University of Zambia Medical Library

HIV/AIDS in Zambia: March 1999

"Chibula Calls for Change in Lifestyles." By Kelvin Shimo
The Post, March 31, 1999

President Frederick Chiluba yesterday called on Zambians to change their lifestyles if the scourge of HIV/AIDS is to be curbed. President Chiluba, meeting a delegation of United States government and congressional officials at State House yesterday, bemoaned the increasing number of orphans in the country due to the AIDS scourge. "Productive manpower is dying because of the disease. Zambia is charcterised by a large population of youths who are sexually active," President Chiluba said. "It is sad the holocaust is not choosing who to kill." He said the picture on the ground was gloomy and that the war against the scourge cannot be won by Zambia alone but concerted efforts from all countries concerned.

President Chiluba, paying tribute to US President Bill Clinton described him as a friend of Africa for his intervention in the fight against HIV/AIDS. He commended President Clinton's concern for the region more especially the peace efforts being pursued in the Congo Democratic Republic (DRC). President Chiluba said he was also getting concerned about the stalemate in the DRC talks but President Laurent Kabila's willingness to meet the rebels has cheered him up. "We commend President Clinton for his efforts to bring peace to the world in general," said President Chiluba.

Delegation leader, Clinton's advisor on AIDS Sandy Thurman, called on African leaders to invest more resources in the fight against HIV/AIDS as they have done with curbing wars. "Its better to fight AIDS than kill each other," she said. The delegation is on a fact finding mission to three African countries - Zambia, Uganda and South Africa. Thurman said more people are dying from AIDS hence the need for commitment to fight the scourge should be from the top. She said her government has given US $1 million to Zambia to help fight the scourge.

Thurman said her delegation had come to learn from the Zambian situation. Congress woman Carolyn Kilpatrick said time has come for Africa to have a large chunk of aid from United States like Israel and Congress woman Sheila Jackson called for more education and awareness on AIDS.

"Chibula Hails Clinton's Role in fight Against AIDS."
The Daily Mail, March 31, 1999

President Chiluba said yesterday Zambia appreciated American President Bill Clinton's concern about the HIV/AIDS pandemic in the country. Mr Chiluba added that President Clinton had adopted a leading role in ensuring that Africa was put on the world map in trade. He was speaking when a visiting US delegation called on him at State House. Mr Chiluba told the delegation that he was worried about the number of young professionals that were dying from the disease. He noted that this was having a negative impact on national development as Zambia's population is made up of many young people.

Mr Chiluba further stated that the world needed to combine efforts and resources in the fight against the pandemic. He also called for the change of life styles among the people to control the spread of the disease. Mr Chiluba assured the US delegation that he was making headway in resolving the conflict in the Democratic Republic of Congo.

At the same occasion, delegation leader Ms Sandy Thurman, who is also Director of the White House office on HIV/AIDS, said her country was aware that many people were dying of AIDS in the region. She said her country would continue helping Zambia in the fight against the disease. Congresswoman Carolyn Kilpatrick said the US government was committed to building partnerships with African governments. She also noted that AIDS was a world epidemic which needed concerted efforts from all stakeholders if it is to be controlled.

"AIDS Fight in $1M Boost."
Times of Zambia, March 29, 1999

The United States government has given Zambia an additional $1m for combating HIV/AIDS. This brings to $4m the total funds committed to fighting the disease this year through the United States Agency for International Development (USAID). US President Bill Clinton's advisor on HIV/AIDS Sandy Thurman said this on arrival at the Lusaka International Airport yesterday. Ms Thurman, leading a delegation of US government and congressional officials on a fact-finding mission to three African nations, said the team's goal was to learn about efforts being made to prevent and alleviate the suffering caused by HIV/AIDS.

