U.N. Says Aids Prevention Will Save Millions of Lives In Africa
CategoriesThe U.N. estimates that by focusing on prevention, up to 43 million lives could be saved in Africa, according to a recent report issued by UNAIDS. For once, I find myself in agreement, although not without some additional comments.
The "third option" of the U.N. scenario asks for
"investments in health systems, agriculture, education, electrification, water and roads to change fundamentally the ways donors provide aid and recipient countries deal with the donations, to avoid inflation and not promote dependency."This would make a lot of sense, because Africans are generally less than well nourished, and are subject to frequent infections by water-carried diseases. The reason for such a health-adverse environment is a generalized economic decline helped by the self interest with which industrialized countries provide what is laughingly called 'aid' to developing nations. So yes to aid for infrastructure, but with one important caveat: please no more aid in the form of loans which need to be re-paid with interest, and please no conditions to spend the aid on mega-projects that benefit mostly foreign contractors or suppliers linked to the nation giving the aid.
An effective prevention strategy would also ensure that nutritional supplements are supplied until sufficiently nutritious, locally grown food can be provided. Selenium and three aminoacids seem to be of particular importance in proofing the immune system, according to Dr. Harold Foster, a Canadian geologist specialized in identifying the causes of chronic disease as determined by relative prevalence or absence of nutritional elements in soil.
South Africa is also looking into and is testing simple natural medicines that help improve immunity.
Aids could be defeated by such simple measures and the U.N. goal of saving millions of lives could be brilliantly exceeded if we concentrated on making the countries self-sufficient in terms of food production (no genetic modification experiments, please), in terms of basic hygiene requirements such as clean water and proper waste treatment and re-cycling, and in terms of providing a decent living to all Africans.
Is that too much to ask?
Here is a copy of the New York Times article and a short piece on the U.N. report:
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A U.N. Report Takes a Hard Look at Fighting AIDS in Africa
By Lawrence K. Altman
(originally published in The New York Times)Saturday 05 March 2005
Billions more dollars will be needed to curb the spread of AIDS in Africa, but as countries increase their donations, the amounts will be less important than how well they are spent and in what context, a new report from the United Nations AIDS program said yesterday.
Pouring more money into programs to combat AIDS could do more harm than good unless they are effectively coordinated, the report, "AIDS in Africa," said.
Otherwise, the report said, major financing increases could serve to drive an "AIDS industry rather than to drive a massively improved response." The report was released at a meeting in Addis Ababa, Ethiopia.
As H.I.V., the AIDS virus, spreads further, Africa will face "an unprecedented crisis and a challenge never before seen since the advent of slavery," Dr. Peter Piot, the executive director of the Geneva-based United Nations AIDS program, said at a news conference in Addis Ababa, according to Reuters.
The United Nations said the report was intended to improve decision-making and deepen public understanding of the possible course of the AIDS epidemic in Africa by 2025, when "no one under the age of 50 in Africa will be able to remember a world without AIDS."
By then, 89 million more people in Africa could be infected with H.I.V., under the worst circumstances, the United Nations said. An estimated 25.4 million people in Africa are infected now.
"The death toll will continue to rise, no matter what is done," the United Nations report said. "There is no single policy prescription that will change the outcome of the epidemic."
The report describes three plausible situations in which the AIDS pandemic could play out across Africa by 2025. The situations were told as stories that were prepared over the last two years and intended to be provocative, not to provide all the solutions.
In one outline, African countries adopt tough long-term measures in which leaders exert the discipline to equate action with rhetoric and focus on prevention. By 2025, the numbers would grow but then fall to today's levels and continue to fall. But the number of orphans would double. This plan would cost an estimated $100 billion with the United States spending $5 billion a year to 2015 and then $6 billion a year.
In a second situation, which would be medically focused, prevention measures would not be stepped up, so anti-retroviral drugs would be easier to obtain than good nutrition and clean water. In this approach, government leaders would fail to get ahead of the AIDS epidemic, and Africa's poverty and underdevelopment would deepen. Keeping such services at today's level would cost $4 billion a year by 2025.
A third outline envisioned investments in health systems, agriculture, education, electrification, water and roads to change fundamentally the ways donors provide aid and recipient countries deal with the donations, to avoid inflation and not promote dependency. Such a situation would provide anti-retroviral drugs to 70 percent of people needing them by 2025.
That effort would be expected to halve the number of people living with H.I.V. and AIDS despite an anticipated growth in population of 50 percent. The cost would be $200 billion, with the United States increasing its contribution to $10 billion a year by 2014 and sustaining that amount until 2025, when it would begin to decrease.
The United Nations prepared the report with support from the African Development Bank, the Bill and Melinda Gates Foundation, Royal Dutch Shell, the World Bank and a number of government agencies and drug companies. The report is available online at www.unaids.org.
With Help and Effort, Up to 43 Million Africans Can Avoid HIV over Next 20 Years
UN News ServiceFriday 04 March 2005
Using story-telling methods, the Joint UN Programme on HIV/AIDS (UNAIDS) has devised three scenarios to estimate how decisions made today may alter the pandemic's course in Africa, with the best offering hope to save 43 million people on the continent.
"The scenarios are not predictions," UNAIDS Executive Director Peter Piot told a news conference to launch the report in Addis Ababa, Ethiopia.
"The scenarios highlight the various choices that are likely to confront African countries in the coming decades," he added. "Millions of new infections can be prevented if Africa and the rest of the world decide to tackle AIDS as an exceptional crisis that has the potential to devastate entire societies and economies."
According to the UNAIDS 2004 report, "Sub-Saharan Africa is home to just over 10 per cent of the world's population - and almost two-thirds of all people living with HIV," or 25 million to 28 million of the world's 34 million to 46 million, while North Africa and the Middle East combined have 420,000 to 730,000 infected.
The scenarios, conceived by 150 people, mainly African, spotlight the factors that has made many African countries the worst affected by the disease.
The "Traps and Legacies" scenario spotlights how poverty causes malnutrition and the inability to procure expensive protection, gender inequality disempowers wives who wish to end relations with infected husbands, and overall underdevelopment limiting the spread of prevention messages.
Under this prediction, the scramble to roll out retroviral therapy "leaves few lasting benefits and takes precedence over the much-needed scale-up of prevention." African leaders and their donor partners, keen to show quick results, are unable to invest in long-term change. Aid donors fail to live up to promises, while "the so-called war on global terrorism spills over into Africa, determining donor funding patterns."
If these negative actions continue and if HIV is merely medicalized and seen as an issue of individual behaviour change, by 2025 AIDS will remain at an adult prevalence of about 5 per cent, the report says. "Because there is a failure to get ahead of the epidemic in terms of prevention, the costs continue to rise and this rise continues into the foreseeable future."
The scenario called "Tough Choices" describes the future if African leaders take a long-term view of prevention, even if the short-term scene is bleak. It would require "navigating between helpful and risk-enhancing cultural traditions," choosing between rural needs and urban benefits, and balancing continental alliances and nation building.
Despite population growth, the number of people living with AIDS would "fall to levels similar to what they are today and continue to fall as long as long-term investments in social, economic and human capital over the next two decades begin to pay off."
The best-case prediction, "Times of Transition: Africa Overcomes," envisages what might happen "if all of today's good intentions were translated into the coherent and integrated development response necessary to tackle HIV and AIDS in Africa."
In this scenario, a rapid rollout of treatment and effective prevention strategies would be supported by a very
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