Economic crisis 'threatens to re-ignite Aids epidemic'

ActionAid UK

The current financial crisis threatens to re-ignite an Aids epidemic if donors renege on their promises to fund universal access to treatment, warns anti-poverty agency ActionAid.

“The Global Fund has put on hold funds for 2009 and we are worried about the disastrous impact this will have on people in developing countries,” said Leonard Okello, ActionAid’s international head of HIV/Aids

Adequate nutrition together with antiretroviral drugs is crucial to a healthy life yet fluctuating food prices are already affecting the health of millions of people living with HIV.

“Many South Africans who have HIV are poor and the biggest problem we have right now is food prices,” said ActionAid Global Youth Network activist, Salamina Motsoage from Orange Farm, south east of Johannesburg.

“Most South Africans receiving treatment are barely eating two proper meals a day and their health is deteriorating,” she said.

South Africa has one of the severest HIV/Aids epidemics in the world. About 5.5 million people, or 18.8% of the adult population, have HIV, according to the UN. In 2005, there were about 900 deaths a day.

Former South African president Thabo Mbeki’s government recently came under fire for what was believed to be the avoidable deaths of more than a third of a million people as a result of the Aids policies in vogue at the time.

In 2007, an estimated three million people in low and middle income countries were receiving anti-retrovirals – a 50% increase since December 2006 and a 10-fold rise over the last five years.

South Africa, Malawi and Zambia were named as three countries in the Southern African region where the HIV infection rate is stabilising, according to a UNAIDS report in July 2008. While gains are being made with HIV prevention, there are still major setbacks and it is crucial that funding remains a priority.

“There were over 1.1 million Aids-related deaths in east and southern Africa in 2007,” said Okello. “This figure represents more than half of all global Aids deaths,” he said.

Most developing countries are likely to cut social spending due to falling exports, weakening currencies and declines in foreign investment, yet primary health care in many developing countries, with high HIV prevalence rates, is limited or dysfunctional.

In the absence of adequate funding, countries may resort to other more controversial tactics to reduce Aids related deaths such as compulsory testing and criminalisation of transmission. ActionAid is against these measures because they violate the rights of people with HIV and promote stigma and discrimination.

“Failure to fund HIV could mean the difference between life and death to millions of people in developing countries,” said James Kamau, Kenya Treatment Access Movement’s Coordinator. “HIV is still a huge priority in Africa.”

ENDS

Note to editors:
ActionAid works with local communities to promote the rights and dignity of people with AIDS. It also promotes care and support while supporting innovative tools and processes such as Stepping Stones and Society Tackling Aids through Rights (STAR), increasing community action on HIV prevention and treatment. Recognising the urgent need to re-invigorate community mobilisation, ActionAid is organising a global citizen summit in early 2009 to explore and agree radical actions to mobilise, test and treat the nations and stop HIV infections.

Ends

Note to Editors:

For media interviews contact: Sarah Gillam, on + 44 7738 884014 in London or Irene Ndiritu in Johannesburg South Africa + 27 845 428441

ActionAid’s Head of HIV/AIDS - Leonard Okello based in Kenya – available on Monday and Tuesday for interviews.

ActionAid is an international anti-poverty agency working in over 40 countries taking sides with poor people to end poverty and injustice together www.actionaid.org

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CASE STUDY FROM ETHIOPIA

My name is Birknesh Deme. I am 18.

After my mother died in 2003, my grandfather took me into his house in Yeka Abalo villages.

The area is vast and spacious- possibly one GASHA (around 90 acres). I love the neighbourhood where I lived. Had it not been for the hardship, I would have loved to remain there. I always remember it, it is something that I never forget. It is the place I was born and raised and I was very happy with it. It is very green and during the summer months, there is a pleasant wind.

I was quite close to my grandfather and I loved him very much, but I was not that dear to him. He did love me, but he would not do as many things for me as he did for his children, my mother’s sister and brother who are older than me. We all lived together, but he did not treat me and my younger sister as his own children. He did not take any steps to help us and raise us up as a result of the loss we suffered, even though we did quite a lot for him, including cooking.

