Inter Press Service - Monday, January 4, 1999
Hazwell Kanjaye

Conducted by the Malawi government and the World Bank, the new AIDS assessment study, says the hardest hit sectors include education and health, where the annual personnel death rate is now three percent, six times higher than the predicted 0.5 percent.

Malawi, with a population of 12 million people, reported its first AIDS case in 1985. By the end of 1997, nearly one million Malawians had tested positive for the Human Immunodeficiency Virus(HIV), which causes AIDS.

According to the National AIDS Control Programme, two million Malawians will test HIV-Positive by the year 2010.

The new assessment study says that Malawi's average life expectancy, which was predicted to rise to 57 years in 2010, will now drop to 44 years. Now life expectancy is at 43 years.

"The epidemic has now reached crisis proportions," says Health Minister Harry Thomson. "Productivity and growth of the labour force will fall, while health expenditure will increase".

The estimated financial cost of caring for AIDS patients until they die is estimated between 200-900 U.S. Dollars, almost four times the country's per capital income, and much higher than the per capital health budget.

Health Minister Thomson says in the next 10 years, 70,000 children will be orphaned annually, while the annual number of people with full-blown AIDS will reach 100,000. "The unfortunate part is that the most affected young Malawian adults happen to be the ones upon whom the development of this country depends," he says.

The challenge of AIDS prevention in Malawi is to move beyond awareness to behavioural change. Although Malawians begin sexual activity at an early age, overall condom use, for example, remains low.

In a 1996 survey by the country's Ministry of Economic Planning and Development, only six percent of men and three percent of women reported condom use for their most recent sexual encounter.

During the same survey, only 22 percent of women aged 15-19 and 37 percent of those aged 30-34 who had heard of AIDS knew at least two ways of avoiding HIV transmission.

Malawi also only imports 18.7 million condoms annually, far below that of other Southern African countries like Zimbabwe which imports about 65 million condoms annually for public sector distribution alone.

At a Consultative Group meeting in Lilongwe last month, donors asked Malawi to incorporate the dimension of HIV/AIDS in all of its development programmes. "The urgency of the AIDS situation calls for greatly strengthened political leadership and increased investment in behaviour change interventions," said Barbara Kafka, World Bank Country Director for Malawi.

Kafka added that the National AIDS secretariat, now under the Ministry of Health, lacks an adequate operating budget and staff, and might be better placed outside any particular ministry "so as to better catalyse responses in all sectors, not only health".

The United Nations Joint Programme on HIV/AIDS (UNAIDS) is helping Malawi to develop a five-year (1999-2004) National Strategic Plan that will guide planning and implementation of HIV/AIDS activities.

United Nations Development Programme (UNDP) Resident Coordinator Terence Jones says the plan should be used to build momentum and the context in which leaders at community, regional and national level can discuss HIV prevention and mitigation of impact.

"Unless these partnerships -- the political support, the funding, the goods and services, and the people -- in other words the resources, are adequately mobilised, our initiatives to stem the epidemic will be hindered," Jones adds. (END/IPS/hk/pm/99)
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