Ms Thurman who is director of the White House office on national AIDS policy said after the African tour, a report of the findings and recommendation would be presented to President Clinton. She said special attention would be given to the plight of children orphaned by AIDS. The delegation which included US Congress representatives Caroline Kilpatrick and Sheila Jackson Lee was received at the airport by Health Permanent Secretary Kashiwa Bulaya, and US ambassador to Zambia Arlene Render.

"Zambian Women To Benefit From Anti-AIDS Retroviral Drug."
The Daily Mail, March 27, 1999

The Joint United Nations Programme on HIV/AIDS (UNAIDS) has announced that it has chosen Zambia out of the Sub-Saharan Africa for free provision of AZT, an anti-AIDS retroviral drug to pregnant women to inhibit the transmission of the AIDS virus to a newly-born baby. The National Food and Nutrition Commission (NFNC) has since embarked on a USAIDS programme to sensitise the community, more especially expecting women on the issue.

Worldwide, an estimated three million children under the age of 15 years have been infected with HIV to date. Mother-to-child transmission during pregnancy, delivery or breast feeding is responsible for more than 90 per cent of HIV infection in children. The remaining 10 per cent are infected through contaminated blood or sexual abuse. Mother-to-child transmission rates vary considerably. In the industrialised world, the risk of an infant acquiring HIV from an infected mother ranges from 15 to 20 per cent, compared with 25-45 per cent in developing countries.

Differences in breast feeding rates may account for much of this variation. While in the developed world women who are diagnosed positive to HIV and are breast feeding rely much on the bottle, in developing countries such as Zambia, the situation is different as nearly all of the mothers depend so much on the breast, mostly as a result of no alternative due to poverty. Research shows that the risk of transmission is significantly higher if a woman becomes infected with HIV during pregnancy or while breast feeding, and when the mother is in an advanced stage of the disease. Breast feeding is thus a significant and preventable mode of HIV transmission to infants, creating an urgent need to educate, counsel, and support women and families so that they can decide how best to feed infants in the context of HIV.

According to Dr Piet Reijer, of the National AIDS/STD/TB & Leprosy Programme NASTLP), it can be assumed that in Zambia infants of HIV-infected mothers are not infected at birth, which will be true in approximately 80 cases. "When mothers receive antiretroviral treatment during pregnancy, it can be assumed that over 90 per cent of infants will be born infected," Dr Reijer said. Breast feeding is normally the best way to feed an infant. However, when the mother is infected with HIV, it may be preferable to replace breast milk to reduce the risk of transmission to her infant. The risk of illness and death from replacement feeding should be less than the risk of transmission through breast feeding. Otherwise, there is no advantage to replacement feeding.

Linda Shikabonga, 34, a woman who has gone out in the open to announce that she is HIV positive believes that the escalating high infant mortality rate being experienced in the country is as a result of most of the babies dying of AIDS after having born with the virus from the mother. She urged women, more especially those who are expecting to go for a blood test and determine their serostatus so that they can be aware of the outcome should they have an infant. To those who are still single, the advice is that they should not fall pregnant once they are diagnosed to be HIV positive or simply register for the allocation of AZT once the programme commences.

Shikabonga is chairperson of the Positive Women Support Group, an organisation that would be one of those involved in the distribution of the AZT drug to pregnant women. Besides the National Food and Nutrition Commission, other non-governmental organisations short listed for distribution of the antiretroviral drug would be The Network of Zambian People Living with HIV/AIDS (NZP+), and the communications Network on AIDS, Law and Ethics (CONAIDS). CONAIDS National Coordinator Christopher Mumba (Jnr) said in Lusaka that an announcement would be made to the community soon after UNAIDS had made available the drug in the country.

"US Mission on HIV/AIDS to Zambia."
Streetkid-L, March 26, 1999

The White House is sending (saturday) a team of development experts on an eight-day visit to Zambia, Uganda and South Africa. the team will assess the impact of AIDS in those countries and the effectiveness of local programs in combating the disease. Nejla Sammakia reports. Sandy Thurman, head of the US mission, says the disease is responsible for creating millions of orphans in Sub-saharan Africa.