My mother passed away whilst we were small (when I was 13 and my sister was 12). As the older sister, I was the one who was working to provide us with our daily food and clothing each year.

When I was 15, I started to do chores in the village. Initially I worked as a day labourer, cutting grass and other work.

I started school when I was seven years old, but discontinued my schooling for the sake of my sister. I used to think to myself I would become a nurse after finishing my education. We don’t know many things living in rural areas and we do not know where diseases come from. If I had become a nurse, I would have happily educated those who do not know. Teaching gives me joy. In my own village, no one taught me anything, so I would love to teach those who have not been educated.

When I was 17, while I was doing day labour, my grandfather persistently wanted to wed me to someone. I didn’t want to. I wanted to live with my sister and improve both of our conditions together.

The whole village rose up against me and reprimanded me, saying this would not be possible and I must be forced me to marry.

When the elders came to ask for my hand in marriage, I knew nothing about it. I don’t know how many came at the time, I really did not see anything at all until the day of the wedding.

It is common for girls not to know they are being promised in marriage. In the place where I live, it is the families who usually give their daughters hand in marriage. There are some cases that the woman does get to decide for herself, but this is rare. When this happens, there is a saying that she’s ‘under instruction.’

Parents also find it difficult to refuse a man who comes asking for their daughters hand in marriage. The father will usually give in, giving the excuse that he finds it difficult to say ‘no’ to the man’s he has refused once already.

The marriage was all agreed by the time I heard about it. The first I knew was when I was told I would need new clothes, which would be bought for me.

When, I asked what the clothes were for, I was given the explanation that I was to be married. I protested, saying how could this be without my knowledge?

I said clearly that I didn’t want anyone to arrange a marriage for me. Those who’ve got married live miserable lives. All I wanted to do was work for myself and live with my sister, but no one would have any of it. My grandfather said that unless I got married, he would not give me land on which to build a house or allow me to continue to live with him.

I refused as much as I could, but they insisted and pushed me until I agreed to be taken to buy the clothes.

I was so unhappy, but my grandfather had made up his mind. I kept asking him why this was happening to me. How would I live like this? Would I be miserable forever? I had these thoughts constantly on my mind. During the daytime, my thoughts would be taken up by work but the moment I returned home, they came back to me.

In my village, most of the girls who have got married lead miserable lives. They worry about life and if the husband is poor, it is the wife who’ll have to work. In a rural community, a married woman encounters hardship and will live a life of suffering. When I envisaged my life once I got married, I thought I would always live a miserable life and I thought about this constantly.

When my aunt heard my protests, she said my grandfather should leave me to be abducted if I’m not willing to get married of my own accord. I argued with my aunt who advised my grandfather to refuse me land and disallow me from building a house.

The wedding date was set within a month of the wedding clothes being bought and my finding out about the marriage. I don’t know if my grandfather had even met the groom before he agreed my hand in marriage. I had certainly never met him.

When I was told who the groom would be, I detested him immediately. I didn’t even want to meet him and, I would go out of my way to avoid him. Even when there was talk of him in my presence, I would cry and feel angry at the same time.

I had never had many male friends. When I left home, I went straight to work and back again. I suppose I lived quite a withdrawn life, which made the prospect of marriage more frightening.

The only person I could confide in was my cousin, whom I dearly love and consider a sister. She has been my confidante for a long time and cried when I told her what was happening, but said that she could not advise me either way. She just cried with me as there was nothing she could say.

A wedding feast was arranged for me, but I continued to protest. I said that with the money that would be used for preparing the feast, I could improve my future! My grandfather refused and said: “Let me see you wed before I die and I will have no regrets.”He reiterated that he’d not give me land or a house and also would not permit me to build one. And so I gave in, because I had no alternative.

As the wedding day approached, I decided to ask the man I was due to marry to take a HIV test. I had heard of people contracting HIV and people in the community talking about it. I knew it could be spread by razor blades or needles and also through sexual relations.

