The AIDS Epidemic
Africa has suffered through centuries of famine, war, disease, corruption, and poverty. But now something new has invaded this troubled continent and now threats to create a humanitarian crisis that the world has now seen since the days of the black plague in Europe. That something "new" is the HIV virus and nowhere has it inflected more pain and suffering than in Africa. Consider what AIDS is now doing to Africa:
- It is estimated that 1 in 5 African adults is now infected with the HIV virus. Because of malnutrition and lack of medication, most Africans who contract the HIV virus will not survive more than ten years. Thus, if 1 in 5 African adults is already infected with the virus, how many people are going to die in the next ten years?
- More than 8,000 people die of AIDS each day in Africa.
- Few people in Africa are tested for the HIV virus; thus, few people in Africa (who are infected with the virus) know that they are infected and are passing it on to their spouses and children. The only way most people discover that they have the virus is when they become deathly sick with full-blown AIDS.
- Zambia has the 6th worst AIDS epidemic in the world.
- Only 1% of those who have the HIV virus in Zambia are receiving any medication for their disease.
- It is estimated that 8 out of every 10 hospital beds in Lusaka are filled with a patient dying of AIDS.
- More than 120,000 people are dying each year in Zambia from AIDS.
- Zambia has lost 3300 school teachers to AIDS in the last ten years. This demonstrates how AIDS is affecting the infrastructure of Africa. As Africa looses its most educated and skilled people to AIDS, all Africa's other problems only become much worse. What happens to Africa, for example, when there are fewer teachers to teach the next generation. Obviously, the development of Africa is going to be seriously affected by this.
- All Africa's other/older problems are getting worse. T.B. rates, for example, have more than quadrupled in the last ten years. Poverty, disease, famine, etc will only become worse in the coming years.
- There are more than 25 million orphans in Africa whose parents have died of AIDS.
- Only 2 of the 15 billion dollars that President Bush promised (Jan 2003) to fight AIDS in Africa has yet been appropriated by Congress. One wonders if the USA will do little more than talk about this great problem.
- It is estimated that 1 in 4 women of childbearing age in South Africa are infected with the HIV virus. This means that these women will have children and unknowingly pass this virus on to their children and husbands (fathers). This also means, therefore, that both parents are likely to die within ten years and leave behind more than 3-4 children with no means of caring for themselves.
According to the latest U.N. report, it is estimated that 70% of all HIV infected people throughout the world live in sub-Sahara Africa. It is estimated that one in every five Africans is now infected with this deadly virus. And, because of malnutrition (already weakened immune system), the unavailability of AIDS medications, and the abundance of malaria and infectious diseases (e.g. tuberculosis, hepatitis, cholera, typhoid, etc), it is estimated that a person in Zambia who contracts the HIV virus will not live more than three to six years. Thus, with one-in-five already infected with the virus, you can imagine how many people in Africa will die in the next five years and how many orphans will be left behind unable to care for themselves! It is estimated that there is already 30 million orphans in Africa and that this number is expected to increase to 50 million within the next five years!
Zambia is listed sixth in the world as having the most infected people per-capita. It is estimated that eight in every ten hospital beds in Lusaka is filled with a patient dying of AIDS. This virus is devastating every level of society, meaning that Zambia is also loosing its most valuable and productive citizens. For example, it was reported in 2004 that Zambia lost 3300 school teachers to the virus. Key business and government leaders also being lost to this epidemic. All of this seriously undermines the future development and economic growth of the country. One can only imagine, then, how this is affecting the overall healthcare system of the country. In fact, the dangers of treating AIDS patients (along with more lucrative-paying jobs in Europe) is causing may doctors and nurses to leave Africa for healthcare jobs in Europe and elsewhere. The number of healthcare workers who have died from treating AIDS victims in Africa has led to a dramatic increase in mortality rates among doctors and nurses throughout Africa.
There have been many studies as to why the AIDS virus has spread so abundantly in Africa. These reasons would include the fact that the virus is generally thought to have begun first in Africa (meaning it has been there longest). The use of dirty needles (treating numerous patients with the same syringe) is certainly a major contributor. Widespread promiscuity (with little use of condoms that are expensive for most) and the prevalence of infidelity among husbands is another factor. But, perhaps the number one reason for the spread of the virus throughout the southern regions of the continent is the sexual behavior of truck drivers in Africa. To list must also be added the fact that malnutrition and the abundance of infectious diseases in sub-Sahara Africa has already undermined the people’s immune system so that they are more vulnerable to infection when exposed to the virus at any level.
