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| Tuesday, 25 July, 2000, 09:31 GMT 10:31 UK Can Aids be defeated? ![]() Former South African president Nelson Mandela has closed the Aids conference in Durban with a call to unity in the fight against the disease.
What do you think is the way forward in the fight against Aids? This week's debate on Talking Point ON AIR, the phone-in programme of the BBC World Service and BBC News Online, aired your views on the Aids crisis in Africa and around the world. Robin Lustig presented the programme and was joined by the UN Aids programme's Bernard Schwartlander from Geneva. Clink on the link below to watch and listen to Talking Point On Air Your comments since the programme: As the AIDS hysteria spreads, I have heard a lot of misinformation creeping back into some radio talk shows in my country - particularly that AIDS was created by the West to annihilate blacks. What's needed is more rational information and education on HIV to stem the tide of such ignorance on the subject. While a cure for AIDS appears nowhere in sight, dramatic changes in behavioural patterns can certainly help. As an African I believe that we should speak out the problem. In Ethiopia for example, when someone dies with all the symptoms of AIDS no one says he died from AIDS. People tell you that he was playing out in the cold and without giving attention a minor pneumonia has killed him. So everybody believes that way and says he has not seen anyone, who died of AIDS. So, let us call AIDS AIDS and a COLD a COLD. Then people start believing that they have seen AIDS.
Ajay, UK The so called activists holding conferences in high places and, living in luxury beach resorts in Durban ought to look at the millions of poor people dying of the disease because they cannot afford the drugs. They ought to be ashamed of themselves and try for a change to listen to themselves. It is such misconceived approach to the disease that is the undoing of our continent. What did the Durban conference achieve now? Shame on all those delegates!
B. Kowal, USA President Mbeki pointed out the real problem in Africa is poverty. This in turn has been massively exacerbated by overpopulation due largely to outmoded breeding practices. It was once important to have 5-6 children as one could expect half to die early in life and their labour was needed. Infrastructure of all kinds cannot possibly hope to cope with an annual growth rate of 5% or more. Everyone needs to realise the benefit of having 1-2 healthy, well provided for children as opposed to 5-6 that one cannot support. Education is the best answer to problems of this nature. Perhaps these people should be taught simple facts that have been known to the western world for some time. For example, there is no way you can have sex with multiple partners and guarantee safety from HIV. The risks can be mitigated but the only 100% safe method is abstinence. Of course, such a view is widely regarded as being small-minded so it's unlikely anything will come of it.
Jemius Shumba, Zimbabwe All this talk about who is to blame. In the end we cannot cure any virus, perhaps HIV will be the first one we cure? Perhaps people can be made to be so careful that AIDS dies out in a few generations? The prognosis is not good; perhaps in the end it will eradicate humanity.
Roselyn Mungai, Kenya The role of the major religions in Africa needs to be considered. Unless and until the two major religions of the region, Islam and Catholicism put common sense before discredited dogma, and encourage the use of condoms, then government campaigns will largely be wasted. Here is a chance for the two religions to show that they CAN work in the interests of their members, rather than, as is usually the case, against them. It is certain that the German government under Helmut Kohl has done nothing to fight Aids. The new German government under Schr�der is continuing this "tradition". My question is, when will Germany together with the whole Europe finally wake up? A vaccine or a cure can only be found in western laboratories. What they need is a strong support by their governments which is still not coming so far.
The UN needs to do something to help this kind of problem, because I'm sure that if they don't do anything in the future, the situation will become worse. Aids is present in every corner, we need to prevent the growth of it. Africa is a very poor continent, and the people who live there have never had a good grounding in life. They don't know how fatal aids can be - the result is certain death. Lucia Paz, Brazil I think Aids is always linked with poverty. People have poor education in their poor countries. Women and men do not realise that it is important to have safe sex - it is not just for themselves, it is for a whole generation.
Meena, Switzerland I think that African problems with thousands of people dying because of Aids is caused because people have no idea about this disease. The governments do nothing to try to explain to people what can cause Aids and what they can do to avoid this terrible disease.
But it is important to give medicines free of charge to the people who have Aids, given that these medicines are very expensive. The governments of poor countries do not help the poor people that have this illness. They prefer to worry about other areas, not so important as health. Maybe an international member like the UN can interfere in these countries and give them some money to buy medicine supplies for poor people. It is confirmed that the poor countries have the biggest percentages of Aids in their population. So, it is time to help these countries. Mariana Deperon, Brazil Personally I feel that Africans are completely unaware of the outside forces that are plotting their demise and eventual death. It is no coincidence that this continent is plagued with wars, famine, and disease while the western powers look on with a smile. AIDS is spread in Africa because the society seems to underestimate its impact. Even in funeral where people die from AIDS, family members never say that the person die from AIDS. TB, cancer etc have been mentioned as the cause. If we really want to contain AIDS then we must address the AIDS issue in its totality. That is its spread, poverty and ignorance are not excuses.
