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INSIDE AFRICA
World AIDS Day
Aired December 1, 2007 - 12:30:00 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
FEMI OKE, CNN ANCHOR: Hello, I'm Femi Oke. This is INSIDE AFRICA, your weekly look at life and issues on the continent. In the show today, we mark World AIDS Day by looking at the heavy toll the virus has taken around Africa. But also, the impact of treatment and prevention programs in the fight against this terrible disease.
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UNIDENTIFIED MALE: We have seen a massive mobilization to provide treatment to the millions who need it, and we've seen remarkable progress made in that regard.
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OKE: AIDS experts are reporting progress in many parts of Africa. Antiretroviral drug programs in countries like Rwanda, Botswana and South Africa have slowed the spread of the disease, and allowed many people who are infected with it to leave virtually normal life.
But South Africa still has more than 5 million HIV cases, the most in the world. And about 900 South Africans die of AIDS every day.
Infection rates are even higher in the country side. Robyn Curnow visited a rural community where death is everywhere.
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ROBYN CURNOW, CNN CORRESPONDENT: These three little boys eating a packet of chips we gave them are the loneliest children we've ever seen. Left to fend for themselves, almost forgotten, after their mother and aunts died of AIDS earlier this year and their elder brother was killed in a train accident last month. None of them know what's happened to their fathers.
14-year old Lindani tells us, "we just sit, sometimes we work."
His youngest brother, 4-year old Uzamo (ph) is HIV-positive. He cries a lot. So too does Lindani, who seems traumatized, shell-shocked.
Of the three brothers, 6-years old Uncosiapa (ph) seems the most carefree. He sometimes does more than just sit or work. He loves to draw in the sand outside their home.
It's an areas like this that the true horror of the epidemic reveals itself. People living in this valley say that no one has been spared, and that nearly every single household has been affected by HIV/AIDS.
Mavis Mtambu is a community health worker hired by an international organization who walks these hills going door to door, and sees the full scale of the epidemic.
MAVIS MTAMBU, HEALTH WORKER: Yeah, I think out of (inaudible) 70 percent is HIV. 70 percent is HIV, yeah.
CURNOW: Mavis Mtambu says 12 other children under the age of 12 live alone, AIDS orphans like Mbambo boys in this community. She says she tries to keep an eye on them. Once with her own Mani (ph), she took little Uzamo to the clinic 20 kilometers away, hoping to get him onto antiretroviral drugs. She says the clinic refused, saying the child needed to be sicker before he could qualify for life-saving therapy.
MTAMBU: He's not getting the right food, the right treatment. No one takes him to the doctor. If I'm not here, or Mrs. Clemate (ph) is not here, nobody looks after him.
CURNOW: Mrs. Clemate is a neighbor. She pops in sometimes to check on the boys, but she's got her own grandchildren to look after. Two of her own children died of AIDS.
Grandmothers across this valley are shouldering the burden of the epidemic. Christina Mkize relies on this small vegetable patch to feed her 11 grandchildren and foster children, all orphaned by AIDS like 13-year old Mfundo (ph).
Mrs. Mkize tells me all those who suffer come to me. I've accepted that, but it makes me sick and stresses me out. I can't sleep at night.
She's 77 and her eyesight is going, so she gets the children to read to her from the Bible, small comfort for a family made up of those left behind.
The young and the very old are trying to hold together this community, says Mavis.
MTAMBU: I have to say, there's no future the way I see it, no future. Because people are dying, people are sick, and people are still going to die in this area.
CURNOW: Death, it seems, is these children's only companion. The fresh graves of their family members reminding them that HIV/AIDS has already stolen their childhood and perhaps also their future.
Robyn Curnow, CNN, in Kanini (ph), KwaZulu-Natal, South Africa.
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OKE: That's a really tough story to watch, but perhaps we have some good news coming up. Earlier this month, the U.N. aid agency cut its estimate of worldwide HIV infections. New data suggests about 33 million people are HIV-positive, compared to an estimated 40 million according to the old figures. The report includes steep cuts in infection rates for both India and Nigeria.