The American agency for international development (AID) says that, by the year 2030, more than 40 million children around the world will have lost one or both parents to AIDS. Many of the countries of Sub-saharan Africa have launched anti-AIDS health projects, as well as programs to help victims and their families. Ms. Thurman's team is going to stop in Zambia, Uganda and South Africa, which have been hard hit by AIDS. Ms. Thurman says each of these countries is coping with the disease in different ways.

"We want to be able to give contrasts here. So Zambia is really grappling with the epidemic. It's just beginning to build infrastructure and start programs to cope with the epidemic, they've got some wonderful programs in the ground and communities that are supporting children and families."

Ms. Thurman says Uganda has been able to mount a fairly effective program to fight the disease, in large part because the Kampala government anticipated the problem and mounted an aggressive campaign to contain AIDS. She says the situation is very different in South Africa, where one in eight persons is infected with HIV -- the virus that causes AIDS -- and up to 1,600 new infections are reported every day.

"I think South Africa is on the brink. It can go one way or the other. We want to look at ways that we can support South Africa in making sure that they get a handle on this epidemic and that we can work together to make sure that the damage isn't done to South Africa that 's been done to some other countries surrounding South Africa."

The US delegation will visit various sites, including churches and orphanages, as well as villages especially ravaged by AIDS, such as Masaka in southern Uganda. The delegation will also meet with a 70-year old grandmother in Uganda who lost all 11 of her children to AIDS and is now caring for her 35 grandchildren by working at a local farming project. "HIV and AIDS in Africa, and around the world, is not just a health issue it's an economic issue, it's a security issue. So it's an issue for all of civil society, when you look at the impact, particularly on working populations."

Ms Thurman says the delegation's visit to Africa came about as the result of a pledge president Clinton made on World AIDS Day last December, when he announced a 10 million dollar initiative to study what can be done to help children who have been orphaned because of AIDS.

Source: Voice of America

"Mother to Child Transmission Working Group (MTCT New Bulletin 1: January, 1999)"
Health-L, March 26, 1999

The Zambian HIV Mother to Child Transmission (MTCT) Working Group evolved from a meeting held on the 30th July, 998 involving various stakeholders and scientists. This meeting was to reach a consensus for the establishment of a permanent working group, was to inform participants on work conducted in Zambia on HIV Voluntary Counseling and Testing (VCT) in antenatal clinics, and was to discuss up coming HIVNET MTCT clinical trials aimed at reducing MTCT of HIV. It was hoped that future collaboration with an established MTCT working group would:

• Increase awareness among Zambians on issues arising from on-going HIV MTCT research both globally and nationally
• Improve the efficient use of available resources
• Define the national research agenda for MTCT research, including interventions

The Ministry of Health (MOH) endorsed the formation of the MTCT Working Group and group members were appointed by the Minister of Health, in August, 1998. Terms of reference for the working group include:

• To act as an advisory body, for the Central Board of Health to the government, through the Ministry of Health, in all matters pertaining to preventing and mitigating HIV MTCT in Zambia.
• To actively advocate for the development of appropriate policy and strategies responses by the Government (through the Ministry of Health, Central Board of Health and other organs) in order to reduce HIV MTCT consistent with the political, economic, and social and cultural context in Zambia.
• To identify, in collaboration with local and international institutions, prioritize research in the field of HIV MTCT and identify as well as support urgent interventions that reduce HIV MTCT.
• To coordinate and provide liaison about ongoing and future research and interventions in relation to HIV MTCT. Additionally, the MTCT working group will provide scientifically and technically accurate information on HIV MTCT to the National HIV/AIDS Research Committee and any other Research and Ethics Committees that may be institution-based which require this information in assessing proposals for research.
• To collate and disseminate up-to-date and scientifically accurate information on HIV MTCT. This entails keeping abreast with new global thinking and interpreting this within the context and realities that prevail in Zambia.
• To foster the establishment of local, national and international networks that address issues of HIV MTCT in liaison and consultation with the Ministry of Health, Central Board of Health, the National AIDS Council and Secretariat and any other relevant institutions.
• To be pro-active in identifying actual and potential sources of funding (local and external) for HIV MTCT research and interventions and to advise groups seeking such assistance of the availability of such support.
• To constantly review and advise Government on research and implementation strategies in preventing HIV transmission in the light of technological, scientific and pharmaceutical advances consistent with regional and country priorities.

