The latest statistics on the AIDS epidemic in Mozambique indicate that 16,2 per cent of all Mozambicans aged between 15 and 49 are carrying the HIV virus that causes AIDS, Health Minister Ivo Garrido said on Wednesday.
Briefing the Mozambican parliament, the Assembly of the Republic, on the epidemic, Garrido said that the province with the highest infection rate is Sofala in the centre of the country with a figure of 26,5 per cent. The northern province of Cabo Delgado has the lowest rate, 8,6 per cent.
These figures come from the 2004 epidemiological surveillance round, which used 36 sentinel sites covering both urban and rural areas, and all 11 provinces.
In 2004 there were estimated to be 1,4 million HIV-positive Mozambicans, said Garrido. Of that number, 80.000 were children, 570.000 were adult men, and 800.000 were adult women.
This “feminisation” of the epidemic, the Minister said, was due not only to biology, but to “socio-economic factors that harm girls and young women”.
There were thought to have been 109.000 new HIV infections in 2004, of which 34.000 were in girls under the age of 20. There were 97.000 AIDS deaths in 2004, including 20,000 children under the age of five. There are now 270.000 Mozambicans under the age of 17 who have lost one or both parents to AIDS.
Garrido warned that, unless current trends are reversed, life expectancy will continue to decline. Without the AIDS epidemic life expectancy at birth in 2004 should have been 46,4 years – in fact, it was just 38 years.
Trained staff are likely to die at a frightening rate.
Garrido said that, at the current pace, the country will lose 9.200 teachers and over 6.000 health professionals to AIDS by 2010. The number of people employed in education and health would shrink, because “our training capacity is slower than the pace of deaths”.
Health Units would be packed with AIDS patients, he added, and the “astronomical costs” of dealing with the epidemic meant that less money would be available for other health activities.
Prevention remained the governments priority and, since 95 per cent of cases are contracted sexually, safe sex was an imperative. The distribution of condoms, free of charge, had risen to 25 million a year, Garrido said.
He also stressed the importance of voluntary testing, and dismissed out of hand the arguments of those who say they do not want to know whether they are HIV-positive.
– There are only two possibilities – either a person is infected or he is not. If he knows he is infected, he has a chance of treatment. If he does not know, he will die, said Garrido.
There are now 155 Counselling and Voluntary Testing Offices in Mozambique. Since 2001 they have tested over 350.000 people.
Although contamination through unsterilised instruments accounts for only a small proportion of AIDS cases, the Health Ministry is taking no chances and has stepped up biosecurity measures.
One example of this care, Garrido said, is that every one of the almost ten million children reached in the recent measles vaccination campaign, was injected with a disposable needle that was only used once.
Treatment of AIDS sufferers with antiretroviral drugs (livsforlængende medicin) began in 2002, said Garrido, initially on a small scale because of the high costs of the treatment.
The development of cheaper generic anti-retrovirals has allowed expansion, and currently over 15.000 Mozambicans are receiving anti-retroviral therapy in 31 health posts covering all the provinces.
Garrido said the ministry intends to expand the availability of anti-retrovirals to all 128 districts. But he warned that treatment was not simply a matter of giving patients a supply of pills: laboratory tests must be given to ascertain the patients CD4 count.
The CD4 cells are the part of the bodys immune system attacked by the HIV virus, and the current medical consensus is that it is not worth administering anti-retrovirals until the number of CD4 cells drops to 200 or less per microlitre of blood.
Garrido stressed the importance of educating young Mozambicans before they become sexually active. Adolescents aged between 10 and 14 were the “window of hope”.
Virtually nobody in this age group is HIV-positive (because most children infected in their mothers wombs have died before they are 10, and few children of this age have embarked on sexual activity).
In improving the prevention campaign, “we must resist the easy temptation of importing measures from other countries and implanting them mechanically in Mozambique”, said Garrido.
– If we want our messages and our counselling to lead to a real change of behaviour we must take our cultural values into account, noted he.
He called for increased involvement of village, neighbourhood, religious and sports leaders, since they are respected figures and their advice will be followed.
Kilder: Agencia de Informacao de Mocambique og The Push Journal