Ali Ghafoori, Afghanistan Drug companies, capitalism and colonialism do not cause AIDS. Behaviour does. Ignorant, reckless and dangerous sexual relations do. Period. These acts have infected the blood supply and passed this disease to newborns. It's not economics. It's morality. Learn and live. From a Western point of view, its down to economics. From an African point of view, its behaviour and education. AIDS will decimate Africa if nothing is done. I think it is time for all nations to all 'chip in' to finance adequate research to come up with a new cure for this disease. Russia ought to quit making weapons that are being shipped to third world countries and so should the Chinese. And, the U.S. along with allies needs to do the same. Let's quit making these nasty things and spend the money in such a way that everybody benefits.
GT, Italy/USA Whilst poverty is a factor that cannot be ignored in this whole debate it can't be the overriding issue - Bangladesh and India don't seem to have a problem with HIV/AIDS whilst they do have a problem with poverty. This must point towards a behavioural cause to this epidemic. I think its appalling that these drugs are not available to all those who need them. I am fed up with the amount that has been given/spent in the rich western world to gay organisations for Aids patients, who ignore the needs of gays with other diseases. I write this from a personal viewpoint as in 1992 I developed Leukaemia, and as a gay man approached gay organisations in the UK where I was living and received absolutely no support, nor did I on returning to Australia. I am Ugandan, currently in Germany. I don't think there is a family in Uganda that has not been affected by HIV-Aids. I am very grateful to our President, Yoweri Museveni, for never being ashamed to raise the issue in public and for all he and many others have done to raise awareness of the problem and for helping to bring down the numbers of those affected. The comments of the South African president I fail to understand and I doubt very much whether they will help the people of South Africa in their fight against Aids. Many of your correspondents seem to assume that the prosperity we enjoy in the West is the norm but it was only in recent memory that such diseases like TB and polio were conquered in Europe and America. Many diseases were beaten largely because drug companies and others working within the free market system. Compelling or blackmailing drug companies to provide subsidised medicines will not be the best long-term solution. Your comments during the programme: HIV/Aids is a big problem in Botswana - 30% of the people here seem to be affected. People are very well educated about the disease but the behaviour of people isn't changing. We have to tell people to use a condom when they have sex. Certain groups are using Aids to spread a moral message. The Catholic church must change their belief that people who catch Aids deserve it. I would like more money spent on prevention and less on conferences. I have been HIV positive for seven years and have been taking combination therapy for several years. I'm taking very toxic drugs every day of my life and am unable to work. The conference had brought about world leadership. We can do something about it - treatment, prevention, and changing attitudes. We have to destigmatise sex. Society has to be more enlightened about peoples' behaviours. If the cost of Aids drugs can come down to 10% of the normal price, what is the real marginal cost of manufacture? Aids is an extreme example of the differences in healthcare between Africa and the West. The UN is too tied up with bureacracy and appeasing power-blocs. Isn't there an African organisation that can try to find its own solutions, working with its own communities? Why doesn't the UN purchase the drugs licenses and make them freely available to the whole world? I congratulate President Mbeki because he wants to re-evaluate everything we know about Aids. A massive diversion of resources to research on Aids wouldn't necessarily help Africa. The African health crisis goes beyond anything we can attribute to a single virus. Africans continue to die of easily preventable diseases related to poverty.
