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Battling HIV/AIDS

Joe Opio/The New Vision/Twenty Ten

Associated feature: Living Positive (Photo feature), FIFA Supports HIV Work (Text feature)

Location: Johannesburg, South Africa

The fight against HIV/AIDS in South Africa.

Bafana Bafana might have already exited the 2010 FIFA World Cup, but while Carlos Alberto Parreira’s boys played to nationwide acclaim, another brigade of locals was pursuing an even more treacherous mission.

The Young Men Christians Association (YMCA) saw a window of opportunity the moment South Africa were declared hosts. For most South Africans that window was purely commercial, but the YMCA and its partners had a more noble undertaking in mind. Starting in June, when the World Cup kicked off, the YMCA rolled out a concerted HIV/AIDS prevention campaign that, they hope, will galvanize South Africa’s struggle against the deadly scourge.

“Like everyone else, we think the World Cup gives us a chance to spread the message about South Africa’s fight against HIV/AIDS,” reveals Tsepo Dlamini, a seasoned volunteer at the local YMCA branch in Orlando, Soweto. Soweto is in the impoverished part of Gauteng, a province that, alongside KwaZulu-Natal, is reputed to host 55 per cent of all South Africans infected with HIV.

Dlamini admits: “AIDS is such a problem in this country and we believe that like many other South Africans, we can capitalize on the popularity of the World Cup to somehow urge people to join the struggle against it. We hope that the football stars who are in South Africa for the World Cup will help use their status to influence people to change their behaviour.”

It won’t be the first time that South Africa has exploited hosting rights to a major football tournament to crusade against the scourge. In January 1996, when South Africa hosted the African Cup of Nations, Bafana Bafana joined the AIDS Awareness Campaign by wearing red ribbons to all public appearances throughout their march to the continental title.

The struggle against AIDS is one that most researchers and local activists think South Africa has been losing. Just recently, South Africa’s Chris Hani Baragwanath Hospital, the world’s largest hospital, revealed that, “50 to 80 per cent of our patients have HIV.” To make matters worse, a report in the Lancet Medical Journal disclosed that while South Africa forms just 0.7 per cent of the global population, it carries 17 per cent of the world’s HIV burden. In fact, today, South Africa is home to 5.7 million infected people, with almost one in every five adults positive and an estimated 1,000 people killed every day.

So, while Bafana Bafana were the second lowest-ranked team at the World Cup, just above North Korea, South Africa won the race hands down among all gathered when it came to countries with the highest prevalence rate of reported HIV/AIDS infections.

“That’s one thing that strikes you instantly,” Dlamini confesses. “Of all the countries taking part in the World Cup, we have the highest HIV prevalence rate. In fact, even among those countries not taking part, we’re still the country with the highest number of infections, as well as the highest number of people living with AIDS. This is why it’s critical that we use this World Cup to sustain our campaign to check the rampant spread of HIV/AIDS in this country.”

Dlamini and others like him are heeding a call to arms from South Africa’s Health Minister Aaron Motsoaledi. Motsoaledi spent the entire build-up to the World Cup urging the government and all stakeholders to intensify the fight against AIDS.

“A war is still going to be won. We'll only win when we stand together as government ... as civil society,” Motsoaledi was quoted as saying at a conference in Midrand two months back. “We need to come out with guns blazing to fight this scourge.”

With a cure yet to be discovered, the YMCA and its partners have focused their World Cup campaign on prevention of the spread of the disease through voluntary counselling and testing. “It’s a critical month for us,” Dlamini states. “Remember that this is a month when school in South Africa has broken up, all students are on holiday. South Africa will be hosting an influx of visitors who are going to be in a festive mood. Mix a holiday atmosphere with the alcohol and the partying mood of most of the fans of the World Cup, and people will be tempted to become reckless. So, we’re trying to preach responsible living for all involved. We intend to keep this campaign going throughout the tournament.”

He continues: “The World Cup gives us an opportunity since it’s an event that will capture nationwide attention. Our mission is to try and tap into that collective attention and sensitize the people. We want to help eradicate among others, the stigma that is attached to admitting to HIV infection, faithfulness and abstinence, especially among youths.” Dlamini readily admits that his team will be concentrating most of its attention on the youth. “We’re especially targeting the youth in and around Soweto,” Dlamini affirms. “As studies keep showing, young people are the most vulnerable demographic to HIV/AIDS. Most AIDS-related deaths are among the youth, especially girls.”

