Nigeria is estimated to have the 3rd largest number of people living with HIV in the world after India and South Africa HIV and the stigma that it carries within a Nigerian context has been the focus of some attention on Nigerian blogs and websites in the past few weeks. For an account of the furore which involved the editor of a leading society magazine, Genevieve, see here It is surprising that in spite of many years of campaigning, very little has changed in terms of attitudes. Another recent example relates to a man who has lost his job in what must certainly count as discriminatory circumstances and finally there is this e mail, allegedly sent from a Nigerian medical doctor in the United States to an HIV positive Nigerian activist who shares the same surname.
The area of HIV/AIDS is one where the government of President Obasanjo expended much energy with some results. The president was photographed very early in his tenure with HIV positive men, women and children and the photographs were splashed on billboards across the country. Last year the then president took an HIV test to promote testing during the World AIDS Day ceremonies. Nigeria was also one of the first African countries to commit to providing universal access to treatment for people with HIV, although transmitting this pledge into reality has proved more challenging than making the initial announcement, perhaps because of problems such as these
There is a good (if slightly dated) summary on HIV in Nigeria on the avert website
In addition to stigma, some of the continuing challenges include anecdotal reports that some of the US funded PEPFAR treatment programmes are cannibalizing staff and patients from each other in a bid to meet targets; the increasing unilateral focus on abstinence only programmes driven both by US government funding policies; the vertical nature of many of the HIV programmes which mean that the underlying absence of health service infrastructure remains a problem and the over-arching issues of leadership.
Never doubt that a small group of thoughtful committed people can change the world; indeed it is the only thing that ever has…Margaret Mead
Facing the Challenges of HIV/AIDS
Around the world, more than 47 million people are now infected with the HIV/AIDS, It is now a weapon of mankind destruction. It has killed more than 30 million people worldwide according to UNAID and WHO reports since the 1st of December 1981 when it was first recognized. This makes it the worst recorded pandemic in the history of pandemics against mankind. In 2006 alone, it was reported to have killed between 2.5 to 3.5 million people with more than 380000 as children. The large number of these people killed is from the sub Saharan Africa. In some Sub-Saharan African countries, HIV/AIDS is expected to lower life expectancy by as much as 25 years.
AIDS is no longer a problem of medication. It is a problem of development. It is not just an individual hardship. It also threatens to decimate the future prospects of poor countries, wiping away years of hard-won improvements in development indicators. As a result of the disease, many poor countries are witnessing a worsening in child survival rates, reduced life expectancy, crumbling and over-burdened health care systems, the breakdown of family structures and the decimation of a generation in the prime of their working lives.
Bangladesh’s socio-economic status, traditional social ills, cultural myths on sex and sexuality and a huge population of marginalised people make it extremely vulnerable to the HIV/AIDS epidemic. Everyone buying sex in Bangladesh is having unprotected sex some of the time, and a large majority don’t use condoms most of the time. Behaviors that bring the highest risk of infection in Bangladesh are unprotected sex between sex workers and their clients, needle sharing and unprotected sex between men.
Though the country overall has a low prevalence rate, it has reported concentrated epidemics among vulnerable population such as IDUs. There are already localized epidemics within vulnerable groups in, and the virus would spread among the IDUs’ family or sexual partner. According to the social development specialist and AIDS researcher Mohammad Khairul Alam, “It should be realized that there is no alternative to develop and enhance life skills of vulnerable girls and women to cope with epidemic. They may be assisted on the various levels to become engaged in grooming their confidence and organized. At the same time, their voices should be allowed to be heard loud and clear. Thus the collective effort of women is born with the sense or purpose that they will be stirred up to share perceptions improving their access to reproductive health related information and services.”
In many poor countries, commercial female sex workers are frequently exposed to HIV and other sexually transmitted infections (STIs/STDs). Where sex workers have poor access to health care and HIV prevention services, HIV prevalence can be as high as 50-90%. Evidence shows that targeted prevention interventions in sex work settings can turn the pandemic around.
Bangladesh is a high prevalence of sexually transmitted diseases, particularly among commercial sex workers; there are available injection drug users and sex workers all over the country, low condom use in the general population. Considering the high prevalence of HIV risk factors among the Bangladeshi population, HIV prevention research is particularly important for Bangladesh. It is very awful, several organization in Bangladesh are working only to prevent HIV/AIDS but few of them like as ‘Rainbow Nari O Shishu Kallyan Foundation’ try to develop proper strategic plane, so should increase research based organization recently.
Poverty in Bangladesh is a deeply entrenched and complex phenomenon. Sequentially, the HIV/AIDS epidemic amplifies and become deeper poverty by its serious economic impact on individuals, households and different sectors of the economy. Poverty is the reason why messages of prevention and control do not make an impact on a vast majority of the vulnerable population.
Sources: World Bank, UNAIDS, UNICEF.
Kh. Zahir Hossain
M & E Specialist (BWSPP)
The World Bank
Dhaka, Bangladesh
Mobile: 01711453171
Zahir.hossain@gmail.com