There is one other factor that is also important to take special note of. Women and children are at a higher risk of being infected because of a lack of legal rights. Women and young girls are especially vulnerable to rape, physical abuse and discrimination. They are at a physical, economic and legal disadvantage and have little social status. Women cannot negotiate for use of a condom and cannot say no to an unfaithful husband. Monogamous married women are powerless against infection by husbands with outside partners. Economic dependency prevents women from leaving unsafe sexual relationships. Discriminatory practices still continue, such as “widows inheritance” (where women whose husbands die are “inherited” by their brothers-in-law.” There is also the widespread believe that sex with women/children who are virgins will cure one of the AIDS virus. This myth has contributed greatly to the rape of women and children and their infection of the virus. In most countries the laws against rape are either weak or nonexistent or they are not enforced.
In recent years we have seen an increased concern in the West about the spread of the virus in Africa and this has led to a dramatic increase in donations to efforts in fighting the spread of the virus in Africa. Billons of dollars have been given. However, these efforts do not seem to be effecting any noticeable change in the spread of the virus. This is due to the limited focus that is inherent to most of these western approaches.
First, there is the predominate assumption that education and free condoms will bring about a change in sexual behavior. Unfortunately, however, these approaches seem to ignore the deeper spiritual and cultural factors which lay at the heart of the problem. Africa is a cultural deeply embedded in the beliefs and practices of the spirit world. Africa shares a fatalistic worldview that interprets suffering and misfortune as the practical outcomes of spiritual activity taking place in the unseen realm of this world. The question is not a matter of how the virus is spread but, rather, a matter of who caused the infection (i.e., what spirit/demon or person via a witchdoctor’s curse caused the infection). Thus, ultimately, the spread of AIDS in Africa is basically a spiritual problem and will not be solved by secular educational methods of the West.
The second shortcoming inherent in most western approaches is the failure to address the matter of beliefs and moral ethics that influence sexual behavior in Africa. This is, of course, touches upon the fierce debate that rages on between western governments and the religious communities of those countries (i.e., safe sex verse abstentious). Secularists argue that religious teaches favoring abstentious does not protect those who choose not to abstain. The religious community, on the other hands, argues that teaching the use of condoms only encourages more sexual promiscuity and does not truly protect people from infection (as condoms do fail). Perhaps the best solution is not a matter of either/or, but one involving both approaches. Sexual promiscuity cannot be ignored as a serious problem in any society where AIDS is widespread and where the effective use of condoms is not evident. It would seem, therefore, that any approach that ignores the moral and religious teachings about sex (e.g. those taught in the Bible) is an approach that lacking the most critical component to fighting the spread of AIDS. However, because there people who will not submit to religious and moral teachings of the Bible, there does seem to be a practical need for the government to educate people about the use of condoms. Nevertheless, the battle against the spread of AIDS in Africa will not be won unless there is a change in the sexual behavior of the people and this is the job of the church in Africa. Biblical teachings on sex and marital fidelity are crucial to fighting the spread of AIDS in Africa. Secular education that neither addresses the spirit world nor incorporates the fundamental values of the Bible is destined to fail miserably in Africa.
There is yet a third component to AIDS problem in Africa and that has to do with the institution of marriage itself. Because Africa has a long history of discrimination against women and because marriages have long tradition of “arranged marriages,” intimacy between husbands and wives has been basically lacking. The primary sources for intimacy are largely those found within the same gender. Male attitudes that value women as little more than property and as servants of men further undermines the possibility of male-female intimacy. Physical abuse, rape, and the overall lack of social position/power assigned to women also fosters marital indifference and insensitivity. This is not how God designed for marriage (Gen 2). Neither is it consistent with Jesus’ example or his teachings about servanthood (Mt 7:12; John 13); nor does it harmonize with Paul’s teachings about marital love (Eph 5:21-25). Consequently, any successful effort in fighting the battle against AIDS in Africa MUST also address the nature of marital relationships in Africa (e.g. value of women, how husbands should treat their wives, the partner/companion relationship that God designed for husband-wife relationships, the nature of love, marital intimacy, etc). In addition, the Bible’s teachings on the sanctity of marriage is critical to this effort (i.e., sex outside marriage is against God’s will).
This is why those efforts to fight the spread of AIDS in Africa that are based solely on education and the passing out of free condoms will not halt/reverse the epidemic. There are, of course, other components that need to be addressed as well that we have not mentioned here (e.g., economic, political and nutritional). Malnutrition due to poverty and political unrest (wars) is a problem that needs solving. Poverty effects the AIDS epidemic in that people with HIV cannot afford the medications needed for prolonging life. Poverty increases the stress on marriages and makes women more susceptible to men willing to trade money for sex. All these factors contribute to the spread of AIDS in Africa and must be addressed in some way if the epidemic is to be arrested.