29 January 2002

West Africa: HIV/Aids: The Ravage Continues

As the world continues the search for a cure to the dreaded AIDS disease, no day passes by without a grim picture being painted of how the disease is ravaging the world especially the developing countries of Africa. Rita Offiong writes

The HIV pandemic continues to spread rapidly in many parts of the world. In December 1997, the joint United Nations AIDS programme, (UNAIDS) and the World Health Organisation (WHO), estimated that almost 16,000 people worldwide were becoming infected with HIV every day.

Recently, the United States Embassy in Nigeria, had a dialogue with a cross section of the society on HIV/AIDS. It was held in the annex office of the country's embassy in Lagos and the focus was on Nigeria, Sierra Leone and Kenya.

Hardest hit, according to available statistics, are the youths of sub-Saharan Africa. About two-third of all new HIV infections occur in this region alone with HIV-positive young women out numbering their male counter parts by at least two to one. Young people aged between 15 and 24 comprise about 20 per cent of the world's population but account for 60 per cent of the new HIV infections each year. In most countries of the developing world like Nigeria, only a small proportion of young people infected with HIV knowhave it.

Girls and young women in sub-Saharan Africa are at even higher risk of contracting HIV and other sexually transmitted diseases (STDs) than their male counterparts. For example, in Tanzania, research has shown that 17per cent of young women aged between 15 and 24 were HIV positive compared to their male counterparts.

The chances of avoiding or contracting HIV depend on a number of personal or internal factors. "Our understanding of our own sexuality, our knowledge of how HIV is transmitted, our values and our religious beliefs, our relationship skills and perhaps above all, our self-esteem", are some of the clues listed at the forum. For many people, the most obvious obstacle to their sexual and reproductive health is simply lack of accurate information.

The spread of HIV/AIDS in the Niger-Delta area of the country has risen. The Rivers State Commissio-ner for Health, Dr. Eni Membere- Otagi, spoke on the issue in a workshop recently. He said the spread of the infection is high in the oil exploration sites of the state. According to him, a lot of their staff who are in the productive age bracket, are infected with the virus. He also attributed the rise in the spread of the infection to the emigration of commercial sex workers from the sharia states in the north to the south.

Identified as the major contracting point, saloons have been advised to sterilise their equipment, and if they injure any customer with any of their equipment, they should discard such in order not to get another customer infected. Also, females especially, young girls were advised to curtail their sexual escapades in order to avoid the danger of contracting the dreaded virus that has no cure known to man yet.

According to the 2001 HIV/AIDS Syphilis Sero-Sentinel report, over 40 million people world-wide were said to be infected with the dreaded disease, and five million infected in 2001 alone.

The situational analysis of the national response to the HIV/AIDS pandemic revealed that little impact had been made in stemming the spread of the epidemic.

There was also a rise of HIV infection from 1.8per cent in 1991 to 5.4per cent in 1999, according to the statistics released at the forum. This was attributed to the unstable political climate, lack of a coordinated multi-sectoral approach in the fight against the epidemic. Other negative factors identified were over centralisation of intervention programmes, poor resource allocation to HIV/AIDS prevention and control, competing priorities and other developmental needs.

New Vision a Kampala, Uganda-based newspaper reported recently that no fewer than 3.47million Nigerians have allegedly been infected with the dreaded disease with the increasing level of infection being put at the high rate of 10.2per cent for the year 2001. In a report by the UN, 70per cent of the virus is being transmitted through sexual intercourse between male and female, 10per cent through heterosexual activities and 5per cent among drug addicts, who inject themselves.

In Nigeria, the figures showed that the prevalence rate has increased from 1.8million in 1999 to 5.8 per cent in 2001 with the recorded adult infection rate (15-49 years of age) showing a national average spread of 10 per cent with Abuja residents up to as high as 10.2 per cent from previous year's figures given in a report by Dr. Amina Ndalolo, Minister of State for Health in Abuja last year.

It has been discovered that a large prevalence of these HIV infected patients are usually found in military set-ups. The AIDS control programme, which was started in 1997, has been very active in the military establishment. Taking a close look at the military, the national AIDS control programme of the western area of Free Town, Sierra Leone for instance, visited 34 military hospitals between 1999 and 2000, where 108 civilians randomly selected which is about 38 per cent were HIV positive, and 45 of them tested full blown AIDS.

On August 14, 2001, there was a newspaper report that in the military, out of 1,500 people, 1,000 male tested positive (66.7 per cent), and 190 females out of 310 tested positive, which gives us about 61.2 per cent. Seven hundred out of 800 ECOMOG soldiers tested positive (87.5 per cent or approximately 90 per cent). Two hundred and one male civilians tested positive, out of 415 who were randomly selected (48.4 per cent), and the same randomly selected females, 150 tested positive out of 280 (53.6 per cent). The major factor that contributed to this, according to the report, is the high rate of prostitution in the area.

Taking a closer look at Nigeria, Lagos State has five to six per cent infection rate, a figure said not to be medically accurate, while Benue State has between 16-30 per cent. On the other hand, Edo State which is known for it's women trafficking, has between 16-17per cent rate of infection. Some towns in the northern part of the country are also said to be having high inflation rates.

In Nigeria, the first AIDS case was identified in 1985 and 10,803 cases were reported in June 1997. In that same year, the estimated number of AIDS cases rose to 59,983, and HIV infected people were 2.2 million.

In a recent interview with THISDAY, Dr. Tijani Monsuru of the Lagos State University Teaching Hospital, Ikeja, gave his views on the anti-retrioval drugs said to be used to manage full blown AIDS cases.

He said the drug is very effective depending on the type of virus or viral load in the body system. The more the viral load, the more difficult for the the patient according to Monsuru. He said patients who were HIV positive, and were admitted in the hospitals, take care of themselves, because most nurses neglect them. "The nurses only administer their drugs to them, but when it comes to giving injections they tend to shy away from it", he said. He added that HIV virus when contracted, make the body mechanism weak, and gives room for any form of infection ranging from cough, catarrah, diarrhoea and all other sorts of diseases.

In some cases, when these nurses agree to inject the patients, they only do it with a hand glove that will prevent them from coming in contact with the patient and having any form of injury from the niddle.

He went further by saying that the patients in the hospital since 1999 till date, have been responsible for their drugs, which he stated, are very expensive. He suggested that the government should come to the aid of these patients, by at least, procurring the drugs for them at subsidised rates.

Monsuru counselled that there was the need to care for the people living with AIDS because it could happen to any body. He said most of the people die due to psychological problems and only very few of them die of nutritional or medical problems. "An HIV infected person should not be left alone in a secluded area as this will only worsen his or her condition", the medical practitioner noted.

Also, he said a programme was being run for the patients by the hospital management in order to psyche them up on their conditions. However, he stated that the strategy was not too effective as many of the people involved do not show up.

According to a report, women sex workers constitute 34.2 per cent of the entire population, and since the National Expert Advisory Committee on AIDS was established in 1986, the emphasis have been on blood safety.

The National AIDS Committee was established and its emphasis was on multi-sectional and multi-disciplinary approach. Presidential launching of war against AIDS was in 1991, and National STDs Programme merged with AIDS Control Programme in 1992.

Only discipline can control the spread of HIV virus or AIDS. Every individual is being advised to have a personal self-control, and stick to his or her single partner in order not to allow the virus spread further, and for the infected ones, they need regular medical, moral, and spiritual check-ups and encouragement, according to experts at the forum. AIDS is not just a health problem, but a total human problem, which has psychological effects, and affects regional and global stability and risks slowing down democratic development. It takes away both the present and the future, they concluded.

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