United Press International - Monday, December 29, 2003
Claude Salhani and Ed Susman

The continent, however, remains rife with disasters -- both created by man and as a result of poor or non-existing healthcare, illiteracy, poverty, malnutrition and sub-standard norms of living.

Civil wars have been raging in the Ivory Coast, Liberia, Sudan, Sierra Leone, Somalia and Zimbabwe and refugee crisis of Biblical proportions abound in Angola, the Congo, Rwanda and Burundi, to mention only some of the countries. Tens of millions of people remain displaced as a result of decades of continued warfare, with numbers mounting daily.

Africa remains the worst continent, where in some countries such as the Sudan and Niger, slavery continues to be practiced. Famine is always around the corner in other parts of the continent where life expectancy is the lowest in the world.

A report released Dec. 18 by the World Health Organization estimated at 34 years the average life expectancy in Sierra Leone -- the lowest in the world -- compared to Japan on the other hand -- the highest in the world -- where the average person is expected to live 81.9 years.

The AIDS pandemic in Africa kills 5,000 adults and 1,000 children daily.

The horror and extent of the disease has brought promises of assistance from high-ranking politicians, such as President George W. Bush, but a combination of poverty, government inaction and corruption, myth and stigma continue to drive the epidemic to levels that are difficult for Westerners to fathom.

In the world today, of the 43-million people living with HIV, which causes AIDS, 29.4 million live in sub-Saharan Africa. Of the 5 million people worldwide who will be infected with HIV this year, 3.5 million are in Africa, where 58 percent of those who are HIV-positive are women and the disease is spread mainly due to sexual relations between men and women.

Africa's situation differs tremendously from the United States and Western Europe, where governments and pharmaceutical companies are developing policies and products to treat a disease that affects under 0.5 percent of the population. In Africa, 16 nations have disease prevalence rates exceeding 10 percent -- 20 times that of Western nations -- many governments ignore the epidemic that fills hospital wards and results in millions of homeless orphans.

The continent's epicenter for AIDS is in South Africa, where nearly 5 million people -- 15 percent of the population -- are infected with HIV, and the government for more than three years has blocked efforts to dispense drugs to pregnant women -- drugs that repeatedly have been shown to prevent transmission of HIV to their babies. In South Africa, about 8,000 babies are born to HIV-infected mothers each month. Of those born with the infection, few live beyond age 4.

AIDS has claimed so many lives in South Africa that often, people are buried vertically into the ground for lack of space in cemeteries.

In 2003, South African officials have sought to de-license nevirapine -- the only approved anti-AIDS drug in the country and a medication shown to reduce mother-to-child transmission of the disease. In response, and under pressure from AIDS activists, other government agencies have demanded health officials draw up a plan to provide anti-retroviral drugs to people with AIDS (the organism that causes the disease actually is a retrovirus).

In 2000, at the World AIDS Conference in Durban, nevirapine was offered free to pregnant women in South Africa. Three years later, the drugs remain unavailable.

As a result, an estimated 600 South Africans die from AIDS every day, and thousands more die in Botswana, Zimbabwe and Malawi -- and all across Africa.

In sub-Saharan Africa, there is hardly an adequate word to describe the catastrophic situation where 17 million deaths are due to the disease since the 1980s.

"One has to consider Africa's main agricultural society," Dr. Thomas Quinn, professor of medicine at Johns Hopkins University in Baltimore, said at a meeting of the American Society of Tropical Medicine and Hygiene. "Seven million farmers have died due to AIDS. One has to ask who is farming the land?"

Farming is not the only area affected. "One also has to look at the educational process as well as the working process," Quinn said, explaining that 85 percent of teacher deaths in South Africa over the last 20 years have been due to AIDS.

"From the global perspective, the HIV epidemic has reversed many of the developmental gains that have been achieved in many areas of the world, particularly reversed those gains made over the last three decades," Quinn said. "There has been an economic decline, particularly on the continent of Africa with estimates of that decline ranging from 10 to 40 percent -- a staggering figure in an area that is already economically fragile.

"It has resulted in health system chaos where in some places 50 to 70 to 80 percent of hospital beds may be occupied by HIV-infected people with increasing opportunistic infections many of which go untreated. All of this results in a spiraling factor of political instability."

At an International AIDS Society Conference in Paris, Jean-Paul Moatti, professor of economics at the University of the Mediterranean in Marseilles, cited new figures from the World Bank. He said if the epidemic continues at its present pace, within four generations the economy of South Africa will be halved by AIDS.

Young girls -- even children under age 5 -- often are raped by older men, purportedly due to a widespread myth that sex with a virgin can cure or prevent AIDS. Karl Peltzer, a research specialist at the Human Sciences Research Council, Cape Town, South Africa, said the myth -- as well as aberrant sexual behavior -- and the common pursuit of young women by older men, "has led to a disproportionate number of young girls becoming infected with HIV."

The culture of some African communities exacerbates the problem. In some societies if the husband dies, the husband's relatives take all the family possessions -- including the home and savings, leaving the widow and her children destitute and homeless. The only alternative for many women and many children is commercial sex work, which fuels the spread of the epidemic.

As Quinn noted: "Africa is where AIDS has entrenched itself in the last two to three decades, and is still spiraling out of control. The spread of HIV continues relentlessly across the continent."

Africa may well be dying as the rest of the world watches and dribbles out drugs and money to fight the disease.

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