Dakar — Senegal estimates that 80 thousand of its people are living with HIV/AIDS and that three thousand have already died from the disease. By African standards, the rate of HIV infection - about one per cent of the adult population - is remarkably low.
In parts of Zambia, one in seven adults is HIV positive. In South Africa, the country in the world said to be worst affected by AIDS, one in nine people is reported to be living with HIV/AIDS and the infection rate stands at about 20 per cent. Botswana has an alarming HIV prevalence of 36 per cent.
When in 1986, the Senegalese were putting in place a national policy and strategy, Kenya had not officially even begun to discuss the disease. The government in Nairobi waited until 1999 to end a decade of silence and declare AIDS a national disaster. In South Africa, President Thabo Mbeki was strongly criticised last year when he appeared to question the causal link between HIV and AIDS.
So why has Senegal been able to succeed where other African nations have so far failed to make a significant impact on their HIV problems?
A report by the United Nations' AIDS agency, Unaids ascribes the low level of HIV infection in Senegal to some specific conditions - such as the relatively late start of sexual activity, limited extramarital sex, the use of condoms, especially during commercial sex, and effective programmes for treating sexually transmitted diseases.
The report notes that social and religious values play a role, but also, that the active engagement of the country's leadership, in most spheres, has reinforced a strong AIDS' prevention and education campaign.
During a visit to Senegal, organised by the United Nations' Development Programme (UNDP), for a group of journalists to observe close-up the country's HIV/AIDS strategy, UNDP Communications' Director, Djibril Diallo, said he was particularly impressed by Senegal's advocacy role on HIV/AIDS. He added that without it, the country would have faced far greater expense in dealing with (HIV/AIDS) treatment. "I have been very strengthened, as a Senegalese, by what I have discovered here. I have seen a degree of knowledge about HIV/AIDS that I have not seen in Europe, generally speaking, nor in North America among the rank and file," said Diallo.
Other nations also have strong social and religious values. But the Senegalese government's decision to break the silence surrounding AIDS - and break it early - added a new element. Although the subject remains taboo in some conservative circles, where people are not willing to openly discuss the problem, they do not run away from it.
So religious leaders - both Muslim and Christian - became part of the solution. Although they advocate sexual abstinence as the best way to avoid contracting AIDS, they have also joined the campaign to encourage the use of condoms to prevent infection by or spreading of HIV, if abstaining from sex is not an option.
El Hadj Ousmane Gueye is an Imam (an Islamic religious leader) and the administrative secretary of the Association of Imams of Senegal. "Sixteen years ago, people didn't talk about AIDS. But now we are working together, Muslims and Catholics, to fight AIDS, for a better society. Islam forbids all evil and fornication. Mankind must behave," said the Imam. But he acknowledged that times had changed and Senegal had faced the reality of AIDS. He said Islam forbade the use of condoms, but this had been adapted to exclude people living with AIDS, so that they did not infect others with HIV.
Significantly, and contrary to a belief shared by many Muslims in Senegal, Imam Gueye said Islam acknowledged and took note that "AIDS is an illness and not a divine curse. It is a disease and there is no cure, but you must not run away from people with AIDS." He stressed that other Imams must be trained to spread this message.
Not surprisingly in a country where more than ninety percent of the population is Muslim, religion has been a cohesive factor, binding society together. Changing sexual behaviour, practising abstinence and increasing the use of condoms were due to more than a sense of self-preservation. The UNDP's Diallo noted; "When you hear all those calls (to prayer) by the muezzins, if you are doing something bad, [or] misbehaving, it seems that no matter where you hide, religion is trying to reach you."
Looking ahead
The key elements of the strategy now in Senegal are to maintain political stability and political will and continue the progress made by its prevention and education campaigns. The achievements of projects involving the youth, women, workers and prostitutes are just some of the successes Senegal would like to see duplicated throughout Africa.
Music and the arts have also played their role in reaching the people and spreading the message about AIDS' prevention, protection and education in Senegal.
