JOHANNESBURG, 5 November: The impact of HIV/AIDS in southern Africa, which has nine of the worlds most affected countries, needs to be reassessed as a “humanitarian emergency” on its own, enabling interventions to be made timeously, a leading AIDS researcher argues in a new paper.
For this to happen, Alan Whiteside, director of the Health Economics and HIV/AIDS Research Division of the University of KwaZulu-Natal, South Africa, said in the paper, co-authored by researcher Amy Whalley, the conventional understanding of a humanitarian emergency has to be rethought.
– Traditional humanitarian thinking focuses on the short term, and is often aimed at returning affected populations to “normality”, he said in Reviewing “Emergencies for Swaziland: Shifting the Paradigm in a New Era”.
To make the point, the authors used Swaziland, which has an HIV prevalence rate of 33,4 percent among people aged between 15 to 49 years – the worlds highest, according to UNAIDS – and the worlds lowest life expectancy, just 31,3 years in 2004, as noted in the UNDPs Human Development Report.
The region also has eight other countries with some of the worlds highest prevalence (hyppigheds) rates: Botswana 24,1 percent; Lesotho 23,2 percent; Namibia 19,6 percent; South Africa 18,8 percent; Zambia 17 percent; Mozambique 16,1 percent; Zimbabwe 15,6 percent, and Malawi 14,1 percent, according to UNAIDS.
– HIV/AIDS in Swaziland has been characterised by a slow onset of impacts that have failed to command an emergency response. With insufficient resource allocation and a lack of capacity, slow onset events can become emergencies, Whiteside maintained. The situation was not very different in the regions other affected countries.
Part of the problem was that, spurred by its consistent economic growth in the 1990s, Swaziland had been classified as a “low-middle-income country” by the World Bank, and a “medium human development country” by the UN Development Programme (UNDP).
This classification altered the perception (opfattelsen) of the country in donor and international eyes as a “poor” country to that of one able to support itself, restricting potential external funding.
HIV/AIDS in Swaziland has been characterised by a slow onset of impacts that have failed to command an emergency response. With insufficient resource allocation and a lack of capacity, slow onset events can become emergencies
Whiteside has tried to establish a correlation (sammenhæng) between the ever-increasing HIV prevalence recorded by national sero-sentinel surveillance surveys – which has shot up from 3,9 percent in 1992 to 42,6 percent in 2004 and declined slightly to 39,2 percent in 2006 – and the falling social and economic indicators.
– If negative trends were noticed earlier in Swaziland, some wider shocks may have been preventable, he said.
Over the past 15 years, Swaziland has become characterised by a decline in economic growth, spreading poverty, and a rise in mortality and morbidity rates. – Current death rates now exceed the daily mortality thresholds used by agencies as an indicator of a disaster, Whiteside noted.
The number of people living below poverty line climbed from 65 percent in 1995 to 69 percent in 2001, while annual Gross Domestic Product (GDP) plunged from 6 percent in the 1990s to a current level of around 2 percent, resulting in negative per capita growth.
Whiteside said maize production had more than halved in AIDS-affected households and cited a 2004 study, “A Systematic Review of the Economic Impact of HIV/AIDS on Swaziland”, by F.T. Muwanga, showing that the average loss in GDP growth attributable to HIV/AIDS was around 1,6 percent per year.
Kilder: UN Integrated Regional Information Networks og The Push Journal
