What We're Reading: Making the AIDS crisis worse

The Washington Post published an article Thursday on the public health consequences of recently enacted anti-homosexuality laws in Nigeria, Uganda, and elsewhere – specifically citing their negative impact on the fight against HIV/AIDS.

It is the job of public health officials to account for the reality of human behavior in pursuit of the public good. Anti-gay laws complicate that task in practical ways. MSM who are afraid of prosecution and violence are less likely to attend meetings where they are given education, condoms and lubricants. Less likely to be honest with their physicians about their sexual histories. Less likely to be tested for AIDS and receive treatment and care. And more likely to inadvertently infect others.

When Western governments lecture African countries about their retrograde views, it can feed a populist, anti-colonial backlash. When donors threaten to cut off aid, it can cause lesbian, gay, bisexual and transgender activists to cringe — fearing they will be scapegoated for the punishment of their whole country.

What might be more effective is a forceful health-related message. This is an area in which civil rights — starting out with a simple zone of personal privacy — is a requirement of public health. Nations such as Nigeria and Uganda are committed to ambitious objectives in fighting AIDS. Those goals are unachievable while any group is targeted for discrimination and excluded from effective outreach. 

Senator Coons, chair of the Senate Foreign Relations African Affairs Subcommittee, spoke out against the enactment of Uganda’s Anti-Homosexuality Bill in February calling the law “a setback for human rights around the world” and appeared on MSNBC earlier this month to discuss steps the U.S. can take to combat the law and stand up for Uganda’s LGBT community.

Click here to read the full article on the Washington Post’s website.

What We're Reading: PEPFAR's influence on AIDS in South Africa

The Christian Science Monitor published an article on June 23 on South Africa’s progress in the fight against AIDS.

The United States can and should take pride in the contribution the President's Emergency Plan for AIDS Relief (PEPFAR), along with the UN Global Fund and African governments, has made towards achieving a milestone few believed possible just a few years ago:  HIV/AIDS no longer poses an acute health emergency in many African states.  We have made important contributions in purchasing antiretroviral drugs (ARVs) at discount rates, distributing ARVs to urban as well as rural areas, and improving national capacity to manage the disease.  

The number of new HIV infections across Africa has dropped by 25 percent since 2001 – and more than 50 percent in 13 sub-Saharan African countries – according to the UNAIDS 2012 global report.

Here in South Africa, progress is even sharper. Rates of infection have fallen by at least 30 percent. Nearly 2 million people are on antiretroviral drugs, known as ARVs, which have helped extend the life span of the sick and limit the transmission of the disease. Approximately 75 percent of South Africans who need ARVs have access to them, putting the country just shy of The Global Fund's 80 percent standard for universal access.

Perhaps most meaningful to ordinary South Africans: Life expectancy in South Africa has gone up – reaching levels not seen since 1995.

However, as this article poignantly illustrates, as the rates of new infection and deaths fall, the effects of the acute emergency live on for caregivers and children of HIV/AIDS victims. As these children grow up, the ones who have provided for them – often female relatives and neighbors – are running out of steam, as well as financial and social resources to help launch them successfully into a healthy, productive adulthood.  Studies suggest that children of HIV/AIDS victims are more likely to drop out of school and to suffer from anxiety, depression and abuse than their peers. Many of the women who have taken in multiple orphans are entering middle age and facing their own health problems that are only exacerbated by the growing needs of the children they have taken in and nurtured for many years.

Although the disease itself may pose a diminishing health danger for the population, states are likely to grapple with the social and economic after-effects of the disease for years to come.  As PEPFAR enters its second decade, we would do well to ensure that the needs of those living with the legacy of the epidemic are not forgotten.

Click here to read the full article on CS Monitor’s website.