AIDS Spreads in Africa

“We’re dealing with a kind of contemporary apocalypse.”

THOSE words of Stephen Lewis, UN special envoy for HIV/AIDS in Africa, echo the concern of many about the AIDS situation in sub-Saharan Africa.

A number of factors are involved in the spread of HIV. AIDS, in turn, has exacerbated other problems. The conditions that prevail in some lands in Africa and in other parts of the world where AIDS is gaining ground are often related to the following.

Morality. As sexual contact is the primary means of HIV infection, a lack of clear moral standards evidently promotes the spread of the  disease. Many feel, though, that it is not practical to advocate sexual abstinence for the unmarried. “To simply warn teens to abstain from sex will not work,” writes Francois Dufour in The Star, a newspaper of Johannesburg, South Africa. “They are bombarded daily with sexual images of what they should look like and how they should behave.”

This analysis appears to be confirmed by the conduct of young people. For example, a survey in one country indicated that about a third of youths between the ages of 12 and 17 had engaged in sexual intercourse.

Rape has been described as a national emergency in South Africa. A news report in the Citizen newspaper of Johannesburg stated that it “is so rampant that it overtakes every other health risk posed to this country’s women and, increasingly, to its children as well.” The same article noted: “The rape of children has doubled in recent times . . . These acts are committed seemingly in perpetuation of the myth that an HIV carrier who rapes a virgin will be cured.”

Sexually transmitted disease (STD). There is a high rate of STDs in the region. The South African Medical Journal noted: “The presence of an STD increases the risk of HIV-1 infection 2- to 5-fold.”

 Poverty. Many countries in Africa are battling poverty, and this creates a climate favorable to the spread of AIDS. What may be considered basics in developed countries are not available in most developing lands. Large communities have no electricity and no access to clean drinking water. In rural areas roads are inadequate or nonexistent. Many residents suffer from malnutrition, and medical facilities are minimal.

AIDS has a negative impact on business and industry. As more employees become infected, mining companies are feeling the effects of lost production. Some are considering ways to automate and mechanize certain operations in order to compensate. It was estimated that at one platinum mine in the year 2000, the number of AIDS cases among employees nearly doubled, and about 26 percent of the workers were infected.

A sad outcome of AIDS is the large number of children who become orphans when their parents succumb to the disease. In addition to losing parents and financial security, these children must endure the stigma attached to AIDS. Extended family members or communities are often either too poor to give assistance or are not willing to do so. Many orphans drop out of school. Some turn to prostitution and thus increase the spread of the disease. A number of countries have established government or private programs to give assistance to these orphans.

Ignorance. A large number of those infected with HIV are unaware of it. Many do not want to be tested because of the stigma connected with the disease. “People with, or suspected of having, HIV may be turned away from health care services, denied housing and employment, shunned by their friends and colleagues, turned down for insurance coverage or refused entry into foreign countries,” observed a press release of the Joint United Nations Programme on HIV/AIDS (UNAIDS). Some have even been murdered when their HIV status was discovered.

Culture. In numerous African cultures, women are often not in a position to question their partners about extramarital affairs, to refuse sexual contact, or to suggest safer sexual practices. Cultural beliefs often reflect ignorance and denial about AIDS. For example, the illness may be blamed on witchcraft, and help may be sought from witch doctors.

 Inadequate medical facilities. Already limited medical facilities have been overtaxed even more as a result of AIDS. Two large hospitals report that over half the medical inpatients are HIV positive. The principal medical officer of one hospital in KwaZulu-Natal said that his wards operate at 140-percent capacity. At times, two patients have to share a bed, and a third one will be on the floor underneath it!​—South African Medical Journal.

Tragic as the situation is in Africa, indications are that it could get worse. “We are still at the early stages of the epidemic,” observed Peter Piot of UNAIDS.

It is evident that in some countries efforts are being made to deal with the disease. And for the first time, in June 2001 the United Nations General Assembly held a special conference to discuss HIV/AIDS. Will human efforts bring success? When will the deadly march of AIDS finally be halted?

