it is the first comprehensive look at the behaviour and knowledge relating to HIV/AIDS of young people aged 15 to 24. It also includes the latest country-by-country HIV prevalence rates for the age group.

"We have two dovetailing trends here that are, in large part, driving the HIV/AIDS crisis. One is that young people have sex, something the world must acknowledge as a pre-condition to mounting effective prevention programmes," said Carol Bellamy, Executive Director of UNICEF. "The other is that young people actually don't have the proper knowledge to protect themselves. The tragic consequence is that they are disproportionately falling prey to HIV."

The report stresses that young people are at the centre of the HIV/AIDS epidemic: they are both the hardest hit by the disease and also the key to overcoming it. Yet despite this, strategies for responding to the epidemic generally disregard young people.

The UN organisations that published the report called for unparalleled political commitment to raise the financial and human resources necessary for the fight against HIV/AIDS. This is an effort that must centre on working with young people to provide them with knowledge about HIV and how to avoid infection.

Overall, surveys from 60 countries indicate that more than 50 per cent of young people aged 15 to 24 harbour serious misconceptions about how HIV/AIDS is transmitted -- a strong indicator that young people are not getting access to the right information. In some of the countries most at risk from the virus, the proportion of young people who have correct knowledge to protect themselves is as low as 20 percent. The result: half of all new infections today are in people between the ages of 15 and 24.

"It is clear that young people do not have the information and means to protect themselves from HIV," said Peter Piot, Executive Director of UNAIDS. "Every day 6000 young people get infected with HIV. Each one of these infections can be prevented. Prevention is both cost-effective and feasible: It costs as little as US $8 annually to protect a young person out of school. In every country where HIV transmission has been reduced, it has been among young people that the most spectacular reductions have occurred."

Key findings contained in the report include:

* Young people lack information about HIV/AIDS. In countries with generalised HIV epidemics, such as Cameroon, Central African Republic, Equatorial Guinea, Lesotho and Sierra Leone, more than 80 per cent of young women aged 15 to 24 do not have sufficient knowledge about HIV. In Ukraine, although 99 per cent of girls had heard of AIDS, only 9 per cent could name three ways to avoid infection.

* In many countries with high HIV prevalence rates, unmarried boys and girls are sexually active before age 15. Recent surveys of boys aged 15 to 19 in Gabon, Haiti and Malawi found that more than a quarter reported having sex before 15.

* Proper condom use and other preventive behaviours, like abstinence, need to be taught early. In Burkina Faso, only 45 per cent of boys age 15 to 19 reported using a condom with a non-marital partner, compared to 64 per cent of young men aged 20 to 24. In Malawi, the rates were 29 per cent and 47 per cent. A 1999 survey in the Ukraine found that just 28 per cent of young women aged 15 to 24 had used a condom at first sexual intercourse.

* Adolescent girls are at a very high risk of getting infected, especially in sub-Saharan Africa. It is estimated that more than two-thirds of newly-infected 15 to 19-year-olds in this region are female. In Ethiopia, Malawi, United Republic of Tanzania, Zambia and Zimbabwe, for every 15 to 19-year-old boy who is infected, there are five to six girls infected in the same age group.

Young People Key to Overcoming Pandemic

The report highlights that in countries where the spread of HIV/AIDS is subsiding or declining, such as Thailand and Uganda, it is primarily because young men and women are being given the knowledge, tools and services to adopt safe behaviours. It says there is a strong linkage between what young people know and how they act, and that a safe and protective environment is crucial for them to develop the skills necessary to avoid infection. In addition, it says special efforts are needed to reach especially vulnerable young people, such as injecting drug users and commercial sex workers.

"Young people have unquestionably demonstrated that they are capable of making responsible choices to protect themselves when provided support, and they can educate and motivate others to make safe choices," said Gro Harlem Brundtland, Director-General of WHO. ...

Message-Id: <200207061527.LAA32514@server.africapolicy.org> From: "Africa Action" <apic@igc.org> Date: Sat, 6 Jul 2002 12:11:47 -0500 Subject: Africa: AIDS Updates, 1/2, 07/06/02

Editor: Ali B. Ali-Dinar

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