Selva Appasawmy, Mauritius President Mbeki has never said that HIV doesn't cause Aids. He said he would strengthen South Africa's efforts to prevent Aids. There is overwhelming proof that there is a causal link between the HIV virus and the disease. Gays and drug-takers in the western world lack self-discipline and in Africa women are abused or are weak. Personal self-discipline must be strengthened by government. The destructive forces are television, Hollywood and the permissive society originatin from the 1960's. Dissident scientists never had a problem finding a voice. But some issues are pretty much settled. A lot of what Mbeki was saying was about whether Aids can be treated as an issue in isolation. I don't believe it can. The problem of poverty is a focal point. You have a vicious circle where the haves are exploiting the have-nots. Women without jobs may prostitute themselves. Women must be armed with knowledge and jobs. Some people seem to be in total denial. They don't know which door to knock on. We have a serious situation - not just in Africa - but Africa is faced with the most difficult challenge. I disagree with the emphasis on the dichotomy between Aids and poverty. We are wasting a lot of energy on this debate. Your comments before we went ON AIR:
Hankie, Zambian in USA While everyone is trying to look for something to blame for this calamity there are people who are dying by the day. At this point instead of wasting time blaming someone, people ought to work on finding an effective way to reduce the number of people getting infected by HIV. African governments NEED to increase their education to the public about AIDS. Governments can help by providing accurate information. While science is in search of a cure, people need to at least be informed. What's most dangerous is the false dichotomy between prevention and treatment. Risky behaviours often cause AIDS. Poverty often puts people in positions where they have to engage in risky behaviours. Lack of treatment means that the disease is still around to be spread even if the behaviours aren't inherently risky (breast-feeding, for example). The crisis will not relent until three factors are addressed: education, poverty and treatment. Any course of action which addresses only one or two of these issues will inevitably fail. Aids in Africa is devastating and there is need for positive action. It may be time to listen to Mbeki and tackle the other related diseases (e.g. tuberculosis, fever etc.) that are related to aids and may be worsening the situation. After all, Aids is about resistance of the human body to the virus and these diseases make things worse. His views should not be dismissed outright.
Robert McDonald, USA, Formerly Zambia Once again, the blame is laid at the Western world's feet. When the colonial powers left, these were self-supporting countries that were net exporters of food and products. Now they are basket cases where aid is their main means of acquiring foreign currency. The drug companies spend million/billions of their own money to develop and test these treatments and diseases. They cannot stay in business and develop these drugs, unless they make money. Until the emancipation of women occurs in these poor impoverished countries, there is no hope for Africa. I've even heard stories of family planning workers saying men were taking the birth control pills, because women were too stupid to remember. With the rapid spread of Islam, the African religion, the emancipation of women is a distant fading dream. HIV/AIDS is an infectious disease. It is transmitted knowingly and unknowingly by behaviours that are deemed both licit and illicit across cultures. It is absolutely useless, and a potent form of denial, to excuse the continuing spread of the virus to ignorance. There is ample information, but an absence of courage among leaders to be willing to constructively analyze the belief systems which encourage the denial. Drugs and vaccines will not fix the problem. The virus seeks only to replicate itself and has done so very successfully, in a world population with a hundred excuses to deny this basic fact.
Mark Conlan, United States of America
Andrew Witham, UK I do not know if HIV can be eradicated, but it can be controlled and contained. Medicines for all contagious diseases should be a right not a privilege. Living in a world with increasingly open borders these diseases affect us all, not just one nation, a person or a lifestyle. Many religious leaders have to stop clinging on to antiquated dogma, and face reality. It is also immoral to profit from drugs while millions die because they cannot afford expensive medicines. Advanced Immune Deficiency Syndrome (AIDS) can only be prevented by encouraging people to get married early to chaste partners, and preventing fornication. Anything else will lead to the increase of AIDS. The spread of aids in Africa is in the Africans' own hands, it doesn't cost money to stop having unprotected sex.
Sarah, UK Africa has got to get out of this culture of blaming every ill on a colonial past or western economic policies. The 'west' has shown willingness to help Africa, but in the past African governments and despots have made sure that any financial assistance goes to the wrong people. Whilst vehemently stating their independence from their former 'colonial masters', why do Africans claim western money and goodwill as some sort of birthright? Many more people die every year in developing nations of illnesses other than AIDS, the majority of which can be treated effectively today. Some, such as diarrhoea, would be considered trivial in the western world. AIDS is a high profile disease and we in the western world consider it the main killer in developing nations only because it can still affect us. Instead of pumping millions into an AIDS vaccine spend the money on freely distributing treatment for common illnesses we can cure now and not go on the recommendations of a high-profile Hollywood charity ball. AIDS in Africa will not be defeated by anything short of a successful vaccination program such as that used against smallpox. Just because AIDS in Africa is sexually transmitted rather than airborne doesn't make it self-inflicted. The developed countries must dedicate themselves to creating a vaccine and then distributing it for free otherwise large parts of Africa will be depopulated.
Alex, UK Global economics are locked into a system of haves and have nots. When Aids visits such a poverty ridden world, where free sexual relationship maybe the only affordable luxury, can an alternative outcome exist? Let not any one from the developed world claim not to have multiple sexual partners, or to always indulge in protected sex. I see a very different behaviour. You don't need to spend that much money. You only need to give sex education to one person. The Pope.
