AIDS Devastates Africa

Date 1998

In 1998, more than two million Africans died from AIDS or from diseases associated with HIV, the virus that causes AIDS. As millions of children were orphaned and the continent’s already precarious economic position worsened, international organizations became aware of the urgent need to control the spread of the disease.

Locale Africa

Key Figures

• Yoweri Kaguta Museveni (b. 1944), president of Uganda beginning in 1986
• Peter Piot (b. 1949), executive director of the Joint United Nations Program on HIV/AIDS

Summary of Event

Acquired immunodeficiency syndrome (AIDS) was first identified in the early 1980’s in the United States. Originally thought to be a contained disease found solely among specific populations, AIDS quickly proved itself to be an infectious disease that could and would affect all groups of humans. On the continent of Africa, Uganda, Tanzania, and Rwanda were the first countries to report cases of AIDS to the World Health Organization (WHO) in 1983, and by 1985, other African countries began to report cases. The human immunodeficiency virus (HIV), which causes AIDS, quickly spread throughout the continent, with heaviest concentrations in the sub-Saharan and southern countries, causing it to be called an epidemic.

In 1998, sub-Saharan Africa was home to approximately 10 percent of the world’s population, yet about 70 percent of all HIV/AIDS cases in the world were found there. By the end of that year, the disease had claimed the lives of approximately thirteen million Africans. Among the African nations with the highest HIV prevalence were Botswana, Tanzania, Zimbabwe, Zambia, Uganda, and Malawi. According to the Joint United Nations Program on HIV/AIDS (known as UNAIDS) and WHO, these countries held the highest numbers of persons living with HIV and dying from AIDS. The numbers of people infected with the virus increased steadily during the 1990’s, peaking by the end of 1998.

HIV/AIDS devastated Africa by having its greatest impact on the core of the population—those fifteen to forty-nine years of age. In most sub-Saharan nations, one in every ten persons among the working population and youth was HIV-positive; in some, the number was one in five. Families, businesses, schools and universities, and governments were all affected by this pandemic, necessitating an immediate response of intervention and prevention to save lives and sustain the vitality of these African countries.

The mortality rates associated with HIV/AIDS on the continent of Africa were particularly high for several reasons. One important factor was the culture of silence that encouraged those living with the virus to ignore or conceal their health status. In addition, many of those infected were unaware that they were HIV-positive and so took no precautions against spreading the virus through sexual contact. Sadly, even some of those who did know their HIV-positive status took no action to protect their sexual partners. In addition, many sexually active young people, around the ages of thirteen and fourteen, were unaware of the particulars of the infectious virus and did not use condoms, putting themselves at risk.

The main mode of transmission of HIV on the continent was through heterosexual sex, although homosexuals and intravenous drug users were not excluded. The disease spread quickly because large numbers of persons who were diagnosed late or were never diagnosed refused to use condoms or did not have access to them. HIV was also transmitted from breast-feeding mothers to their infants.

UNAIDS and WHO were active in leading an aggressive campaign to contain and control HIV/AIDS in Africa. Both organizations contributed millions of dollars to HIV/AIDS education, treatment, and testing; they set up offices and programs with Africans to address the HIV/AIDS pandemic. Doctors, nurses, and social workers were sent to Africa to open clinics and disseminate antiretroviral drugs to assist in controlling and containing the spread of HIV/AIDS.

Uganda was one of the first African nations to work collectively and aggressively against the spread of the disease. In 1986, President Yoweri Kaguta Museveni was the first African leader to speak openly about HIV/AIDS. Although it was one of the poorest countries in Africa, Uganda was able to target behavioral interventions such as the implementation of access to HIV prevention programs in workplaces, in the community, and in the schools. Condom use was encouraged and promoted, and condoms were made accessible. Clinics were organized to diagnose and treat sexually transmitted diseases (STDs).

Uganda established the National AIDS Control Program, an aggressive awareness campaign that encompassed Africa’s first voluntary HIV counseling and testing services, and enlisted the help of all spheres of the Ugandan population—community leaders, faith-based groups, and civic society. In less than ten years, Uganda was able to report a significant decrease in the number of HIV/AIDS cases as well as a decline in dangerous behaviors thanks to increases in condom use, sexual abstinence, and mutual monogamy between heterosexual partners.

Other countries—including Senegal, Botswana, and Zambia—followed Uganda’s lead, focusing on targeting behaviors, practices, and beliefs. These programs were successful because they lifted the veil of silence surrounding HIV/AIDS and because they were part of intensive collective efforts by government and community leaders to stop the spread of the disease. One prevention mantra that was adopted was “ABC”—meaning Abstain, Be faithful, and use Condoms. These countries were also assisted in their fight against HIV/AIDS by international private foundations and world organizations such as WHO and UNAIDS.

In those countries that were successful in their fight against the virus, all facets of society were involved. The combined approaches of AIDS awareness campaigns, community involvement and mobilization, targeted behavior change programs (encouraging abstinence, delay in the initiation of sex, mutual monogamy, and condom use), voluntary testing and counseling, and diagnosis, treatment, and management of STDs worked well for those countries that seriously and aggressively implemented them. Even with all these interventions, the spread of HIV/AIDS continued in Africa, largely because of the deficiency of resources—specifically, an insufficient number of trained doctors and nurses to treat patients and an insufficient supply of antiretroviral drugs and condoms received, distributed, and consistently used by patients.

Significance

The continent of Africa’s fight against HIV/AIDS continued into the twenty-first century. Because of particular religious, cultural, social, and economic factors, activists, community leaders, government officials, and religious and spiritual leaders had to work together to encourage the members of high-risk groups first to acknowledge the disease and then to act responsibly in combating its spread. In addition, some isolated populations in areas far from the main city centers did not have immediate access to information or resources to fight the virus.

The impact of HIV/AIDS on the developing nations in Africa demonstrated to the world how AIDS could possibly destroy a society if the disease is not methodically and aggressively confronted. HIV/AIDS has had a global impact, but in Africa in the late 1990’s it moved with particular speed and intensity. The main lesson learned in 1998 in Africa was that fighting the HIV/AIDS pandemic required multiple factors and the use of multiple interventions. Other developing countries on the continent and around the world looked to the example of Uganda specifically as they struggled to reverse the devastation of HIV/AIDS at the close of the twentieth century.

Bibliography

Barnett, Tony, and Piers Blaikie. AIDS in Africa: Its Present and Future Impact. New York: Guilford Press, 1992. Provides information on the development, spread, and impact of AIDS in Africa. Focuses on case studies in Uganda.

Bond, George C., John Kreniske, Ida Susser, and Joan Vincent, eds. AIDS in Africa and the Caribbean. Boulder, Colo.: Westview Press, 1997. Collection of essays presents a general anthropological and sociological overview of AIDS in Africa. Includes specific case studies.

Hope, Kempe Ronald, ed. AIDS and Development in Africa: A Social Science Perspective. New York: Haworth Press, 1999. Collection of essays covers various aspects of the HIV/AIDS crisis in Africa, including the socioeconomic impacts of the disease and its effects on women. Provides a good overview of how HIV/AIDS has affected all of the continent’s nations.

Hunter, Susan. Black Death: AIDS in Africa. New York: Palgrave Macmillan, 2003. Personal account of the situation in Africa by a globally recognized AIDS specialist. Focuses on two women’s experiences with the disease in their everyday lives.