Wednesday, September 7, 2011

Mugabe Needs to be More Careful in his Choice of HIV Advisers


Zimbabwe's President Mugabe has been poorly advised when it comes to understanding HIV transmission: he claims that some of his own officials are contributing to the spread of HIV through promiscuity. Is he not aware that HIV is a difficult virus to transmit through heterosexual sex? It is far easier to transmit through unsafe healthcare practices or cosmetic services.

Instead of addressing important issues, ones that are ignored by the HIV industry, Mugabe is wasting time with admittedly well-funded initiatives that will have little effect, such as promoting 'abstinence', teaching about female condoms in beauty salons and rolling out male circumcision programs. He would be better off to concentrate on safety in beauty salons and in health facilities where circumcisions and other procedures are carried out.

While the world's media, politicians, academics and others obsess about African sexual behavior and the obscene levels it would have to reach (and therefore must have reached) to explain massive HIV epidemics such as that found in Zimbabwe and other countries, HIV transmission that doesn't relate to sexual behavior is allowed to continue, unabated and uninvestigated.

Others claim that sexual behavior is all about money and that you just need to give handouts so that the women don't involve themselves in transactional sex. Would the World Bank and others be able to get away with their insinuations and bald statements if they were talking about people other than Africans?

But there is no evidence that HIV epidemics in Africa are 'driven' by sex, of any kind. HIV may be transmitted sexually, but it has been demonstrated quite clearly that levels of sexual behavior, safe or unsafe, are of little relevance to HIV rates. Countries with high levels of types of sexual behavior considered unsafe can have low HIV prevalence. Whereas, countries with high HIV prevalence can have low levels of these same types of behavior.

If Mugabe is worried about promiscuity, male domination and lack of gender equality, unplanned pregnancies, sexual violence and abuse, or any other issues, he should get on with addressing them. But those issues were around long before HIV was identified; they won't just disappear along with HIV, if HIV ever disappears. Yes, "the role of men is unquestionable", but his Excellency needs to bear in mind that far more women than men are infected with HIV.

And while he is on the subject of prevention of mother to child transmission of HIV (PMTCT), Mr Mugabe should bear in mind that the best way to protect children is to protect their mothers, preferably before they become pregnant. If a mother's life is compromised, so is her child's. The president should investigate conditions in Zimbabwean hospitals and health facilities so that the safety of mothers, children and everyone else can be guaranteed.

Surveys of conditions in health facilities in African countries with serious HIV epidemics show that, right now, people's health can not be guaranteed. Blood is not always adequately screened before being transfused, non-reusable equipment may be reused, often because it's in short supply, precautions to avoid infection with various diseases are not always taken, dangers are not even recognized, at times. There are too few trained, motivated and properly paid health professionals.

Mr Mugabe appears to be badly briefed about the HIV epidemic in Zimbabwe, and in Africa in general. But then, the entire HIV industry has studiously avoided researching non-sexual HIV, investigating possible outbreaks of HIV in health and other facilities and in replacing their highly prejudiced and inaccurate view of sexual transmission of HIV with something that matches the evidence.

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1 comment:

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