luboobi

HIV/AIDS Pandemic in Africa: Trends and Challenges: 

HIV/AIDS Pandemic in Africa: Trends and Challenges Livingstone S. Luboobi Department of Mathematics Makerere University, luboobi@admin.mak.ac.ug P.O. Box 7062, Kampala, Uganda Joseph Y.T. Mugisha Faculty of Computing & Information Technology Makerere University, mugisha@ics.mak.ac.ug P.O. Box 7062, Kampala, Uganda

1. What makes HIV/AIDS Epidemic Unique in Africa?: 

1. What makes HIV/AIDS Epidemic Unique in Africa? Fuel to the epidemic in Africa Ignorance of the people of the disease. Lack of access to prevention. Inadequate treatment and care services. Stigma and discrimination.

Uniqueness of HIV/AIDS Epidemic in Africa (cont) : 

Uniqueness of HIV/AIDS Epidemic in Africa (cont) Other factors that may help explain why HIV/AIDS has hit Africa much more High incidences of sexually transmitted Infections (STIs). Large refugee populations. Seasonal labour migrations that allow multiple sexual partners.

Uniqueness of HIV/AIDS Epidemic in Africa (cont): 

Uniqueness of HIV/AIDS Epidemic in Africa (cont) Varying traditions and cultures among African countries. Marriage patterns in Africa where men prefer younger girls and polygamous tendencies. Sharing of wives is common practice among many African Countries. Widow inheritance is very popular among African families. Sexual cleansing rituals is a very common practice.

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Varying traditions and cultures among African countries (cont) Sex workers among many cities in Africa. Unemployment: Many girls who go to towns to look for jobs fail to obtain them. Early marriages: Many girls are married off early and as such miss school where they could learn more about dangers of such diseases. African people do not to talk about Sexual life in public.

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Varying traditions and cultures among African countries (cont) Women left home by mobile population in many cases end up in extra marital sex with neighbours who happen to come to help her while in need of money and other social needs. Conflict and wars. Where there has been conflicts and wars, effort to extend HIV/AIDS services have been rendered impossible. Postpartum Abstinence: In many parts of sub-Saharan Africa breastfeeding means sexual abstinence of women.

UNAIDS 2004 Report : 

UNAIDS 2004 Report Sub-Saharan Africa is a home to close to two-thirds of all people living with HIV/AIDS. The estimate of HIV/AIDS people in Sub-Saharan Africa at 25.4 Million persons with a 7.4% adult prevalence rate, as compared to 2 Million in Latin America & Caribbean, 1.4 Million in Eastern Europe & Central Asia and 8.2 Million in Asia. In South Africa, Swaziland, Zimbabwe and Botswana there are worrying ever increasing prevalence rates (with figures of up to 27.9% by end of 2003, from 2.4% in 1992, for the case of South Africa . In Madagascar, there has been an alarming rise in prevalence among pregnant women; it increased by almost fourfold since 2001, to reach 1.1% in 2003.

UNAIDS 2004 Report.. : 

UNAIDS 2004 Report.. In West Africa, the epidemic is diverse and changeable. National prevalence has remained relatively low in the Sahel countries, with prevalence around 1%. However, the overall figures can conceal very high infection levels among certain population groups. In Senegal, for example, national HIV prevalence is below 1%, but prevalence rose among sex workers in two cities: from 5% and 8% in 1992, to 14% and 23% in 2002, respectively.

UNAIDS 2004 Report.. : 

UNAIDS 2004 Report.. East Africa now boasts of several examples of gradual, modest declines in medium HIV prevalence. In Uganda the national prevalence fell from 30% in early 1990s to 4.3 by the end of 2001 and 4.1% by end of 2003, remaining subsequently at 5% to 6% through the 2004.

Why Uganda has a gradual decline in the HIV prevalence.: 

Why Uganda has a gradual decline in the HIV prevalence. In 1982 the first AIDS case in Uganda was diagnosed. Between 1982 and 1986 there was little understanding of what AIDS was and what causes it. In 1986 the newly sworn-in President Museveni responded to the emerging HIV crisis in Uganda. Although it did not work immediately because the new government had to settle-in and solve other internal problems such as persistent insurgence, the government maintained AIDS policies among the priority areas and by late 90s, started to see fruits of declining prevalence rate.

