Many (though not all) African leaders are recognizing the peril that AIDS represents to their citizens. In Tanzania, outgoing president Benjamin Mkapa has warned that "AIDS is wiping us out." In Lesotho, a South African enclave, a new door-to-door AIDS testing program has been launched, in response to the fact that a staggering 90% of HIV-positive individuals are believed to be unaware of their status.
Misinformation is still profligate, however. In Swaziland, which is believed to have the worlds highest HIV-infection rate, World AIDS Day events were cancelled. In South Africa, the health minister is promoting the use of vegetables and garlic to alleviate AIDS suffering. (More details availble from the CBC.)
Recently, someone told me in all seriousness that AIDS had been introduced deliberately to Africa via smallpox-vaccination programs. This misinformation still spreads in areas with effective mass media and high levels of education and literacy. In areas without those riches, the rumors surrounding HIV/AIDS are similar to those that spread during cholera epidemics in Europe:
Public suspicion was aroused when inexplicable outbreaks of mass mortality coincided with the sudden arrival of government officials, troops, and medical officers. In Great Britain, where the state was less aggressive, physicians were attacked by crowds who believed they were killing off the poor to obtain corpses for anatomy courses... In France, the wealthy were blamed for poisoning the water supply, and hospitals were reviled as places of medical experimentation on the poor. Even reformers and radicals became afraid of the poor, convinced that cholera had been spread by the state to discredit the reforms being promulgated to help them.
This (and the abiding smallpox-vaccination conspiracy theories) bodes ill for those who hope that a vaccine will "solve" everything. Over 30 vaccines are currently under development, and they are considered by many to be a magic bullet, because they bypass some of the issues that can arise in prevention efforts: the status of women, dislike of condoms, the stigma of seeking treatment. A vaccine would certainly save lives and is worth scientific, financial and governmental support, but it is worth remembering why vaccines have historically been popular with governments:
Governments favored vaccines because they provided an alternative to difficult and expensive sanitation and housing projects for the poor, making social transformation and redistribution of economic resources unnecessary.
When we can inoculate people against HIV/AIDS, we mustn't forget the underlying issues that have added to its impact.
Black Death: AIDS in Africa is at its best when it is reminding us of the power of disease:
Epidemics are one of the strongest forces in nature, acting throughout history to shape human choices and lives in every corner of the world. While wars may take precedence in our thinking, microbes are definitely our fiercest competitors. They have literally changed the world, and have done it many times over in very dramatic ways.
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