Thesis on "AIDS in South Africa"

Thesis 5 pages (1597 words) Sources: 3 Style: MLA

[EXCERPT] . . . .

AIDS in South Africa: A sobering overview and prognosis

The statistic is sobering: South Africa has 0.7% of the world's population and 17% of the world's population infected with HIV (Karim et al. 2009). It also has one of most serious tuberculosis epidemics in the world, a condition that is rendered more severe by disease resistance and AIDS infection. During the era of apartheid, black South Africans were denied adequate access to medical care, and were forced to live in unsanitary and overcrowded conditions that promoted both tuberculosis and the spread of AIDS. Many men left their wives to work as migrant laborers and lived in single-sex hostels during their time away from their families. The long, enforced duration of these separations caused such hostels to be trafficked by prostitutes. Prostitutes were often called 'town wives' because of the common nature of this living arrangement. Couples in which at least one partner was a migrant worker, had a 35% infection rate, versus 19% in demographically similar non-migrant couples (Karim et al. 2009).

Patterns of infection and the evolution of the AIDS epidemic in South African have been somewhat different than in the United States. Although, as in America, the AIDS epidemic began in South Africa's male, gay population, today the face of the HIV epidemic in South Africa is young and female. In fact "In 1992, HIV prevalence rose most rapidly in teenage girls while remaining low in teenage boys" (Karim et al. 2009). Because young women often engage in sexual activity with older males, "peak HIV prevalence in men occurred at an age 5-7 years older than it did in women" according to the most recent survey (Karim et al. 2009). This is a disturbing epidemiological pattern because of what it indicates about male-female relationships in the nation and also because young women, who are at greater risk of contracting the illness because of the nature of the sexual act, may be less aware of how to prevent the illness through prophylactic mean. They may less socially assertive about using a condom, even if they are aware of the need to take such a precaution. The survey also found that the rate of HIV prevalence in young women (25-29 years) was a shocking 30% (Karim et al. 2009).

When the disease of AIDS was first identified within South Africa, the socially conservative apartheid-era government took a judgmental attitude towards the majority of AIDS sufferers, as was typical in many nations during the early stages of the epidemic. The only time the South African government showed any sympathy towards AIDS sufferers was in the case of a small number (approximately one hundred) of patients who contracted HIV through contaminated blood and blood products between the years of 1983 and 1985, before routine screening of donated blood. The government set up a fund to compensate the victims and their families, and while this action may have been commendable, the fact that these afflicted individuals were called the 'innocent victims' of the epidemic obviously suggested that the other types of AIDS sufferers who contracted the illness sexually were not innocent.

Such a moralistic attitude was common even in America during the 1980s, but only in South Africa was the political language used to describe AIDS specifically racialized. According to a 2009 article in the British medical journal The Lancet, "the apartheid government labeled AIDS a 'black disease' to reinforce racial prejudices about black sexual behavior, and used fear as the main tactic in their media. An important aspect of the government's response to HIV during this period was profiling based on race and sexual orientation, which led to the exclusion of men who have sex with men and black people from donating blood" (Karim et al. 2009). Black Africans were turned into a pariah class, and AIDS was used to reinforce racial divisions and racial prejudice. The apartheid-era government was more interested in using AIDS as an excuse to maintain its political divisions between the races than it was to curtail the epidemic in an effective manner.

The epidemiological pattern of the spread of AIDS began to change quite rapidly. "Between 1990 and 1994, there was an exponential increase in the prevalence of HIV infection, with a doubling time of a little over 1 year. HIV prevalence increased in pregnant women from 0.8% in 1990 to 7.6% in 1994. Since 1990, heterosexual transmission has been the dominant mode of HIV transmission between adults in South Africa" (Karim et al. 2009). HIV prevalence rose from 7.6% in 1994 to 20.5% in 2000 and continued to increase, in the face of widespread social and political denial of the problem (Karim 2009). In South Africa today, the situation with HIV / AIDS is alarming in terms of human lives lost and for the future state of an economy where the unemployment rate hovers around 25%. "The financial cost of addressing this epidemic is potentially enormous-if the government health budget continues at its current level, 47% of it would be required to provide first-line and second-line ART for all eligible South Africans by 2014" (Mooney & Gilson 2009).

Anti-retroviral treatment (ART), which has been so successful in prolonging the lives of AIDS patients in America, has not had nearly the same success rate in South Africa, because of poor patient access to healthcare. ART drugs are expensive, require careful patient monitoring, and also demand that the patient is quite medically knowledgeable and personally responsible in administering his or her treatment in a consistent fashion. Low literacy rates and long distances to travel to obtain care, as well as a lack of medical insurance, make treatment of AIDS difficult.

The entire healthcare system of South Africa seems overwhelmed. The current South African health minister, Aaron Motsoaledi, recently issued an apology when faced with doctor's strike upon assuming office only three months ago, acknowledging that doctors were underpaid and overburdened. Although Motsoaledi has won praise for changing the attitude of the government towards AIDS, he is combating many health challenges. South Africa has no national health insurance system. It spends 85% of its gross domestic product (GDP) on health services. 5% of that total, however, is devoted to the care of 7 million people and the remaining 35% for 41 million people (Kapp 2009). Wealthy people in the nation have loudly protested any adaptation of a national health service.

But despite his relatively brief tenure in office, Motsoaledi's attitude has indicated a sea change in the policies of the South African government. His approach to AIDS is both realistic and commendable: "He announced the government would increase distribution of condoms from 283 million to 450 million in 2009-2010 after a Human Sciences Research Council study showed that a fall in infections in people aged 15-19 years was largely attributable to increased condom use among teens who continued to have multiple sexual partners. At the 2009 International AIDS Society Conference in Cape Town, he symbolically put on the Treatment Action Campaign's red 'HIV positive' T-shirt and told cheering demonstrators that the government would honor its obligations on HIV treatment and prevention. The scenes would have been unthinkable under Tshabalala-Msimang," Motsoaledi's predecessor (Kapp 2009).

Former South African Health Minister Manto Tshabalala-Msimang has born the brunt of the criticism for the AIDS epidemic in post-apartheid South Africa: she advocated nutritional remedies as a potential healthcare solution for AIDs and denied that HIV caused AIDS. Although such 'quackery' is not unheard of, what is shocking in the South African context is that AIDS denialism was officially supported by such a prominent person in government, the person responsible for disseminating health knowledge and creating national healthcare policies to treat AIDS. A group of scientists and activists even tired to sue South Africa's AIDS denialists like Tshabalala-Msimang for their role in spreading the epidemic.… READ MORE

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