And despite what appears to be a (inaudible) collecting HIV statistics, health advocates warn that the fight against AIDS still requires more money and a sustained effort.
Dr. Ernest Darkoh launched one of Africa's most successful HIV/AIDS programs in Botswana six years ago. He is now based in South Africa, and has his own company called BroadReach Healthcare. When we spoke earlier this week, Dr. Darkoh talked about dramatic progress in Africa's approach to HIV and AIDS.
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DR. ERNEST DARKOH, AIDS EXPERT: We're truly living in exciting times regarding the response to this epidemic. Just a few years ago, I'd say -- and by 2002, 2003 it was very at that particular point things seemed rather bleak, given that most African countries were not even truly conceiving of what it would take to offer treatment for people who are -- with antiretroviral therapy.
However, since then, we have seen a massive mobilization to provide treatment to the millions who need it, and we've seen remarkable progress made in that regard. So even though the challenge still looms large, the progress is finally beginning to show some impact.
OKE: Are we really looking at leadership, quality of leadership that makes the -- a difference with fighting HIV/AIDS? Let's take, for instance, Botswana, where you did a lot of work. It was the president of Botswana that really helped the program to take off. Tell me more about that.
DARKOH: President Festus Mogae, I believe, is an absolute hero in the fight against HIV, because Botswana was the first country, prior to there being a change, in fact, in the policy position about treatment, that took the courageous step of deciding to provide free antiretroviral treatment to all its nationals who were in need of antiretroviral therapy. And in Botswana in a very short period of time, I'd say, in less than three years, they were already at a point where they were treating probably over 50 percent of the people who needed treatment and seeing progress on the prevention side. And as we sit today, they're probably treating about 90 percent of the people who need to be on treatment for antiretroviral therapy, and more or less have brought to a halt the mortality from HIV/AIDS.
OKE: Where else in Africa are countries seeing some success or dropping in the rate of HIV infections?
DARKOH: In Malawi, in Zambia, in Lesotho. Now, this is despite the fact that the numbers still remain daunting, and in some cases we're still seeing increases in the number of people being infected.
However, that said, these efforts in these countries are making significant ground. Most of these countries started providing treatment not much more than two years ago. So, really, 24 months is a very short period of time when you're addressing an epidemic that has taken decades to basically mature.
I think with the efforts we're putting in towards addressing HIV now, we won't see all the benefit immediately. But I think in the next 10 years, we'll see tremendous uptake in treatment. And also, I think, with the new reemphasis on prevention, we're going to see a lot of, you know, rolling back of the -- the incidence rate, which is the rate of new cases that is occurring on the continent of Africa.
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OKE: And that was AIDS expert Dr. Ernest Darkoh.
Coming up on INSIDE AFRICA -- breaking with tradition to save his own life. A Kenyan man goes under the knife to reduce his risk of contracting HIV.
And an expert explains why World AIDS Day is a time to celebrate in Rwanda. Stay with us.
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UNIDENTIFIED MALE: Making business news in Africa this week. The five countries that make up the East African community have agreed to a new interim trade plan with the European Union. Under the deal, Kenya, Tanzania, Uganda, Rwanda and Burundi will gradually open their markets to European exports over the next 25 years. But E.U. says negotiators will try to complete a comprehensive economic partnership agreement by next year.
And Zimbabwe's chief statistician says the country's food shortage is so severe, he can no longer calculate the monthly inflation numbers. The cost of basic family necessity such as meat, milk and produce are normally used to measure inflation. September's inflation rate was a staggering 7,982 percent, the world's highest.
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OKE: Hello again. You're watching a special World AIDS Day edition of INSIDE AFRICA. This year, the World Health Organization began recommending circumcision as a way to prevent heterosexual transmission of the AIDS virus. Christian Purefoy met a Kenyan man who chose to undergo the procedure, and broke an ancient cultural tradition in the process.
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CHRISTIAN PUREFOY, CNN CORRESPONDENT: Sunday Onyango is about to break one of the greatest taboos in his people's ancient culture. To lower his chances of being infected with AIDS, he's decided to become one of the few men of the Luo people to be circumcised. But he's not worried, he says, because he feels that he has not committed any crime.
