Azad Essa
4 December 2008
opinion
In this paper, Azad Essa explores the extent to which Africa's military has been affected by HIV/AIDS. He outlines the varied responses from Africa's armed forces, with a specific focus on recruitment, care and precarious human rights issues pertaining to HIV-positive personnel. While the scarcity of statistical data forces analysts to continue speculating the challenges, effects and extent of the crisis, it is crucial that African militaries finally assume more responsibility in addressing the pandemic, if not for their own self preservation, then at the very least, towards eliminating the spread of the disease in communities itself.
That HIV/AIDS has become a humanitarian and security crisis across the Africa is an indisputable fact.
Statistics aren't likely to change overnight, and Africa remains the most affected continent with Sub-Saharan Africa accounting for more than 67% of 33 million HIV positive people across the globe. It is therefore no coincidence that HIV/AIDS is considered to be an incessant mode of destabilization on the African continent; an inherent security risk that threatens to disrupt gains in health, development, infrastructure and human development. In fact, while 25% of the continent remains engaged in conflict, in some quarters, HIV/AIDS is considered to be "more destabilizing than the wars currently raging on the continent"[1]
While debates continue - mandatory testing versus human rights; condoms versus abstinence and medical science versus traditional medicine - little is known regarding the extent to which African militaries, responsible for much of the rebuilding and maintenance of peace in post-conflict African states are being affected by HIV/AIDS. While concern over how HIV/AIDS affects Africa's armed forces has increased since the late nineties, there seems to a plethora of gaps in the mainstream understanding of where African armies really stand, as a high risk population group.
HIV is a multifaceted virus, emerging and spread in varying contexts. Some of these include reasons include: socio-economic strife, mobile employment and high risk employment, high incidence of transactional sex and gender imbalances. Military personnel face all of these challenges, which inadvertently place them at the top end of high risk populations, together with truckers, miners and sex workers. What makes military personnel especially at risk is the amount of time spent away from home, stressful and difficult conditions and believe it or not, boredom and lack of entertainment that inadvertently provide military personnel, armed with financial resources, to wander off for sexual escapades. However, the difference between military personnel and the other high risk populations is essentially the crucial factor of secrecy that comes with being part of the military.
In fact, not only is the debate stunted by a lack of statistical data - the very nature of the military as instruments of public and yet national interest - make unearthing an issue like HIV in the military a rather complex affair. Both the military and HIV/AIDS are themes characterized with incessant concealment. HIV/AIDS is permanently surrounded by a cloud of Human Rights sensitivities; confidentiality clauses that serve to protect victims of HIV. This culture of concealment associated with HIV - good intentions granted - mixed with the culture of machismo-protection of military intelligence makes dealing with the crisis of HIV in the military even more intricate.
Without the right treatment, diet, living conditions and attitude, the virus is difficult to manage and affects the mental and physical capacities of HIV positive people. Living and working as a soldier requires the maximum capacities of reflex, concentration and patience that HIV easily undermines without the necessary treatment and counseling.
By implication, knowing the extent to which African forces are affected by the HI-virus is crucial for the continued development of the continent; the maintenance of peace and vanguard of rebuilding societies in post-conflict zones and for the very real containment of the virus in an ever shrinking world.
This paper seeks to make sense of the conundrum of opinion concerning the affect of HIV on Africa's military and highlights how particular defense forces have, contrary to popular belief, responded to the crisis.
African militaries = HIV time bombs?
Even though statistics are difficult to collate, it was generally accepted that in peace time, defense forces across Africa have a HIV prevalence rate of 2 to 5 times the rate of their civilian populations. These statistics, from studies conducted in the late nineties provided the impetus for extreme blanket analyses that predicted the undermining of Africa's security. This is now being widely contested as a generalization, with evidence suggesting that in South Africa, the rate amongst soldiers is marginally higher than civilians, while in the Ethiopian defense force, the rate is actually lower than the general population. But in Cameroon and Ghana - both with generally low prevalence levels - their respective armies had prevalence rates were one and half times, and two and a half times the general population[2] The general consensus therefore, is that African armed forces have a higher prevalence rate than civilian populations, but not necessarily 2 to 5 times their civilian prevalence rates.
And whilst these studies have been regarded as reliable data, there still remains significant confusion over the extent to which defense forces are affected. A clear example of this is the South African Defense Force (SANDF). It has been often suggested that HIV prevalence in the SANDF was abnormally high, between 50% and 70%, when official figures relay an estimate of 23%. Another prime example is Angola's Defense Force, with initial estimates suggesting around 55%, when official reports indicate that rate is not more than 11%[3]. This is by no means an attempt to delegitimise largely accurate analyses or to subvert attention away from a crisis. In fact, according to the CHG Report [4], HIV prevalence of over 5% is already considered a significant erosion of operational capability, for ill-health does mean armies cannot operate at full capacity or be available for peacekeeping activities at the scale needed. Instead, the focus here is merely a reminder that statistics merely tell half the story, and need to be consumed critically.
In 2002 alone, the Malawian Defense force lost 131 personnel mainly to AIDS related illnesses. UNAIDS reported in 2003 that HIV was threatening to decimate more Malawians than any conflict the small nation has ever been involved in[5]. It was estimated in 2005 that HIV positive personnel in the Zambian Defense Force (ZDF) numbered more than the 16.5% that would be found in Zambia's civilian population. As a result the medical service was said to be battling to provide the necessary HIV/AIDS related care to military personnel in need of medication, counseling and other types of support[6] that were crucial to keep personnel healthy, functional and in good spirits.
Likewise, it was revealed in early 2008 that approximately 55% of Zimbabwe's troops were HIV positive, and up to 75% of these troops would succumb to the disease within the year. While reports indicate that the rate of HIV in Zimbabwe has reduced over the past couple of years, the Zimbabwe Human Development report indicates that infections in the military far outweighed the general population rate of 24.6%. According to the Pan-African Treatment Access Movement (PATAM), the situation was compounded by a lack of HIV/AIDS intervention programmes in the army[7]. This is hardly surprising, considering Zimbabwe's current economic crisis. The World Food Programme announced in October 2008 that unless rapid supplies would arrive, Zimbabwe would run out of food by January 2009. The report further noted that the young soldiers recruited were trained to be fearless and aggressive, qualities they often carried into their personal, civilian and sexual lives.
As may be easily deduced, the situation in Southern African nations is far from ordinary or functional, with the impact on particular defense forces in the region highly suggestive of a crisis in these states. At the same time, the case of Southern Africa is hardly surprising, considering the incidence of HIV in the region itself, which is said to be a staggering seventeen times higher than the global average[8]. In 2007, 75% of all AIDS related deaths were located in sub-Saharan Africa, while according to 2002 South African government statistics; seven out of ten military deaths were AIDS related.
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