Another element has been HIV/AIDS training as part of the national school curriculum since 1990. Pupils and their teachers are informed about AIDS.
For Dr Ibra Ndoye is the manager of Senegals National AIDS' programme, "the greatest challenge is to develop and reinforce all our strategies and to innovate, such as mother to child HIV prevention programmes all over Senegal. We must also develop voluntary (HIV) screening, counselling and testing throughout the country, because we see success in Uganda, why not in Senegal?"
Ndoye said Senegal should also learn to balance prevention and intervention in the future, as well as the management of patients.
Some sectors of society in Senegal have been less vigorous than others in fighting against AIDS. Both Ndoye and Diallo stressed that in future, the private sector in Senegal should do more; as Diallo put it, " a company without workers is a company doomed to disappear". Dr Ndoye lamented that the involvement of the private sector had been very weak in Senegal and said it needed to focus on what it could contribute.
Djibril Diallo warned that employers must protect their future profits by looking ahead and launching awareness campaigns, condom distribution and other schemes, or risk losing a whole generation of workers. Diallo pointed to South Africa and Zimbabwe, two countries where employers are now paying more attention to informing workers about the threat of HIV/AIDS, and urged Senegal to follow suit.
Instrumental in helping Senegal confront what has become a national disaster in other countries, and focus on its highly-praised anti-AIDS campaign, is the local presence and commitment of a world renowned Senegalese AIDS' scientist, Professor Souleymane Mboup, He is widely respected for his work on HIV2, a strain of the AIDS virus prevalent in the region, and has been working on HIV/AIDS in Senegal since the 1980s. "One important message is that we need to be supported, because ours can be a model to export to other countries. We have shown that in this (HIV/AIDS) epidemic, it is very important to act very early" Mboup told allAfrica.com.
He heads his country's National AIDS' programme as well as Senegal's Sentinel Surveillance Programme. He is also deeply involved in AIDS' research, coordinating the Convention of Research between Senegal and Harvard University in the United States. Mboup and others in Senegal, fighting against HIV/AIDS, have gained international respect for their work and commitment. Senegalese scientists have collaborated with researchers abroad to assemble data that is used by the government in Dakar and in AIDS reports compiled by the UN and other credible agencies.
Souleymane Mboup's achievements have sent a strong message to the rest of Africa that the continent can draw on its own resources and capacities to tackle HIV/AIDS, and remain confident about the battle ahead, even in the face of limited finance. The logic seems to be that Africa need not see itself as dependent on the west for the intellectual and social resources to move forward.
Sign up for free AllAfrica Newsletters
Get the latest in African news delivered straight to your inbox
He hopes continued political will and more resources will keep down the rate of HIV infection and AIDS in Senegal, while he and his scientific colleagues in and outside Africa continue their search for an AIDS' vaccine. "We are working on many projects that can help, either for understanding the situation to develop a vaccine or see what kind of vaccine will be available. These things are very important to help move in the direction of future vaccines".
The Senegalese scientist said it was essential that funding for Senegal continued. "Unfortunately money goes to support countries with high HIV/AIDS' prevalence rates. This is very important, of course. But it's also important to support countries which reacted very early, like Senegal, to help them to maintain the status quo and strengthen their resolve to keep HIV/AIDS rates low."
And Mboup told allAfrica.com that there was no time to waste: "We are not waiting. We too are contributing. This is my whole life," he said, adding, "It is a challenge for Senegal, but it is also a challenge for the world."
Other articles in the series:
Part 1: A Beacon of Hope in Africa's Fight Against AIDS
Part 2: Living With AIDS - Mabeye's Story
Part 3: Pop Stars and Youth Break Taboos to Spread AIDS Message
Part 4: Prostitution - Frontline of the War to Contain HIV
Part 5: Women - Vulnerable but Vital Campaigners Against AIDS
Part 6: 'This Is My Whole Life' - A Scientist's Dedication to Defeating AIDS
