Trio of burdens
July 21, 2010
Young people in Zambia, like in many other African countries, are waiting longer to have sex, according to a recent UNAIDS report. But more needs to be done in a continent ravaged by AIDS. In Zambia, more than 1 million people are HIV positive.
The national health care system is in dire need of funds in order to provide antiretroviral treatment (ART) to those living with the virus; but in June the Global Fund, the world's largest donor of HIV/AIDS projects in Africa, suspended its funding following a corruption scandal in 2009 in which two officials embezzled $2 million (1.6 million euros) of aid money.
Resistance to some prevention measures
Corruption is just one of the problems. When aid and funds often come from the West, culture also plays a role. What is acceptable in western nations is not always welcome in developing ones, said Edward Greene, the Global Fund's Portfolio Manager for Zambia.
He pointed to a controversial male circumcision program as an example. Some scientists believe that male circumcision may reduce the risk of HIV transmission up to 60 percent. As a result, programs for widespread male circumcision have been promoted in Zambia, Uganda and Tanzania as a means of reducing HIV transmission.
"No one can make a broad statement saying that circumcision reduces the chances of transmission of HIV/AIDS, it has to be combined with counseling and prevention measures," Greene told Deutsche Welle.
Getting people tested still a hurdle
Some of the programs have also met with resistance from non-circumcising ethnic groups, according to Marie Stopes International, an NGO that works on reproductive and sexual health. The organization has tried to combine HIV/AIDS counseling with male circumcision programs. Some 47 percent of the men circumcised from 2009 to 2010 decided to be tested for HIV; nationally, one in three adults has been tested.
The government has promoted the free HIV treatment it has provided since 2004 as a reason to motivate more people to get tested. More than a million people were tested in 2009, twice as many as 2008, and close to a quarter of a million of Zambians are on HIV drugs.
"Access to antiretroviral treatment gave hope to people because counseling and testing is not a dead-end if there's no treatment," Martin Schmid, a project manager in the health division of the KfW Development Bank, told Deutsche Welle.
More money for ARTs
As the number of people tested increases, so does the number of people requiring ARTs. Those who are on ARTs require them for the rest of their lives, and health workers need to monitor the drug regimens of those on treatment.
For a country like Zambia, which suffers from a severe shortage of health care workers and medical resources, this is a daunting task.
And the WHO's recent recommendation that those living with the virus start taking ARTs earlier is likely to raise the need and priority for HIV treatment and possibly underscore the ongoing need for prevention.
Author: Chiponda Chimbelu
Editor: Sean Sinico