Research in South Africa, Uganda and here in Kenya shows circumcision cuts the risk of contracting HIV by up to 60 percent. It is thought that certain cells in the foreskin are prime targets of the virus, and once it's removed, the skin beneath gets tougher, less susceptible to abrasions which could help spread the disease.
Scientists now hope that this will help explain why AIDS, according to national figures, is three times more prevalent in this region than any other in Kenya.
We spoke to the Luo Council of Elders, the custodians of the Luo culture. Culture is dynamic, they say, and they won't stop Luos being circumcised. But they will not support it either.
KAR RIAGA OGARA, LUO COUNCIL OF ELDERS: Anybody who abandoned he or her culture, is a lost.
PUREFOY: Dr. Kawango Agot, the study coordinator for the Kenyan research, says she didn't approach it from the cultural or religious angle. Instead, she focused on the numerous benefits circumcision can provide against AIDS.
DR. KAWANGO AGOT, AIDS STUDY COORDINATOR: I will say it's reduction in the prevalence, because fewer people are going to be infected, and of course, reduction in the new infections that are going to take place.
PUREFOY: Circumcision is no miracle cure, but it is another tool to allow Sunday to ensure his plans for the future are safe.
Christian Purefoy, CNN, Kasimu (ph), Kenya.
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OKE: As you can imagine, it's pretty difficult to film circumcision for television, and I think Christian Purefoy certainly met that challenge.
Coming up on INSIDE AFRICA -- getting results. Antiretroviral drugs and an improving healthcare system help Rwanda stem the tide of AIDS deaths. See you after the break.
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OKE: We turn now to Rwanda, which has an impressive record in its fight against HIV and AIDS. Columbia University's Josh Ruxin directs several healthcare programs in Rwanda, and says he went to live and work there because he thought it was a country where he could have a positive impact.
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JOSH RUXIN, PUBLIC HEALTH EXPERT: Rwanda has really turned out to be one of the success stories in fighting the pandemic of AIDS. The prevalence figures that have come out show that about 3 to 5 percent of the adult population is infected with HIV, and the government, through its programs, has done a superb job at getting much-needed antiretroviral drugs to people who need it. So, in Rwanda, this World AIDS Day is really a time to celebrate great successes.
There is still tremendous challenges ahead, of course, because there are many people who still die from lack of access to antiretrovirals, and many people who don't know their HIV status.
OKE: So, you're saying that it's the treatment, it's the drugs that is making a difference in Rwanda.
RUXIN: Well, it's a combination. Just four or five years ago, there were only two or three health centers in the entire country where someone could go to get HIV tested. Today, there is over 100 such centers. So, that makes a big difference. Just being able to know one's HIV status helps to stem the tide of the epidemic.
Additionally, the government, with funding from the global fund to fight AIDS, tuberculosis and malaria, and also PEPFAR, which is the U.S. government's AIDS initiative, has managed to roll out antiretroviral drugs to over 35,000 people who need them. And this is an enormous proportion of the people who are currently in need.
I think one of the big stories that continues to be untold here is that there are 2.5 million new infections that are going to occur in the coming year. Most of those will be in Sub-Saharan Africa, and I think sometimes people wonder, why so much focus on Africa? And the reason why is that the public health infrastructure is simply not in place in order to address this epidemic.
And the good news about AIDS is that - it's helped to create brand-new moneys which are being used to improve health centers across the continent. But much more is going to be needed if we're going to improve these health centers not only to address the AIDS pandemic, but to address all these other diseases, which are robbing families of mothers and fathers and of children.
One of the health centers that the Millennium Villages project is involved in Rwanda in Mayange, has done such a great job improving the quality of health that a woman in the community approached me just last month, and she said, you know, I'm a little bit angry with you. I used to have a job in this community that I don't have any more. And I said, well, what's exactly is that job, Jacqueline? And she said, well, I used to coordinate the funerals here, and for the last eight months there has not been a single funeral. But just last year, I was coordinating three or four funerals every single week.