He consented to the test, as he always did to everything we ask of him. However when the time for the test arrived, he came up with various excuses. There was always something to do or somewhere to go.

On the day before the wedding, he tried to refuse to take the test for a final time, saying he had somewhere to go and it was not convenient for him to have a test. I put my foot down and told him that today is different. Today was a serious today and we need to take action. With that I persuaded him to come with me.

At the time I went for the test, it was without any worries. I had no real thought that he could cause me to contract HIV or that either of us would be positive.

We were told the results immediately after we took the test. We were together when the female nurse reported the results to us, saying we had different results.

When she said he was positive, I was so worried and did not know what to say because the wedding was arranged for the next day. I was so shocked that a thing like this could just happen out of the blue. I thought how can this be happening to me like this- just out of the blue. What am I going to do?

I was worried about how to tell anyone. If I went ahead with the wedding without saying anything to anyone, I would catch the virus. I know HIV is like fire, it burns those it catches. On the other hand, if I did tell my family, I was scared what they would say to me.

The man I was to marry completely denied the results, saying he did not have the sickness. He went off to Addis Ababa, still planning for the wedding.

He returned in the evening and told me to go and take communion with him. I replied that I would not, but my uncle persuaded me to and sent me against my will. So we took communion together and then returned.

I did not tell my family until the wedding day as I was frightened. When I did tell them, they fell silent. Even my grandfather accepted me back without hesitation, fearing for my safety

The man I was about to marry denied the results again, saying he was not positive. My family said to him that they would not give me in marriage unless he could prove he was negative. They told him to bring the results to prove what he was saying.

In the morning, we went together for a second test, but the result was the same. He was HIV positive and he could no longer deny it.

I told him the man I would not be marrying him, there was no way I would enter in this marriage. He even suggested we could live ‘like brother and sister’ but I said this was not possible. There it ended.

My grandfather was pleased about my escape, saying it would have been a double loss on top of my mother’s death had he lost me too. He even agreed to return the man’s expenses for the wedding.

Usually, the community says a lot of negative things about a person who turns down marriage. The local people tarnish your reputation and call you a ‘skipper’ (loose woman).

In my case, the community was amazed that this had happened. They appreciated my stand, saying that it must be because I am a decent girl. Had this not happened, I’d have gone ahead and ended my own life by going with him.

A good number of people learnt a lesson for themselves from our situation. It was the talk of the town. Very many people, even those who knew none of us, were talking about us because of what they had heard.

I don’t even think about getting married now. I think of leading my own life. After working for a while to save enough money, I will be looking to finding a solution to sustain myself.

If I had gone ahead with the marriage, my life would have been destroyed. I do not believe that my relatives would have nursed me in case I fell ill. I thank my Creator from the bottom of my heart for delivering me.

I now attend an ‘idir’. These are local institutions run by community members. Through this, I have attended training on the issues of HIV and AIDS run by ActionAid and a partner organisation called IMPACT.

ActionAid helped me and also uses my case as an example so that others may learn. Many people have taken the test since my case. The day after my wedding, eleven people went to get their HIV status checked. From then on, no one got married without having a test done.

I felt proud of myself that I can be used as an example and I feel very, very happy to be free from the virus.

About ActionAid:

ActionAid is an anti-poverty agency based in over fifty countries worldwide. The agency works directly with some of the poorest communities in the world to fight poverty, including the spread of HIV/AIDS.

Three quarters of young adults living with HIV in Africa are women. With less control over their own lives, women in developing countries are often more vulnerable to the spread and stigma of the virus and ActionAid is campaigning locally, nationally and internationally to change this.

In Ethiopia, ActionAid works with a partner organisation called IMPACT to initiate educational programmes and train community members in both rural and non-rural areas, to increase general understanding of HIV/AIDS.

December 1 is Worlds AIDS Day. To get involved with ActionAid’s campaign, log onto www.actionaid.org