Aids: Rhetoric and reality

New African, Mar 2001 by Ankomah, Baffour

Baffour Ankomah was in Senegal in early February, on a one-week trip organised by the UNDP for 30 journalists across the world to see how Senegal is winning the war against HIV-Aids. Not entirely surprising to him, he found practical examples of how the rhetoric and reality of Aids are still poles apart.

First a disclaimer! For those who already know my personal views on Aids, the following are not my figures. They come from the Joint United Nations Programme on HIV-Aids (UNAIDS), the umbrella body for the seven UN and other organisations (UNICEF, UNDP, UNFPA, UNDCP, UNESCO, WHO and World Bank) that are now at the forefront of the global fight against HIV-Aids.

According to the figures, released in December 2000 by UNAIDS and WHO, Senegal is not (repeat, not) the country in Africa with the lowest HIV prevalence rate. This is contrary to what UNAIDS and WHO have been telling the world for the past three or so years. Nor does Uganda, the other "island of hope", come anywhere near the top of the league table for the lowest rates in Africa. With an 8.30% rate, Uganda lies a poor 22nd.

Yet for the past three years, UNAIDS and WHO have held up Senegal, Uganda and Thailand as the "islands of hope" in the sea of Aids, to be emulated by others. But UNAIDS and WHO's own figures show that by the end of 1999 there were five (repeat, five) African countries with even lower rates than Senegal.

But the five countries - Madagascar, Equatorial Guinea, Mauritania, Niger and Guinea - get no credit for their efforts. As a result, how and why they managed to have such low rates is not studied by the UN system, and their successes are lost to the world. The big question is: Why?

By the end of 1999, according to UNAIDS and WHO, Senegal had a prevalence rate of 1.77%, Madagascar had 0.15%; Equatorial Guinea 0.51%; Mauritania 0.52%; Niger 1.35% and Guinea 1.54%. So Senegal (1.77%) was, and still is, sixth on the league table.

Living in denial?

The question that troubled me in Senegal, therefore, was: Why Senegal? Why not Madagascar, or Equatorial Guinea, or Mauritania or Niger? Why make an icon our of the sixth brilliant student in the class when there are five even more brilliant chaps ahead of him?

But there were no UNAIDS and WHO officials on the trip to answer these questions. In their absence, Djibril Diallo, the UNDP director of communications (who is Senegalese himself) tried to help, but he was not the right person to answer those questions as when UNAIDS and WHO are putting their figures together, African voices are hardly heard.

Djibril had not even looked at the "end 1999" figures on the world Aids map published last year by UNAIDS and WHO which had been supplied to us in our press packs by the UNDP.

A very articulate and well-travelled man, Djibril had just finished telling us that Senegal had the lowest HIV-Aids rate in Africa, and that "Africa is living in denial" of Aids (the second time he had said it in three days) when I showed him the "world Aids map" and asked whether the figures on it were still relevant.

Yes, he said. In that case, I said, "you are wrong because the figures show Senegal to be the sixth lowest, not the first." I then asked him why the first five countries ahead of Senegal were not given any credit for their efforts by the UN system?

It was in fact a twin question, because I also asked him to expatiate on his other substantive remark that "Africa is living in denial of Aids" when the world Aids map says categorically that UNAIDS and WHO have no figures on the "North Africa and Middle East Region" made up of 20 odd countries. And how is that possible?!

Of the 20 countries in the region, only two: Israel (0.08%) and Cyprus (0.10%) have up-to-date figures. The rest have asterisks in front of their names.

If you check the small print, the asterik says: "For countries marked with an asterik, insufficient data were available to calculate an estimated HIV prevalence rate for end 1999. In these cases, the figure used is the 1994 prevalence rate for the country concerned published by WHO."

UNAIDS and WHO further explain in their latest "Aids Epidemic Update: December 2000" their most current "global summary" of HIV-Aids prevalence, thus:

"North Africa and the Middle East: Because of insufficient data, few new country estimates of HIV infection were produced for this region between 1994 and 1999. Recent evidence, however, suggests that new infections are on the rise. For example, localised studies in southern Algeria show rates of around 1% in pregnant women attending antenatal clinics..."

Ofeibea Quist-Arcton, the correspondent of Allafrica.com, then asked Djibril where the UN system gets its Aids figures. From governments, he said.

Then why do UN officials and Western journalists accuse Africa of "living in denial of Aids" when the "North Africa and Middle East Region" gives them no figures at all?

At least, UNAIDS and WHO have up-to-date estimates on 48 of Africa's 53 countries (except Eritrea, Comoros, Mauritius, Reunion and Somalia). Yet, they still accuse Africa of "living in denial" while the North Africa and Middle East Region is not similarly accused.