Why Uganda has a gradual decline in the HIV prevalence...: 

Why Uganda has a gradual decline in the HIV prevalence... There has been an apparent fall in the number of new infections amongst younger people. Approach used in Uganda is sometimes known as ABC. Abstinence until marriage. Be faithful to a single partner always to use Condom. The message about HIV and AIDS was effectively communicated to a diverse population by the government and by word of mouth. Openness and honesty about the epidemic have been key factors in exposing the risks and how they can be avoided.

Why Uganda has a gradual decline in the HIV prevalence...: 

Why Uganda has a gradual decline in the HIV prevalence... Of recent, attention has been turned to educating the population to the role of ARVs towards a positive living. People have gained confidence in living with persons with HIV/AIDS because they have them in offices and at home. The HIV prevalence of 4.1% is still high. Indeed the now 18 year old insurgence and war in northern Uganda has made extension of HIV/AIDS services very difficult, making the region one of the most affected in spite reported declining prevalence rates in Uganda.

2. The Impact of HIV/AIDS in Africa: 

2. The Impact of HIV/AIDS in Africa

The impact of HIV/AIDS in Africa is noted in nearly all sectors of development : 

The impact of HIV/AIDS in Africa is noted in nearly all sectors of development Obvious increase in total hospitalisation. More health personnel are needed in a continent where there has originally been a shortage of trained health personnel. Education Sector: Poorer households have removed the children from schools (especially girls). A decline in school enrolment has been one of the most visible effects of the epidemic.

The impact of HIV/AIDS in Africa is noted in nearly all sectors of development.. : 

The impact of HIV/AIDS in Africa is noted in nearly all sectors of development.. HIV/AIDS dramatically affects labour, setting back economic activity and social progress. Government revenue and patterns of expenditure: A reduction in the rate of growth of the labour force, combined with falling productivity, means less government revenue from individuals and enterprises. AIDS does not only reverse the effort to reduce poverty but increases on the percentage of people living in extreme poverty.

The impact of HIV/AIDS in Africa is noted in nearly all sectors of development.. : 

The impact of HIV/AIDS in Africa is noted in nearly all sectors of development.. On life Expectancy and population size: It is common knowledge that AIDS has considerably reduced average life expectancy in most of the countries especially Sub-Saharan countries.

3. Levels of involvement in the fight against HIV/AIDS in Africa: 

3. Levels of involvement in the fight against HIV/AIDS in Africa Personal Leadership: Every Individual must break the silence around the norms and practices that fuel HIV/AIDS pandemic. Community Leadership: At the community, there should be a common struggle to overcome HIV/AIDS, in every family, village, township and settlement across Africa. National Leadership: This, carefully done, creates the conditions for community mobilization across the nation.

3. Levels of involvement in the fight against HIV/AIDS in Africa..: 

3. Levels of involvement in the fight against HIV/AIDS in Africa.. Regional Leadership: Africa’s HIV/AIDS pandemic knows no geographic, economic or social boundaries. It demands action at continental level and leadership. International Leadership: International interest in global harmony can create commitment towards expedited HIV/AIDS grant procedures, reduced ARV drug prices, development of vaccine, research effort towards treatment of opportunistic infections, legal enactment of HIV/AIDS by-laws (international code of good practice on HIV/AIDS), and enforcement of transparency and accountability of funds purposely meant for HIV/AIDS programmes

4. Challenges of Treatment in Africa: 

4. Challenges of Treatment in Africa High costs: a demanding treatment regime, and lack of even basic health infrastructure to deliver the treatment were cited as insurmountable barriers to providing treatment to Africans who needed it. Moreover, most of the regimes, even today demand an accompaniment of good, constant dietary, something that these poor families are not able to sustain.

