HIV
The New Face of Africa
Terry Wuerz Volunteer Staff
In the early 1980s, the world was confronted with a conundrum. Medical case reports and World Health Organization bulletins were turning up increased incidences of an extremely rare type of cancer, called Kaposi sarcoma, in young homosexual men. A tumor that involves the skin and mucous membranes such as the inner cheeks, Kaposi sarcoma had previously been observed mainly in elderly Eastern European and Mediterranean men, and never in epidemic proportions.
Soon after, a new illness was described as being behind these strange mucocutaneous lumps: the acquired immunodeficiency syndrome now well known as AIDS. Immediately stigmatized as being a disease of gay men and IV drug users, AIDS killed many who were afflicted in those early years because of a lack of known treatment. The disease was quickly seen by the world as a death sentence, relentlessly coring away at a victim’s defences until the immune system is no more than a hollow shell, easily broken.
In the Western world today, much has changed. The linking of AIDS with a pathogen known as the human immunodeficiency virus (HIV), along with good laboratory tests for this virus, mean that treatment for AIDS patients can start years before they even have symptoms. Antiretroviral drugs (ARVs) are effective at delaying the onset of AIDS for decades, and can even lower transmission rates.
The virus has spread. Women today are just as likely to become infected as men, if not more so.
However, the stigma of homosexuals with AIDS lingers on. Due to intense lobbying activities designed to protect patient anonymity during the early years of AIDS, many of the public health responses put in place to try and prevent its spread have been blunted. Contact tracing and anonymous reporting of new HIV cases to Public Health, responses to communicable disease in place for other STIs, were abandoned. (Recently, HIV has become an anonymously reportable disease in Manitoba, but infected individuals are still not required to name sexual contacts).
In general, developed nations have weathered the AIDS assault with admirable resilience, thanks in part to adequate resources and ease of access to health services. The situation is altogether different in Africa. In a continent where starving children and war-stricken poverty are more the norms than exceptions, HIV/AIDS is poised to tear the social fabric of many African nations to shreds.
One of the major problems with the current outbreak of HIV in sub-Saharan Africa (and, increasingly, in India) is whom the virus is infecting. Infectious disease epidemics of the past — scourges such as the Spanish Flu or the Black Plague — affected mainly the very old and the very young, or those who were already quite seriously ill. The human immunodeficiency virus is transmitted through sexual contact, which in Africa means it is mostly young adults, often parents, who are becoming newly afflicted. Not only does this mar the life of the children, who have to watch their parents die of a disease that is likely to infect them at some point in their lives, it wipes out the young workforce of a continent that is already on the brink of economic disaster.
What is more, Africa does not have the same financial wherewithal to combat the onslaught of HIV and AIDS that Western nations do. To put it more succinctly, these countries are chokingly poor and getting poorer. There is little money available to pay for clean water and food, let alone fancy lab tests for viruses or name-brand medicines.
Our response to this calamity has been disappointing, to say the least. Two years ago, Canada seemed to be taking a leading role with a proposed Patent Act amendment, designed to override patent laws and allow generic, cheap ARVs to be sold in Africa. The bill was defeated under the influence of heavy pressure from pharmaceutical companies, in yet another example of the West ignoring ailing Africa’s calls for help.
All this means that African children are left to watch their parents die, and aging grandparents are being forced to raise another generation of children. There are currently 5 million AIDS orphans in Africa, and the number continues to grow. The question that has yet to be answered is what will happen when the older, healthier generation of grandparents is gone, and it is only the children who are left?
What was originally seen as a crisis in the homosexual community has spiraled into a cataclysmic event in the history of Africa. What will happen in the years to come is unclear, but it is unlikely that the AIDS epidemic will shrink or remain the same in size. If you have Africa on your list of travel destinations, I would go sooner rather than later.
If you wait until later, there may be nothing left to see.
Terry Wuerz is a third-year medical student.
