July 22, 2000
Column #986

''PREVENTION DOES WORK''

     The most remarkable words at the recent AIDS conference in South Africa came from Dr. Peter Lamptey, of Family Health International: ''Prevention does work.''

     Prevention? As TIME magazine reported, ''As a metaphor for hopelessness, it's hard to equal the AIDS crisis in sub-Saharan Africa. Twenty-four million of the area's people are HIV-positive, 70% of the world's infected population. Thirteen million Africans have already died of AIDS, and 10 million more are expected to die within five years. In South Africa, 1 in 5 adults is infected; in Botswana, the rate of infection is 1 in 3.''

     The scale of this pandemic is difficult to grasp. In all of World War I, only 8 million people died, about half the number dead of AIDS in Africa. Life expectancy would have been 73 years in 2010 in Tanzania without AIDS, but will be a grim 33 years instead.

     Nor can Africa pay for the expensive drugs that have dropped the U.S. death rate from 48,000 in 1994 to 14,000 in 1997. African health care spending is only $34 per person per year vs. an average of $2,485 in the U.S.

     Yet AIDS is almost completely preventable if people practice chastity.

     How can that message be communicated in the world's sex-drenched culture? How can it be communicated in Africa which often lacks the most elementary understanding of how disease is transmitted? Tens of thousands of teenage African girls are being ravished by AIDS-infected men who believe that their cure is to have sex with a virgin!

     Nevertheless, even in Africa, where 4 million new people are infected with AIDS annually, a strategy of prevention is working in Senegal and Uganda plus Thailand, says Dr. Lamptey.

     ''Senegal has maintained one of the lowest rates of HIV infections in sub-Sahara Africa,'' he said. Less than 1% of pregnant Senegalese women are infected compared to 10%-45% in various African countries.

     Why? Senegal's President Abdou Dioff courageously discussed the threat of AIDS in the mid-1980's, long before it was addressed by high U.S. officials. Dioff made sure his ministers launched an education campaign. Public service announcements, church groups and Muslim mosques all became involved. ''Every year we have campaigns on television, newspapers, radio showing how to avoid AIDS,'' said Gerald Diouf, a press counselor at Senegal's chancery.

     ''Senegal is a Muslim country, and you don't find HIV in Muslim countries, where there is much more faithfulness in marriage,'' adds Shepherd Smith, of the Institute for Youth Development.

     Thailand, by contrast, is a 95% Buddhist country. Initially, HIV spread quickly through the Thai population, first through intravenous drug users and later through prostitutes, 30 percent of whom were infected by the mid-1990s.

     The country promoted and enforced a ''100% condom-only brothel policy,'' with police making spot checks to be certain that every prostitute required clients to wear one. Condoms were made widely available and cheap. Thailand launched an aggressive education campaign involving business leaders. The government also appropriated $75 million to do widespread testing, so that infected people would learn that they have AIDS and could spread it to others.

     By contrast, 90% of the millions infected in Africa do not know it! Since the disease usually takes a decade before full-blown AIDS kills the person, many are needlessly infected.

     Finally, Uganda, a predominantly Christian country, became ''one of the most severely affected countries, with a total HIV prevalence among adults of almost 10 percent,'' Dr. Lamptey reports. ''It is also one of the countries where the epidemic was recognized early and where it has enjoyed tremendous political leadership as well as commitment of adequate financial resources.''

     Way back in 1987, Uganda President Yoweri Museveni addressed the issue frankly something which Nelson Mandela did not do until last year, and his successor still refuses to do. Museveni's galvanized the media, the Red Cross and the Catholic Church to give health care, and care of orphans. Result? The percent of infected young women has fallen from 28% to 10%.

     Thus, regardless of religious background, ''prevention does work.'' But the primary ingredient is courageous political leadership willing to make a clear moral case.

     What is the U.S. response? For years, very little financial help was made available, and that mostly for condoms which by themselves, had little effect. This week, the U.S. announced $1 billion worth of loans for Africa to buy U.S. drugs. Lamptey's reaction: ''It is disappointing that our country is asking those devastated countries to borrow at a commercial rate.''

     There are 10 million orphans. Readers can help by giving to World Vision (888 56-CHILD), which cares for 20,000+ or Catholic Relief (800 736-3467).

Copyright 2000 Michael J. McManus.