Aids in Africa

Zanele a young, good looking and intelligent woman - is suffering from AIDS. She was infected at the age of nine as a result of having been raped by her stepbrother. She had carried that virus for six years without being aware of it. Because she had not been to a doctor until she had come under Foster Care, she did not know of the deadly consequences of her illness until she was sixteen . While her care-giver cried bitterly, Zanele just said “And? What about it?” Zanele reacted like that because she didn`t know about this illness as most African women did; however, in contrast to most African women, Zanele had the opportunity to receive good medication and to live an almost normal life.
The number of people suffering from AIDS is alarmingly high. By the latest count in 2006, there have been 39,500,000 HIV- positive tested adults and children worldwide. More than half of them (24,700,000) are living in Sub Saharan Africa.

Globale Verbreitung von Aids

Spreading of Aids

But why is it so common over there? There are many reasons.
One is that many women depend on the money they earn as a prostitute. In this job they are exposed to men who want to have non-protected sex and often use practices which hurt the women. Also the high number and often changing sex partners benefit the high HIV rate for prostitutes.
A further reason is the poverty. Because most of the families have already a hard time to feed the whole family, they mostly cannot afford health insurance, medication or contraceptives. The education of the children is also controlled by the poverty. Because the younger members of the family have to work for the family, they are not able to go to school. If they were in school, they would be able to learn about HIV and AIDS, as well as how these are contracted and the ways to protect themselves against them.
There is also the concern of passing on the disease within the family. On an average, African families, for example, are larger than German families. The larger number of children represents good luck for the family as well as more security for the older members as they retire and would be cared for by their children.
The risk of an infection starts with birth. Although there does not have to be a transmission, the chances are high that the baby of an infected woman would also have the virus. Even though a baby would be healthy, it could still be infected during the lactation.
Another dangerous aspect is the fact that the infection is often concealed, because if one member of the family has the virus, it means disgrace for the whole family.

Course of the disease

When the infection occurs, the progression of the virus is not able to be stopped. Within about two weeks, after the infection flu-like symptoms appear. Most of the concerned persons suffer from fever, tiredness, general illness, loss of appetite, aches in the head as well as in the muscles, night sweat, skin rash, sickness, diarrhoea, mouth abscesses, stiff neck, swollen lymph nodes and sensitivity to light.
After this the latency phase begins. This phase lasts nine to eleven years, but of course there are exceptions. During this time the infected person does not have any physical problems; however, once the person is aware of the infection, this could cause many psychological problems. During this apparently good time the virus usually spreads on the whole body.
After that the stage of illness begins. When specific infections or malignant tumours, so called AIDS defining illnesses, have been found, the diagnosis is AIDS. These special infections are not dangerous for a healthy immune system, but in combination with a weakened system, they can cause the final outbreak of the virus. The concerned person is suffering the combination of these infections as well as tumours, which are also called “opportune infections”.

Schematischer Krankheitsverlauf

Currency of the infection

The HI-Virus consists of an exterior cover which connects the virus with the host cell and an inside crown cap, which contains the blueprint of the virus, the RNA. Additionally, the virus contains enzymes which coordinate the progeny of the host cell. Cells on which the virus wants to connect have to hold the special protein CD4, which serves as an identifying feature. Most interesting for the HI-Virus are the T- helping cells, which are very important for the human immune system as well as to some intestinal, brain and skin cells. On the surface of each of them you can find the CD4 protein. The T-helping cells carry out an important function in the human body. For example they afford protection against organisms which cause diseases, such as a virus or bacilli. Through the infection caused by the HI-Virus, the T-helping cells become destroyed and so the immune system, the defence system of the human body, grows weaker. When the HI-Virus connects with the host cell, the host cell absorbs it and the cover of the HI-Virus breaks. So the host cell contains the genetic information of the virus. The HIV uses the infected cell to copy this genetic information again and again. It also uses it to build new proteins for a new virus. To do that, the HI-Virus moderates its genetic information, the RNA, to fit to the genetic information of the host cell, the DNA. The newly assigned viral genetic information is built into the host cell with the help of the enzyme ligase. Then the production of the new virus-proteins begins. But before the HI-Virus can be built together, the proteins have to be trimmed to fit. That happens through the help of the enzyme protease. At the end the newly formed virus leaves the host cell and is able to infect new cells.
So, without the right medication, the immune system is helplessly exposed to the HI-Virus.

Impact on economy and society

One out of every ten adults in sub-Saharan Africa suffers from AIDS which also has serious social and economic consequences.
Already in 1999 on the World AIDS Conference in Zambia, different states announced AIDS as a disaster hindering development. In 2001 at the extra General Assembly, the people appealed for new arrangements. But it took a long time until this awareness also reached the Government and the making of policies started. At the present time, AIDS continues to be an important element of every discussion and strategy to eradicate poverty.
Sub Saharan Africa always was and still is one of the poorest parts of the world. According to the World Bank classification, 38 of the 49 states are considered poor. Almost half of the population is living in poverty. That means that they live with just one dollar per day.
Their low participation (2%) on the global trade clarifies that. That has a lot of reasons. The economy is influenced by the low industrial and agricultural efficiency, the low level of education and the high participation in a subsistence economy, that means that many farmers can not earn money with their work, because mostly they just reach a self- sufficiency. Furthermore the dependency on a few agricultural and industrial resources controls the economy. Production only for local markets as well as very little integration in the global economy result in great poverty. Poverty intensifies the AIDS problem; while, on the other hand, the AIDS problem intensifies the poverty.
For example, the factor worker is influenced by AIDS. That comes through the fact that most of the infected, apart from infants , die at an economically very productive age. As a result, there are significant changes in the African society.
Although the death rate has decreased since the sixties through the improvement of living conditions, the number of people with AIDS has increased lately, and especially in the poorer and highly affected countries, the death rate has also increased.
With a further increasing death rate, several influences on the business sector are guaranteed. At first, the increasing absence rate of the workforce, higher costs for sick- and death benefits, higher wages resulted in a decrease of really good workers as well as a lower efficiency rate.
Many of the people who are dying are from the military, the administration , and skilled professionals such as teachers, as well as many more who are important for the development of the country.
Also influences on the household are guaranteed. Because of the illness or death of a family member, the number of orphans and homeless children increases. The family has to endure increasing costs for illness, death and funeral, making it impossible to save money as well as having less buying power.

The overcoming

Plakate zur Aufklärung in Abidjan, Elfenbeinküste

The overcoming of AIDS in Africa depends on different developments:
On the one hand it depend on the different charity organizations worldwide, which fight for the overcoming. With donations they can serve the people with the essential medication, so that they can have a much more acceptable life as they would have without their help. But the organizations do not just reach single families, with the building of a new health centre, for example, a bigger part of the population can be reached. Accommodations like this can also support the prevention of Aids. In many cases a psychologist, who talks to the woman and children, can be really helpful.
On the other hand a lot of people ask themselves, “What can I do for the overcoming”, besides donations. The point is that although we are thousands of miles away from Africa we have to be aware of the fact that Aids is an issue we all have to think about and above all speak about.
Even if people do not have the money to build a new hospital, as long as they do not keep silence about Aids they help people in Africa and all over the world to be not forgotten.
The example of Zanele, the young woman with a boyfriend, who loves to listen to music, dance, laugh, have fun and dream about having her own children, certainly indicates that this goal can be reached.

Charlotte Mann


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