Soon after members were appointed, the MTCT working group held their first meeting. At this meeting the group agreed to hold a one-day retreat at Lilayi Lodge in Lusaka for the group whose objectives were:

• To disseminate the most current information related to the Zambian MTCT situation, to the MTCT members in order for them to have a better understanding of the issues around MTCT
• To discuss the relevance of HIV MTCT global responses to the Africa and more specifically Zambian
• To present and discuss terms of reference and a work plan for the MTCT working group.

In order to achieve the above objectives, the following were the main discussion topics:

• Overviews of HIV MTCT
• The Zambian HIV situation with special emphasis of MTCT
• Facts on MTCT
• Strategies and responses to HIV MTCT
• MTCT drug trials
• Relevance of global interventions in the African context
• Breast-feeding guidelines from WHO, UNICEF, and UNAIDS
• Alternatives to breast-feeding
• Care for mothers and children

Conclusion:
The group achieved its main objectives of understanding the issues around MTCT. The magnitude of the problem and some of the solutions for Zambia were identified. The group also reaffirmed its full commitment to advocating for feasible solutions.

The following resolutions were adopted:

• The MTCT working group will be chaired by Dr Chewe Luo, Consultant Paediatrician, at Department of Paediatrics and Child health at UTH Board;
• The meeting agreed on monthly meetings to start in December;
• The groups terms of reference and the work plan was adopted;
• Membership to the working group includes:
  • Dr P. McDermot UNICEF
  • Dr E. Chomba UTH
  • Prof. GJ Bhat UTH
  • Dr G. Silwamba CBoH
  • Dr. C. Osborne CorpMed
  • Prof. A Haworth Chainama Counseling Services
  • Dr S. Mpuka CMAZ
  • Dr. C. Kaseba UTH
  • Dr. G Shakankale UTH
  • Mr D. Chipanta UTH
  • Dr. P. Matondo UTH
  • Dr. C. Luo UTH
  • Prof. C. Chintu UTH
  • Dr. D. Mulenga UNICEF
  • Dr. D. Phiri CBoH
  • Mrs M.K Chintu NFNC
  • Dr S. Weinreich Kara
  • Dr. Y. Ahmed UTH
  • Dr Walloch Nkana Hospital
  • Kimura UTH
  • Dr. M. Sichone NASTLP
  
  
• UNFPA, UNAIDS and USAID were also included to the membership. From the main committee, four working groups and their chairs were identified. These agreed on addressing particular project areas as follows:
  
  • Public Health/Advocacy - Dr C. Osborne
  • Community networks - Dr S. Mpuka
  • Care of the mother - Dr C. Kaseba
  • Care of the child - Dr Z. Munkumbwa
• The MTCT working group also adopted the UNAIDS MTCT Initiative for developing countries and committed to urgently write up a proposal to UNICEF.

For more information contact:

Chipo M. Mwela
MTCT
c/o Department of Paediatric and Child Health
University Teaching Hospital
Box RW1
Tel: 252118
Lusaka,Zambia

"Media Can Help Reduce HIV Spread." By Mildred Mpundu
Times of Zambia, March 26, 1999

Of the estimated 1.02m people infected with HIV in Zambia, only 10 per cent of these actually progressed from HIV to AIDS. Most did not know they were infected, and many had no symptoms at all. But almost all will develop AIDS and die within the next 10 years or so according to HIV/AIDS in Zambia: Background, projections, Impacts and interventions 1997 report by the Ministry of Health and Central Board of Health.