[Box/Picture on page 5]

THE AIDS DRUG NEVIRAPINE AND SOUTH AFRICA’S DILEMMA

What is nevirapine? According to journalist Nicole Itano, it is “an antiretroviral drug that tests have shown can halve the likelihood of AIDS being transmitted [from a mother] to her child.” A German drug company offered to supply it to South Africa free of charge for the next five years. Yet, by August 2001, the government had not accepted the offer. What is the problem?

South Africa has 4.7 million HIV-positive people, more than any other country in the world. The Economist of London reported in February 2002 that South African President Thabo Mbeki “doubts the conventional view that HIV causes AIDS” and “is suspicious of the cost, safety and usefulness of anti-AIDS drugs. He has not banned them, but South African doctors are discouraged from using them.” Why is this a major concern? Because thousands of babies are born with HIV each year in South Africa and 25 percent of pregnant women carry the virus.

As a result of this conflict of views, a legal case was mounted in the courts to force the government to distribute nevirapine. South Africa’s Constitutional Court issued its opinion in April 2002. According to Ravi Nessman, writing in The Washington Post, the court ruled that “the government must make the drug available at health institutions with the capacity to administer it.” While the South African government had been offering the drug at 18 pilot sites across the country, this new ruling is said to have offered hope to all the HIV-positive pregnant women in the nation.

 [Box/Picture on page 6]

A CUNNING VIRUS ENTRAPS THE CELL

Step for a moment into the minute world of the human immunodeficiency virus (HIV). A scientist observed: “After many, many years of peering at virus particles through the electron microscope, I have still not ceased to be amazed and excited by the precision and intricacy of design in something so very, very small.”

A virus is smaller than a bacterium, which, in turn, is much smaller than the average human cell. According to one authority, HIV is so small that “230 million [particles of HIV] would fit on the period at the end of this sentence.” A virus cannot multiply unless it infiltrates a host cell and commandeers the cell’s resources.

When HIV invades the human body, it must contend with the considerable forces that are at the disposal of the immune system. * A defense network composed of white blood cells is produced in the bone marrow. The white blood cells include two main types of lymphocytes, known as T cells and B cells. Some other white blood cells are called phagocytes, or “cell eaters.”

The various categories of T cells have different assigned functions. Those called helper T cells play a key role in the war strategy. Helper T cells assist in identifying foreign invaders and issue instructions for the production of cells that attack and destroy the enemy. In its attack, HIV particularly targets these helper T cells. Killer T cells are activated to destroy body cells that have been invaded. B cells produce antibodies that are recruited in the fight against infections.

A Cunning Strategy

HIV is classified as a retrovirus. The genetic blueprint of HIV is in the form of RNA (ribonucleic acid) and not DNA (deoxyribonucleic acid). HIV belongs to a specific subgroup of retroviruses known as lentiviruses because it can be latent for a lengthy period before serious symptoms of disease become manifest.

When HIV gains entry into a host cell, it is able to use the cell’s mechanism to further its own ends. It “reprograms” the DNA of the cell to make many copies of HIV. But before it can do this, HIV must use a different “language.” It must change its own RNA into DNA so that it can be read and understood by the host cell’s machinery. To accomplish this, HIV employs a viral enzyme called reverse transcriptase. In time, the cell dies, after first producing thousands of new HIV particles. These newly produced particles infect other cells.

Once the number of helper T cells has dropped significantly, other forces can overrun the body without fear of attack. The body succumbs to all sorts of diseases and infections. The infected individual has advanced to full-blown AIDS. HIV has succeeded in crippling the whole immune system.

This is a simplified explanation. It must be borne in mind that there is much that researchers do not know, both about the immune system and about how HIV operates.

For the best part of two decades, this little virus has engaged the mental and physical resources of top medical investigators around the world, which has entailed large financial expenditures. As a result, much has been learned about HIV. Dr. Sherwin B. Nuland, a surgeon, commented some years ago: “The amount of information that has . . . been gathered about the human immunodeficiency virus and the progress made in mounting a defense against its onslaughts are nothing less than an astonishment.”

Nevertheless, the deadly march of AIDS continues at an alarming pace.

[Footnote]

[Picture]

HIV invades the lymphocytes of the immune system and reprograms them to produce HIV

[Credit Line]

CDC, Atlanta, Ga.

[Picture on page 7]

Thousands of young people do adhere to Bible standards