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AIDS in Southern Africa

The challenge of AIDS means rethinking established certainties and needs innovative solutions

Noerine Kaleeba, a well known AIDS activist from Uganda, recently told the story of how her mother produced the photograph of Noerine's primary school leaving class of 45 pupils and asked her “where are they now?”. Five are still living. Forty are dead, the majority from AIDS. Other Africans tell similar stories of losing four or five of their siblings, friends, parents, and partners and of having to cope with rapidly increased families by taking in orphans. There are many other horror stories of the African epidemic—households headed by children, abandoned children, rejection, stigma, discrimination, racism, and the abuse of human rights due to AIDS. Perhaps President Mbeki was right when he asked “what is unique about African AIDS?”.

What is unique about HIV/AIDS in Southern Africa is that the epidemic has moved on a scale that is unprecedented in disease. It has cut its way through the fabric of society and left a bewildered population, governments in denial, and levels of pain and suffering that are impossible to describe or measure. It has prompted a reaction from the world's media of a continent sinking under the burden of disease, of villages being wiped out, of despair and devastation. As such many of the racial prejudices about Africa are reinforced: that it is a continent unable to develop or to help itself; that governments are corrupt, ineffectual, and inefficient; and that the people are uneducated, superstitious, and culturally locked into old and mysterious beliefs.

In this reading AIDS is easy to understand. It feeds on countries that are unstable. It feeds off poverty and it feeds off a community in which sexual behaviour is unregulated and in which social norms and values are lacking. And in this way …