The report states that actual AIDS cases are only the tip of the pyramid accounting for 10 per cent, while those infected with HIV but have not yet developed AIDS account for 90 per cent. And yet there is no cure. All there is are a combination of drugs known as combination therapy or drug "cocktails" which inhibit the spread of HIV within a persons body. This is a good thing, but there are disadvantages to it. Firstly, they are costly. Winston Zulu, chairman of Network of Zambian People Living with HIV/AIDS (NZP+) is on a $ 1,500 (almost K3.5m ) per month combination. This means that Winstone spends $18,000 per year apart from other medical expenses. How many people living with AIDS can afford that? The Zambian Government spends less than $10 per person per year for all health services.

"Apart from being expensive the time to take these medicines are difficult, the side effects are unpredictable though my life has improved and even better and I am still alive," said Winston. The HIV/AIDS in Zambia report says that HIV spreads through mutation and a mutant variety that evolves in response to the "cocktails" could be even deadlier than the current virus. - It says there are several considerations to be taken into account; - Most treatments for HIV/AIDS are still experimental, and the long-term effectiveness is unknown. Failure rates are high. - It is also unclear whether an immune system already damaged by the AIDS virus can ever be restored to normal. - Many patients cannot tolerate the side effects of the drugs and for them the combination therapy treatment are useless. - Patients need to start treatment soon after becoming infected. Most newly infected persons do not realise they are HIV-positive in time to use this approach. - The drugs - from 20 up to 60 pills a day or from 7,000 to 21,000 a year! have to be taken under the strictest regimen, including time of day and with meals or on an empty stomach.

Even small variations from the prescribed pattern can render the treatment ineffective. Patients also need constant access to sophisticated medical laboratories to track viral counts in the body. Though highly expensive an experiment even for developed countries new combination drugs create hope for the future. The treatment treats opportunistic infections that develop because of the weakened immune system. Research on vaccines continues around the world. But scientists believe that these vaccines are not likely to be ready for at least the next five or ten years. And when the vaccines are finally available there will be problems in producing large quantities and delivering the vaccine to a large number of people. "Neither drugs nor vaccines will likely reduce the heterosexual spread of HIV in Zambia in the next several years." Much has been done to prevent and control HIV/AIDS through the National AIDS/STD/TB and Leprosy Programme (NASTLP) and other organisations. Much still needs to be done to address this serious pandemic.

Among the questions being asked for strategic planning is who should be involved and what should they do? One area that should play a role is the media. "There are many things happening (good and bad) and we are at the mercy of the media to keep in touch with what is going on," said Winston at a NZP+ AIDS and the media workshop held in Lusaka recently. He said the media can help change perceptions and attitudes; it can help change behaviour for those who are serious about not getting infected. There is little that can be achieved in this area without the active participation of the media. The workshop was aimed at producing results that would help reduce infections and improve the quality of life of those living with the disease.

Officially opening the workshop, Information Minister Newstead Zimba said the media played a critical role and is the best weapon with which to fight the HIV/AIDS pandemic. "Its ability to reach a wider population of our society including people who cannot read or write, especially for radio, makes the media a far superior weapon than any other with which to fight the spread of HIV/AIDS. The success of other methods to fight the scourge is dependent on the media," he said. The media has a social responsibility to work hard and bring a social mobilisation. Among the issues raised during the workshop was the negative attitudes portrayed by the media in their coverage of HIV/AIDS related issues. The choice of words used in articles is important in avoiding reinforcing prejudice and to clarify essential issues of human rights and dignity which are so often early casualties of the epidemic. The UNDP HIV language policy to use such words as "person with HIV" and not "person with AIDS" or "person living with AIDS" and not "HIV-Infected" unless it is used to describe the medical conditions which conform to the current case definition of clinical diseases.