Dlamini and the YMCA hope to build on successes by similar AIDS awareness campaigns that have had an impact. Among the more prominent campaigns are Soul City and Soul Buddyz, two youth-oriented programmes that inspired a decline in new infections among teenagers. At the peak of both campaigns, HIV prevalence figures in the 15-19 year age group fell from 16 per cent in 2005, to 14 per cent in 2006 and 13 per cent in 2007, before a slight loss of effectiveness in 2008.

The struggle by the YMCA and its partners might seem routine to most visitors whose countries have waged successful battles against the scourge, but to Dlamini and other activists in South Africa, it’s a gigantic step forward for a nation which became a global laughing stock in 2000. Then, South African president Thabo Mbeki outraged scientists and AIDS experts when he dared question well-established scientific facts about whether HIV actually caused AIDS.

It was a slap in the face of modern science.

Mbeki, an otherwise urban, well-educated statesman, thereafter invited several people who echoed his beliefs to join his Presidential AIDS Advisory Panel and instituted debatable government policies that ran in opposition to universal research about the virus. He also controversially appointed, as health minister, Manto Tshabalala-Msimang, a woman who promoted garlic, lemon juice and beetroot as AIDS remedies at the expense of antiretroviral drugs, which she claimed were toxic.

In 2009, after his ouster, Mbeki’s policies alone were blamed for the early deaths of more than 330,000 South Africans. It’s an unfortunate legacy. Estimates show that by 2005, South Africa should have been treating half of the people living with HIV/AIDS, but with the policies in place, help only reached 23 per cent. It was an unflattering portrait in comparison to neighbours Botswana and Namibia who were providing treatment to 85 per cent and 71 per cent of patients respectively.

Experts still brand South Africa’s response to AIDS under Mbeki, “a case of bad, or even evil, public health”, and his departure heralded a new chapter for South Africa’s struggle.

It’s a chapter that was finally opened after Tshabalala-Msimang’s successor declared that “the era of denialism is over completely”.

Health minister Motsoaledi has spearheaded the new crusade, calling for a, “massive change in behaviour and attitude” among South Africans, while voicing shame over past policies. “The figures are shocking. As to whether they are a result of what we did in the past 10 years, to me that's obvious. I don't think we'd have been here if we had approached the problem in a different way. It's a really obvious question. Yes, our attitude toward HIV/AIDS put us here where we are.”

The YMCA’s campaign is mainly aimed at behavioural change, though Dlamini hastens to add that their approach is a multi-pronged effort towards prevention.

“Whatever the debates, there’s no doubt that prevention is the best weapon against HIV/AIDS,” Dlamini says. He might only be a volunteer in a provincial NGO, but Dlamini’s view that now is the time to act are shared by Motsoaledi, who remains critical of South Africa for lagging behind the rest of Africa in the fight against HIV/AIDS.

“If the scourge of HIV….is a snake, the head is South Africa,” Motsoaledi has often told the media. “If you want to kill a snake, you start with the head and it will die. While many African countries are implementing; South Africa is still debating. We’re a country that debates. We’re buying 400-million condoms per annum, but we’re debating how moral would it be for us to go there [to schools] and line up kids and give them condoms, or whether the government should preach abstinence from sex to children.”

Motsoaledi has gone to great lengths to defend South Africa’s lamentable record in the region. He notably came under severe criticism last year when a UNAIDS summit of African health ministers in Kigali, Rwanda deplored South Africa for the failure of its AIDS programmes.

Motsoaledi tells of how former Botswana president, Festus Mogae asked: “We can understand the poor statistics in the rest of the region, how do we explain South Africa, a highly industrialised country?”

It was a rhetorical question that offers a scathing indictment on the World Cup hosts.

Randall Tobias, another activist, joined South Africa’s fight against HIV/AIDS in 2003. However, he has mixed memories about that period. “We did an enormous amount of good in the early days in South Africa, not because of the Health Ministry, but in spite of the Health Ministry.”

It’s doubtless South Africa has been scarred. At least now, Dlamini, the YMCA and other activists can dare to hope that an alliance with the government will reverse the tide of the battle. The World Cup could provide a good starting battleground!

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