Western governments are spending tens of billions of dollars treating HIV-positive patients in the worst affected countries. But despite the programmes producing anti-retroviral drugs that keep those with HIV alive, 60 million people have already been infected and AIDS is likely to cost one in six lives in Africa by 2015.
 Elisabeth Pisani |
According to Elizabeth Pisani, journalist turned epidemiologist and author of The wisdom of whores, getting the West and Asia to cut down on risky sex and sharing infected needles has been ignored but can be achieved.
But she argues the real problem is Africa. In parts of the continent it is common to have multiple sexual partners and changing that social pattern is much more complicated. Ms Pisani says,
"It is difficult to focus people's attention on something that is of such high prevalence in the general population that it's almost become normalised. In some countries, one in ten, one in five, even one in three adults are already infected with this virus. One thing we can do is at least to treat HIV like a sexually transmitted infectious disease."Many point a finger of blame at South Africa's former president Thabo Mbeki when it comes to the lack of success in fighting AIDS. Most recently a Harvard University report claimed that this attitude, saying that having unprotected sex is not directly responsible for the spread of AIDS, was damaging.
"Damaging, not just in South Africa itself, but globally," Ms Pisani says. "It is very difficult to quantify that damage, it's also very difficult to undo."
|
|
One thing leads to another
Leaders should draw a very straight connection between unprotected sex with more than one partner, HIV infection, AIDS, and death, Ms Pisani says. It worked in Uganda, where that direct line was drawn very clearly.
"Uganda was the very first country to see a generalised epidemic reversed. But what was a very pragmatic approach and an effective approach in Uganda, has been reversed, and unfortunately the success that it brought is also being reversed."
Preventable
It looks like Uganda was one of the few successes, however shortlived. With 60 million people infected worldwide, has the fight against the spread of HIV failed? Ms Pisani for one considers it a failure:
"They are infected with what should be a preventable virus. For example we still have a very, very large HIV epidemic among people who inject drugs, in many countries. That is something that is really quite easy technically to deal with. But we're still not doing the things that we know work. We haven't been targeting the commercial sex industry sufficiently in a lot of countries; a disproportionate number of infections take place in commercial sex."
The impression that the numbers are not as high as predicted in the 1980s is misleading, Ms Pisani contends.
In some communities the rate of infection is as high as it could possibly be, she says: "Drugs injectors in Indonesia, for example, are 55 percent infected; gay men in Thailand 30 percent infected."
Gays, drugs users and the sex industry
The absence of a high level of infection in the general population is not the result of any awareness programme, but is simply because their patterns of sexual behaviour don't support the spread of the virus.
Ms Pisani strongly advocates that prevention programmes should concentrate on those groups most at risk: "gay men, people who inject drugs, and those who sell sex and buy it."
Tags: aids, Elizabeth Pisani, hiv