Terms such as "full-blown AIDS' and "pre-AIDS condition" are inaccurate. Words encouraged are "us" and not "them" as all of us are living within the epidemic. "Living in poverty" and not "poverty stricken," "children living in families affected by "HIV" not "orphans," "AIDS orphans" or "children orphaned by AIDS." The Lusaka NZP AIDS and the media workshop resolved that there was need to sensitise the media in order to influence attitudes. There is need for the media to have access to HIV/AIDS activists, experts for effective coverage of the pandemic. That there is need for the media to adhere to professional ethics to ensure positive coverage; The need for media to use positive language terminologies acceptable to all people; Need for the media to be mindful of legal; implications when reporting on HIV/AIDS; Need for specialised reporting on HIV/AIDS and other health issues.

Lastly, it was resolved that there was need for the creation of a HIV/AIDS database by stakeholders for media use. Yes, the media could help educate the public and help change behavioural change and reduce the number of HIV infections. Those living with HIV/AIDS need compassion, care and support. Stigmatising and discriminating them is not the right thing to do.

"New Book and Video on 'Volunteers in Home Care for People with HIV/AIDS'"
Health-L, March 23, 1999

A new book and video in the Strategies for Hope Series, published by ActionAid, will be launched in Ndola, Zambia, on 23 March. These materials, entitled Under the Mupundu Tree, describe how community volunteers play a front-line role in tuberculosis control and home care for people with HIV/AIDS in some of Zambia's poorest urban areas. The book and video demonstrate how TB control and home care for people with HIV/AIDS can have a powerful and mutually reinforcing impact.

Zambia, like most other countries in sub-Saharan Africa, faces the daunting challenge of addressing the needs of huge numbers of people affected by the dual epidemic of TB and HIV/AIDS. Their needs are not only for medical and nursing care, but also for material, social, psychological and spiritual support. The 'home care' strategy takes a comprehensive approach to the needs of individuals, families and communities affected by the dual epidemic.

Under the Mupundu Tree describes how, in 23 low-income urban communities in Zambia's Copperbelt, the Health Department of the Catholic Diocese of Ndola has achieved high cure rates for TB treatment, at reasonable cost, within a home care programme for people with TB and HIV/AIDS. The key to the success of this programme is the role played by over 500 volunteers -mostly women- who are supported by community nurses and backed up by hospital services. The book and video depict the work of those volunteers -the people 'under the mupundu tree'- who understand the problems caused by HIV/AIDS and TB because they encounter them in their own families, and with their neighbours and friends, every day of their lives.

Under the Mupundu Tree will be extremely useful to health and development workers in Zambia -and many other countries, not only in sub-Saharan Africa- where volunteers are a potentially precious asset in community-based efforts to cope with the devastating impact of HIV/AIDS and TB. The book and the accompanying video depict their day-to-day activities, explore their motivation and examine how they cope with the problems they face. "One of the strengths of the Strategies for Hope Series is the inclusion of personal stories of people involved in AIDS work, which in this case illustrate how caring people can be..."- AIDS Analysis Africa, Vol. 9, No. 5, Feb/March 1999.

Under the Mupundu Tree is distributed by Teaching-aids at Low Cost (TALC). The price of the book is 3.50 Pound Sterling (including postage and packing worldwide). Free copies of the materials are available to organisations in sub-Saharan Africa that are unable to purchase them. Editions of the materials in Bemba and Nyanja are in preparation. Distribution addresses:

TALC, P.O. Box 49,
St Albans, Herts AL1 5TX, U.K.
Fax: (44) 1727 846852
E-mail: talcuk@btinternet.com

Catholic Diocese of Ndola (Bemba and Nyanja materials only)
Health Department, Box 70244,
Ndola, Zambia.
Phone: (02) 613146.
Fax (Office hours only): (02) 615884.
E-mail: healdept@zamnet.zm

"AIDS Patients Challenged."
Times of Zambia, March 23, 1999

An HIV positive psychosocial counsellor in Livingstone has challenged people with HIV/AIDS in the city to come out in the open for help to lengthen their lives through counselling and proper medical advice. Speaking to the Zambia News Agency (Zana) in Livingstone Jethro Muchindu, 40 a person living positively with HIV who lost his wife in 1993, challenged people with HIV/AIDS in Livingstone to come out in the open in order to benefit and live longer as they would be assisted to improve on their health.

