Demography
New African Visions for Combating AIDS
by Lane Jennings
For Africa, ending poverty and fighting AIDS go hand in hand.
The next decades could see Africa either turn the corner in its battle
against AIDS or struggle desperately to keep from losing ground. The difference will
depend on more than medicine.
Sub-Saharan Africa holds barely 10% of the world's total population but
more than 60% of all those now living with HIV. As 2004 ended, UN estimates put this
figure at about 25.4 million—a total that has remained fairly stable in recent years.
But this only means that the number of people newly infected each year (some 3.1 million
in 2004) is largely offset by those who die of AIDS (2.3 million in 2004).
So far, efforts to combat AIDS throughout the region have achieved only
limited local successes, despite medical expertise and material support from many donors.
But now the joint United Nations Program on HIV/AIDS (UNAIDS) has taken a new approach,
inviting Africans to develop and compare scenarios that go beyond statistical projections
to explore possibilities for coming to grips with the AIDS epidemic in the next 20 years.
In their new report, "AIDS in Africa: Three Scenarios to 2025,"
the UNAIDS team offers narratives illustrating the results that might be produced by
different policy approaches and decisions.
1. Tough Choices. This scenario is patterned on the model
of Uganda, one of the countries most successful at fighting AIDS. Unable to rely on
appropriate and timely help from the developed Western nations, courageous national
leaders consistently aim to maximize long-term benefits even when this means diverting
limited resources away from immediate needs (i.e., they promote HIV prevention over AIDS
treatment). Despite inevitable conflicts pitting the interests of the nation as a whole
against those of local communities or individuals, this approach, which places health
within the context of overall development goals, shows how much determination and
sustained effort might accomplish with only a modest increase to the resources currently
available.
2. Traps and Legacies. In this scenario, the past
effectively dictates the future. Unable to overcome existing weaknesses of poverty, poor
education, ethnic conflict, and under development, African efforts to fight AIDS are
doomed to frustration. Foreign donor and local leaders both seek quick results that waste
resources and ultimately discourage needed long-term efforts. In 2025, overall conditions
in the region are little improved. The problem is not lack of means or insufficient
effort, but failure to cooperate and plan ahead.
3. Times of Transition. This is what could happen if
Africans, and the world, work for peace and development everywhere. Firm commitments by
Western nations to fund sustained treatment for existing AIDS victims, combined with
national programs across Africa to boost HIV-prevention efforts, promote education, reduce
poverty, expand opportunities for women, and enhance human rights, could
"fundamentally alter the future course of Africa" in the twenty-first century.
More than that, such cooperation on a global scale would contribute to the achievement of
peace among nations, for it would involve recognizing the interdependence of Africa and
the world.
The UNAIDS team presents each of these three scenarios first in the form
of a folktale, in which different animals interact to deal with a crisis in their village.
These folktales might seem to be only a touch of local color inserted to dress up an
otherwise Western-style rational analysis, but in fact the stories enhance creative
futures thinking, helping readers to engage their emotions while weighing alternatives and
envisioning outcomes. Background materials accompanying the scenarios include thoughtful
commentary, a glossary of terms, suggested readings, fact sheets on AIDS in Africa and the
Middle East, and a CD-ROM containing most of the material used to develop the scenarios,
including research papers and interviews all searchable by keyword.
"AIDS in Africa" is not intended as a prediction of what the
future must be, or even a prescription to be followed in detail to produce the best
possible outcome for every African nation and individual concerned with the ongoing
dangers posed by HIV/AIDS. The report does provide an intriguing and, on the whole,
encouraging example of how even seemingly overwhelming problems can be tackled when looked
at in relation to other serious concerns and when desired results can be evaluated over
time frames longer than the usual one to five years.
Source: "AIDS in Africa: Three Scenarios to 2025,"
Joint United Nations Program on HIV/AIDS (UNAIDS), 2005. UNAIDS, 20 Avenue Appia, 1211
Geneva 27, Switzerland. Web site www.unaids.org.
