ii) Constraints to effective fight against HIV/AIDS

There are many reasons why control and prevention of HIV/AIDS is difficult. The following are some of the main highlights;

Denial by the political establishment and lack of political will and commitment to control HIV/AIDS Stigma associated with HIV/AIDS, which is deeply entrenched in African Culture, and traditions on sex related issues.

Poverty, ignorance and economic stagnation that has resulted in loss of livelihoods.
Crumbling health sector especially after implementation of the structural adjustment programs

The stand taken by the Church (Especially the Catholic church) against some of the prevention methods in practice. They abhor all except abstinence and being faithful to a faithful partner.

Presence of risk groups in the society; Persons engaging in high risk practices such as commercial sex workers and long distance truck drivers.

Action oriented media reporting rather than dealing with sensational news in the fight against HIV/AIDS in the region.

Legal and ethical issues on AIDS. This includes laws relating to AIDS infection and the Doctors confidentiality on AIDS/ HIV related cases.

Cultural hindrances to HIV/AIDS control. The approach to AIDS control has a cultural angle and its only providing resources to the grassroots groups such as women groups that the message can be delivered to the correct consumers.

Low availability and affordability of drugs. Drugs to suppress the effects of HIV/AIDS are too expensive and out of rich for majority of the PLWA.

Women have less ability to cope with HIV/AIDS or to prevent it because of their high dependency on men.

iii) Associated social and economic impacts

The people in the region recognize the devastating impact of HIV/AIDS on development and the well being of the people. Noted with great apprehension is the fact that the pandemic is being fueled by poverty, malnutrition, ignorance and cultural values and practices such as wife inheritance, circumcision rites where blades are shared, female genital mutilation and scarifications. The effect of HIV/AIDS can be seen at various levels of the social structure. The affected include the youth, mothers, fathers, children, the nuns, priests and the aged. The case study below provides a real life experience.

Case study: ‘Uganda Priest with HIV Praised’.

Take the case of the first priest to declare having AIDS in Uganda, Gideon Byamugisha. His wife died 8 years earlier and he himself diagnosed HIV positive. His declaration as being HIV positive helped him become a crusader for those already infected. He expected to be thrown out by his Anglican Church, but instead got a lot of support and empathy. This is not to mean that he has not encountered difficulties within the church. Once he was refused to speak at a Christian rally in Rwanda. However, as an infected person, he has the following message for us and I quote“ we need to integrate HIV/AIDS into our day to day life of the church’ and “Religious leaders should not just condemn unlawful sex but unsafe sex as well. We need to understand that there is usually more sexual activity in our community than we are prepared to accept” Gideon is under drugs received from US and his health has improved.

In order to understand the grave situation that HIV/AIDS has brought on the countries in the region, its effects on key sectors are analyzed and highlighted below;

Effects at family level

Disintegration of families and increased stress for the extended family that shoulders the victims of HIV/AIDS
Increase in numbers of school dropouts
Increase in child headed households
Increase in orphans and windows. The National AIDS/STD control program (Nascop) estimates that over a third of children in Kenya will be orphaned by HIV/AIDS by the year 2011. Most orphans are under care of their grandparents.
Overstretched traditional systems of caring for the orphans.
The estimated cost per patient, direct and indirect, amounts to $7165.50 per year. The annual average per capita income in Kenya is $ 280.00. This makes the AIDS related costs to be very high.
Increase in susceptibility to opportunistic infection, notably, Tuberculosis, Pneumonia, Cholera and typhoid.
Reduction in disposable income for the families due to death of the “bread earners” Reduction in productivity as the healthy family members attend to the persons with full-blown AIDS. The actual picture is brought home by the case study below

Case study: The setup is in the countryside, rural Kenya, the parents are dead and only the grand mothers are left to care for a multitude of children left behind by their departed parents. The problem is that the grandmothers are themselves in their twilights with neither the resources nor the energy for the daunting task placed on their hands. Read all in the attachment on ‘How AIDS is changing the structure of the families’

a) Effect on the education Sector

To illustrate the impact of HIV/AIDS in the education sector, Kenya is a good example. Currently, there are 5.6 million children in primary and colleges, out of whom 14.5 % (aged between 10-24 and mainly in colleges) are HIV positive and have the highest infection rates. Out of the total student population, 1.3 million have lost their parents and the biggest challenge is how to help the orphans cope with the loss and continue learning. In schools and colleges, the teachers have been identified as best agents of influencing behavioral changes among the student population.

In Kenya, the death rate of experienced teachers is 6,000 per year, more than training can replenish. This has caused reduction in supply of qualified and experienced teachers.
Children kept out of school to support the family, either by working or looking after the sick.
Children kept out of school because of lack of school fees, often eventually turn to drugs, commercial sex and child labor.

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Other Articles of Interest:

What Would Jesus Do About Aids?
by Jonathan Frerichs, LWR Communication Director

Standing With Africa
by LWR President, Kathryn Wolford

Stand With Africa: A Campaign of Hope?
Written by Cathie DeGonia, Stand With Africa Campaign Communication Coordinator