Sango, USA The other day I went to the funeral of a friend who died of AIDS. She has not been able to work for 6 month, couldn't walk for 2, went blind 4 weeks ago stopped eating in the last 2 and couldn't talk in the last days. On the day she had died I had not seen her for about a month and I couldn't recognise her anymore. At the end of the day AIDS is a social problem with medical symptoms. Its spread is based on the fact that people choose to act without responsibility or sense of choice. Here in Botswana the general level of education is high, people are informed about the virus and know how it spreads. But still rich and poor seem to be affected equally.
Lifestyles don't change. Overall Botswana is showing that being informed makes no difference as it doesn't change behaviour. This, despite the fact that funerals have reached astronomical levels and the papers are full of stories on AIDS. At the end of the day life goes on as if nothing is happening. How do you make people face the facts if the majority does not care? I don't know.
Val, USA I was in Malawi recently and I got talking to a young guy who was involved with an organisation called "Image Youth Society". They travel around the country, particularly in rural areas, and try to educate young people about the dangers of AIDS and the importance of using condoms, but one of the biggest problems that they encounter is traditional beliefs and practices. For example, many young men believe that a traditional healer can cure them of the virus. Many more still believe that sleeping with a virgin will do the job. Condoms are available for free in all hospitals and medical centres but most people are too shy to ask for them - sex still very much a taboo subject in Malawi. In the mean time, people in are literally dropping like flies.
Andrew Meissner, USA I think all the conspiracy theories directed against the developed nations that are mentioned here say a lot about the problem. If the Africans believe that some other malicious force cause all the problems they have then they will never learn to cope with their problems. But then again it is always easier to stick your head in the sand and blame someone else. It is time these people grew up and took responsibility for themselves. Then MAYBE things would start to improve. For as long as the "right" to have free sex with any (consenting) partner is promoted AIDS will never be defeated. To defeat a disease like this, carriers should have to declare the fact and abstain from sexual relations with non-carriers.
Mark, Germany From what I understand, HIV is not that easy to catch. It does not float around in the air and pick its victims at random. It is basically a behaviour-based virus, and is avoidable.
Steve, USA In a continent where millions of people are illiterate, living on less than a dollar a day, without access to safe drinking water, chronically malnourished, an "expensive" disease like AIDS will spread like fire. AIDS will continue to spread in Africa not because the people do not wish to fight it, but because they CANNOT afford to fight it. It is reported that more than US$1.5 trillion is exchanged daily in the world's currency markets and that it costs only 1% of global income to eradicate poverty. In such a "wealthy" world, it is immoral to let millions of Africans die of HIV-AIDS just because they cannot afford the expensive drugs. Working in Malawi, I found people were confused and frightened by HIV/ AIDS. Much of the confusion was due to the mixed messages given out by NGOs. While some promote safe sex, many others are funded by religions that refuse to discuss sexual health and only preach abstinence. Some even claimed condoms cause illnesses!! With advice like this, how can Malawian girls and boys learn to make sensible decisions about safe sex? Africa needs to hear one clear coherent set of guidelines from scientists, religious leaders and her own governments, small scale education programmes are not enough. The Roman Catholic Church has to bear a great deal of responsibility for preaching that the use of condoms is "sinful". I hope the Vatican can sleep easy with millions of deaths as a result of their twisting scripture out of all context. In Uganda where there has been a sustained HIV/ AIDS campaign since 1987, we still have a rampant AIDS problem. I am inclined to dispute the success in halting the spread as reported in the media. In my family (extended), and I know my story is not unfamiliar, we buried someone every weekend last year. EVERY weekend. It is very hard for me to believe that the tide is being stemmed in any way. When I see the general sexual attitudes in Kampala, I see no hope at all.
Rob Sykes, Australia It was predicable from the onset that AIDS would do damage to Africa because of the existential realities of bad hygiene, hunger, unawareness, illiteracy, poor medical care and numerous irresponsible governments. As much as I personally feel very disturbed about the situation, it is my theory that AIDS started elsewhere and was introduced to Africa by both African and non-African travellers and visitors. Its transmission and spread in the continent have been perpetuated by certain customs and conditions in the different communities. I heard from a South African friend that advice leaflets and condoms have been passed out in SA. Unfortunately, the two were stapled together. I fear, fundamental mistakes like this will stall the recovery before it has even got off the ground. Africa's problem is two-fold. On the one hand, the high illiteracy rate, corrupt leadership and the general hopelessness of the continent and on the other hand, Western society's apathy towards Africa is responsible for the ever-deteriorating conditions. Only divine intervention or something of that magnitude can save Africa.
