Less successful prevention programmes

Less successful prevention programmes

Other African countries, such as Botswana, Namibia and South Africa, continue to harbour extremely severe, generalised epidemics that show no signs of abating. Mass media and social marketing projects have been launched in an attempt to change behaviour, alongside condom distribution and other interventions. These efforts do seem to have had some effect – particularly on levels of condom use – but so far they have not made a significant dent in infection rates. In late 2005 the Global Fund withdrew funding for South Africa’s largest HIV prevention project, loveLife, due to concerns that it was not cost effective.²⁷

Many activists believe that weak political leadership has severely hampered the response to HIV in South Africa

Many activists believe that weak political leadership has severely hampered the response to HIV in South Africa, where more than 5 million people are already infected. In particular, President Mbeki’s government was very slow to begin providing nevirapine and other drugs to help prevent mother-to-child transmission of the virus. In 2005, only around 14.6% of pregnant women with HIV received preventive treatment, according to UNAIDS (though the government’s own estimate is much higher).²⁸ This rate is quite typical for an African country, but is surprisingly low given South Africa’s relative wealth and resources.

Most children born with HIV in Africa die before their fifth birthday. The few who receive antiretroviral treatment can expect to live longer, but it would be much better if they were never infected in the first place. The vast majority of the two million children living with HIV in Africa would have been born healthy had their mothers received the kind of preventive care found in Western countries. At present, most African women are not even tested for HIV, let alone offered the drugs, counselling and infant formula that would help protect their babies.

Although all African countries have facilities for screening blood for HIV, most cannot guarantee the degree of safety found in the developed world. Because voluntary donors are rare, blood is often collected from family members and paid donors, which increases the risk of transmitting HIV. Use of poor quality test kits, unreliable supplies of equipment, and lack of trained staff can all compound this risk. Thirty-three of forty African countries surveyed in 2004 reported that they did not have fully operational quality systems in the blood transfusion service, including HIV testing. These countries collected around 2.7 million units of blood during that year, of which 88.5% were not tested for HIV in a quality-assured manner. Nevertheless, the blood safety measures already in place avert an estimated 500,000 HIV infections each year.