But because we're currently providing antiretrovirals, providing HIV/AIDS testing, providing insecticide-treated bed nets, these deaths are no longer happening. And what I think that really demonstrates is how when the Rwandan people are provided with the finding and inputs that they need in order to fight off these diseases, they can accomplish great things in very short order.
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OKE: Dr. Ruxin also says the AIDS epidemic is a symptom of poverty. When it comes to fighting it, improving agriculture, education, and public health services around Africa are critical.
Next on INSIDE AFRICA, one of our CNN team returns to Lesotho, where thousands of HIV-positive children would have faced certain death a couple of years ago. Now, they have a shot at a normal life.
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OKE: You're watching INSIDE AFRICA. Welcome back.
AIDS is taking a terrible toll on children around the continent. In Lesotho, a country of about 2 million people, the disease has orphaned an estimated 100,000 children, and thousands more are HIV-positive. My CNN colleague Lindsay Korley (ph) has a unique prospective on the crisis because she's worked with orphans in Lesotho. Lindsay recently went back to check on the pace of progress, and she put together this video diary.
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UNIDENTIFIED FEMALE: My journey in Lesotho began in 2006 as a volunteer for an orphanage in Maseru. I was caring for just a few of Lesotho's 100,000 orphans. (inaudible) in toilets, cemeteries or along the roads, children are the most vulnerable victims of poverty and HIV. I fell in love with all the abandoned children I worked with.
I celebrated their first steps, first words and first birthdays. I was also there when seven of them died.
It's impossible to describe watching a child die in your arms. AIDS is so unforgiving. I would hold a child, feeling powerless.
People ask me how I've gotten over those deaths. I haven't.
In Lesotho's only public hospital, there is one local pediatrician, few trained nurses and little medical equipment. On any given day, children are dying from pneumonia and malnutrition.
Due to the stigma associated with AIDS, these mothers won't disclose their children's HIV status. Without antiretroviral medications, or ARVs, half the children with HIV will die before their second birthday.
When I returned to Lesotho in October for CNN, I noticed the country had made small advances. This state-of-the-art pediatric clinic was founded by an American medical school. Thousands of children now have better access to medication.
UNIDENTIFIED FEMALE: And how has Lopito (ph) been doing with her ARVs? Is she taking them every day, like she's supposed to?
DR. KATHY FERRER, BAYLOR INTL. PEDIATRIC AIDS INST.: Before I came in June of 2005, there were probably less than 20 kids on ARVs in the entire country, and a lot of that was because the medicines weren't around, and then we didn't have health professionals who knew how to give out the medicines, how to diagnose, how to prescribe.
UNIDENTIFIED FEMALE: Lesotho has a long battle ahead against the lethal combination of hunger and AIDS. The life expectancy here has fallen to just 39 years old.
FERRER: You can give a child ARVs, but if they're starving to death, then the ARVs don't really matter.
UNIDENTIFIED FEMALE: The difference between the children in these pictures and the children of America is access - access to basic health care and food.
But there is hope, for Lesotho and for Africa. By caring for one child at a time.
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OKE: That was our Lindsay Korley in Lesotho.
Now, before we go, I want to make sure we see you back here next weekend. I don't want you to miss documentary filmmaker Sorious Samura. In his latest film, he sets out to prove that just one problem is holding back Africa, and that's corruption.
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SORIOUS SAMURA, FILMMAKER: In most of the countries in Africa, children are taught how to bribe or how to even sell their bodies to teachers so they can get promoted to different classes.
In Sierra Leone, 375,000 children do not attend school, and now, for today at least, Bala (ph) is one of them. He has been sent home again because he can't pay the latest bribe.
So that's where we have to start pointing the torch light, and I'm hoping that people would get that, that it's not just about being (inaudible), but it's about saying you know what, we have a problem. Let's look at where the problem is and deal with it.
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OKE: You can see more of my interview with Sorious Samura next week on INSIDE AFRICA, and you can also see his new documentary, "Living With Corruption," which premieres next weekend right here on CNN. So we have the interview, we have the documentary, this show is not just thrown together.
I'm Femi Oke. Thanks for watching. I'll see you next time. Take care.
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