President Mbeki's comments are irrelevant to the efforts required to find a cure for AIDS. They are the comments of a person frustrated by the confusion surrounding the issue. In my view, the international community needs to address two critical aspects of the issue, which are; a) the high cost of drugs, and b) the recognition of the research being conducted by African doctors. On the issue of cost of drugs, the developed countries have been slow in convincing drug manufacturers to charge less for their valuable medications. In essence, drug companies are reaping fortunes at the expense of the suffering AIDS patients. Regarding research, quite a few African doctors have developed "potential AIDS cures", but their efforts seem to be unrecognised. Co-ordinating their efforts would go a long way in finding a cure but it seems the West will not recognise a remedy developed in Africa. By denying affordable drugs to Africans, the rich Western countries are practising "health care apartheid". Africa is a continent in self-denial. Various countries, especially Nigeria, are all living in false beliefs of one-nationhood. The Europeans and other races have sorted out their problems and are living in the real world. Africa is still living in darkness and false beliefs that they can make their present situations work. Instead, it is ravaged with AIDS, poverty, and confusion. The ridiculous comments made by President Thabo Mbeki that HIV is not the cause of AIDS may help him in the short term but are damning for his country and continent. Some have suggested that his is a corrupt regime that does not want to spend any money on HIV because he wants it for himself. Whether that is true or not will be open to scrutiny over time. The fact that the drugs companies want to sell their drugs at a good rate of return is understandable. That notwithstanding, it would not be unreasonable for the UN to purchase the licence for treatments of prophylactics and make them widely available. This has been suggested before and rejected, but we just have not offered enough money. The price may be high, but not as high as the cost of the lives that are continuing to be lost.
Anonymous, UK I would like to begin by saying that since AIDS/ HIV is a global problem and efforts to find a lasting cure is a priority, why are the available drugs expensive? Also, why does Africa seem to be left out in the sense of making the drugs so expensive that very few can afford them? Its been said that the disease is destroying Africa. Does the world care or is it another Kosovo-Rwanda story? There is a clear correlation between the Sub-Saharan AIDS map and tourism. Inference beyond reasonable doubt, leads us to conclude that infected Western tourists are culprits in the spread of the AIDS dilemma. A visit to those Southern African countries will expose your eyes to their high inter-racial sex markets - even involving underage girls. These tourists abuse the poor natives with the exchange of sex, for a token of their higher valued currencies. What can Africa do? I guess it is too late in the day. However, West Africa should take heed and ban child prostitution, both internal and international. That will be a step in the right direction. Poverty alleviation is the key to the puzzle.
Ezekiel Pajibo, Liberian refugee resident in USA Africa needs to educate its population about AIDS but it needs the resources to do so. However, so much of this potentially great continent is under the tyranny of corrupt and cruel regimes that are only interested in stealing from the people they supposedly serve. Increased literacy is the most effective weapon against disease as information can then be supplied to large numbers of people relatively cheaply. Unless this happens the future looks bleak. Pharmaceutical companies may come up with a solution but they are not renowned for their altruism. The poor are treated with less respect, given less choice of service providers and offered lower-quality amenities. In trying to buy health from their own pockets, they pay and become poorer. Without addressing behaviour, the response to prevention strategies will always be limited. We'll create some results here and there, but unless there is a fundamental change in behaviour, there will be no drastic change in the evolution of the epidemic. Sooner or later Africa will declare victory over Aids, the virus killer. You only have to wait and see. Stop begging the West for goodness sake!
John Nevitt, UK
Samuel, USA
Pius M Katunzi, Uganda In underdeveloped countries the major reason of ANY failure against disease is the lack of literacy/education. I think SA government should make society more aware, because if we want to win the war against such diseases we must take the help of entire society.
There is no elaborate and honourable funeral for such a person and s/he will never become an ancestor to whom the living pray. In other words, that person is lost and forgotten forever. Victims of Aids in Africa today die the second type of death, "bad death". It is understandable, therefore, why most Africans are unwilling to admit that a family member is dying from Aids. The way to help this situation is for leaders to convince themselves that Aids is an infection, like, say malaria, and to talk about it more openly. Felix Epie, USA Personally I feel that Africans are completely unaware of the outside forces that are plotting their demise and eventual death. It is no coincidence that this continent is plagued with wars, famine, and disease while the western powers look on with a smile. |
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