4. Challenges of Treatment in Africa..: 

4. Challenges of Treatment in Africa.. The main problems that arise in administering treatment protocols are: Sustainability of the regimes. The drugs are taken at a monthly rate and sustaining the monthly cost can be afforded by very few. The Cost of the drugs: Even though the regime cost up to $10,000 in the early 1990s has now come down to an average of $200, still it is extremely unaffordable by Africa

5. Scaling up the Response to HIV/AIDS: 

5. Scaling up the Response to HIV/AIDS The best way forward for Africa to fight the scourge is to develop a multisectoral approach. Currently, the impact on the epidemic in many countries is comprised of fragmentation. Different actors are pursuing HIV/AIDS agendas in isolation from each other. Governments should let all those stakeholders willing and able to help at local levels be involved as part of their duties.

5. Scaling up the Response to HIV/AIDS..: 

5. Scaling up the Response to HIV/AIDS.. Need for high-level political support and decentralized planning for behaviour change Condom marketing and promotion Intensify STIs control and prevention programmes aimed at discouraging multiple sexual partnerships

6. HIV/AIDS Research and Scientific Trends in Africa: 

6. HIV/AIDS Research and Scientific Trends in Africa HIV/AIDS has emerged as one of the leading challenges for global public health. It is critical to estimate the magnitude and projection of the HIV/AIDS epidemic in order to effectively plan and evaluate control and treatment strategies, e.g. of vaccine trials Mathematical modelling has been used as a tool to project demographic, economic and social impact in Africa

6. HIV/AIDS Research and Scientific Trends in Africa..: 

6. HIV/AIDS Research and Scientific Trends in Africa.. Other models have been designed targeting preventive measures. A dynamic compartmental simulation model to identify the best strategies for preventing spread of HIV/AIDS was described for Botswana and India. Extension of previous mathematical models that were developed to estimate epidemic trends based on sentinel surveillance data from pregnant women using sub-Saharan Africa has been done to improve the methodological basis for modelling the HIV/AIDS.

6. HIV/AIDS Research and Scientific Trends in Africa..: 

6. HIV/AIDS Research and Scientific Trends in Africa.. There is a new initiative to build capacity across Africa to collect data and conduct quantitative analyses necessary to understand the dynamics of major diseases afflicting the continent, with an initial emphasis on HIV/AIDS. More recent research is focusing on the modelling the in vivo (within-host) dynamics of HIV in preparation for the anticipated break-through in the development of an HIV vaccine

7. New Challenges: : 

7. New Challenges:

(a) The Problem of Complacency: 

(a) The Problem of Complacency Complacency about the need for HIV prevention may be among the strongest barriers communities face as they plan to meet the next century's prevention needs. The success of HAART is good news: for the infected people live longer and better lives, but this may lull people into believing that preventing HIV infection is no longer important. While the number of AIDS cases is declining, the number of people living with HIV infection is growing. There are also a number of cultural factors that need to be considered when carrying out research in Africa and elsewhere.

(b) Re-emerging of Resistant Strains: 

(b) Re-emerging of Resistant Strains Today there is an eminent problem of re-emerging of more resistant HIV strain when the HIV/AIDS patients on ARVs engage in unprotected sex. Drug-resistant HIV strains are threatening to undo the benefits of ARVs offered to patients. Resistant strains have been reported from the world over, including India.

(c) HIV/AIDS Vaccine : 

(c) HIV/AIDS Vaccine A few vaccine development and trials are being carried out in Africa, and these need to be promoted and reinforced.

8. Conclusion: 

8. Conclusion Much greater numbers of people who acquired HIV over up to 10 past years are becoming ill now - so the AIDS impact in Africa is not yet fully known. In the absence of massively expanded prevention efforts, the AIDS death toll in Africa will continue rising for another decade. The worst of the AIDS impact in Africa will be felt in the next decade and beyond. However, it is not too late to introduce measures to reduce that impact, including wider access to HIV medicines and help for the poor.

8. Conclusion..: 

8. Conclusion.. Now with overstretched resources, economies of Africa need heavy international partnership to enable them be part of the global efforts to fight AIDS. African Scientists must form research collaborations with the rest of the world towards HIV vaccine development so that they can see themselves as belonging to, than waiting for success.