Estimates by the United Nations Programme on HIV/AIDS that 1 in 5 adults in Zambia are infected with HIV and that 300000 children have become orphans through AIDS have been attacked as “alarmist” by the government in Lusaka.
A recent report by the World Bank warned: “Not since the bubonic plague of the European Middle Ages has there been so large a threat to hundreds of millions of people—and the future of entire economies—AIDS is no longer a problem of medication. It is a problem of development.”
However, Zambia’s government is now furious with the UN and is refusing to accept the latest estimates on the prevalence of AIDS and HIV. On 31 July it officially rejected the UN’s estimates and attempted to ban all AIDS statistics compiled by independent organisations. The director of the Central Statistics Office, David Diangamo, said that the information released by the UN’s programme was “incorrect” and the prevalence was grossly inflated. “We will not accept that any [foreign] representative in this country should tell us that 20%of the adult population is HIV positive.”
However, an official report from the Zambian Health Ministry, which was released in June, confirmed the estimates made by the UN in July, stating that “Zambia has one of the worst HIV/AIDS pandemics in the world, with an estimated 20%of the adult population HIV positive.”
Next month, the capital will host the 11th international conference on AIDS and sexually transmitted diseases in Africa, bringing some 5000 specialists together to discuss AIDS and its social consequences. The UN’s numbers are likely to come in for closer scrutiny at the conference, but local studies using anonymous antenatal screening and tests of donated blood tend to confirm them.
Three sites have been designated in Zambia to identify pregnant women who are infected with HIV, treat them with zidovudine, and monitor their progress. The zidovudine has been donated to the UNAIDS programme, and the Turner Foundation, an American charity, has donated $400000 (£250000) to implement it. A two week course of zidovudine can reduce perinatal transmission by around 30%.
Dr Yusuf Ahmed, head of obstetrics and gynaecology at Lusaka Teaching Hospital, said, “We find that 25-30%of women booking in clinics in urban areas are HIV positive.” He also spoke of the importance of developing short and cost efficient interventions to reduce perinatal transmission of HIV in a country with a per capita health expenditure of under $10 (£6).
“As part of the UNAIDS initiative we’re giving antiretroviral [drugs] to a number of HIV infected women late in pregnancy, just before labour,” said Dr Ahmed. “We know that it works—we need to know whether we can make it work in our context. We’re looking at 10000 expectant mothers to try to find 3000 who are willing to be tested and who are HIV positive, who we’ll use as a sample for this project.”
Figure.
JEREMY HORNER/PANOS
An 18 month old child is buried in Lusaka’s main cemetery after dying of an HIV related illness