"I challenge all those living with HIV/AIDS to come out in the open and take advantage of the recently established voluntary counselling and testing services being offered at Maramba and Dambwa central clinics, Sepo drop-in centre and Livingstone General Hospital to enable them know their status."

And those found positive can plan for the future of their dependants and can be assisted through proper counselling to live positively. "Once you know your status, you can make choices for things that are good for our health such as stopping drinking beer, smoking and preference for protected sex or abstinence. One becomes well informed and this helps to prolong life for those living positively," Mr Muchindu said.

Mr Muchindu is a member of the Livingstone support group with 14 members who are all HIV positive. He used to work under the liquidated Contract Haulage company and now he works for the United Nations as a volunteer specialist on the new project known as RAF 96/vo1-UNV support to people living with HIV/AIDS based at Livingstone district health management board/Sepo -drop- in -centre. Mr Muchindu was among personalities who organised an HIV/AIDS demonstration campaign with Interfaith (a team made of different religions and churches) for HIV/AIDS awareness today. He spoke at the rally at Livingstone secondary and challenged those living with HIV/AIDS to come out in the open and reinforce their efforts to scale down the HIV/AIDS pandemic in Livingstone.

Mr Muchindu's group has so far helped Livingstone support group for people living with HIV/AIDS to compile their constitution and had it registered. Mr Muchindu is now visiting Maramba clients giving his own experiences in an effort to form another support group to help others living with the HIV virus but are still hiding.

"HIV/AIDS Still Lacks Distinct Concern." By Chris Mumba
The Daily Mail, March 22, 1999

Publishing statistics on the number of people infected with the HIV virus is important, but it tells us only part of the story. What the numbers fail to disclose are the human elements of this epidemic - individuals getting sick, being absent from work or leaving behind young children for grandparents to look after.

The impact of the HIV/AIDS epidemic permeates every sector of society, yet it continues to be perceived as an issue solely for the health sector, rarely capturing the same fervor with politicians and company directors as the current levels of crime and violence. Perhaps part of the problem is that people do not believe AIDS exists because they do not see it. This invisibility of AIDS is in part due to the stigma attached to people living with HIV/AIDS.

There are countless stories of people being harassed and dismissed because of their HIV status - domestic workers being sacked because of the perceived risk to children and the office workers who is isolated and told to use only the phone in her office. Society openly offers care and support in cancer patients and those with diarrhoea or heart disease, but when it comes to HIV/AIDS there is a distinct lack of compassion. With such a hostile environment, credit goes to those who have been brave enough to "come out" and disclose their status, helping the fight against AIDS by giving this killer condition a human face. People living with HIV infection who openly share their serostatus and experiences do so in an attempt to normalise the disease.

The United Nations, through agencies such as the United Nations Development Programme (UNDP), have launched projects in Zambian, Malawi and South Africa to recruit positive men and women to work in various host institutions, where those with personal experiences with the disease can give the epidemic a human and public face. The project's country coordinator for both Zambia and Malawi, Ethel Kapyepye noted in an interview that the pilot project was also meant to grant economic and psychological empowerment to persons living with HIV/AIDS and their close families.

"We also intend to use the expertise and knowledge of persons living with this epidemic to contribute to the challenges against HIV/AIDS and help mitigate its deadly spread," said Ms Kapyepye. Ten volunteers have so far been recruited and are serving as National United Nations Volunteers (NUNV) on a one-year contract while 10 more will be recruited in May this year. Among the 10 already working as NUNVs is Winston Zulu, 35, the first Zambian to go out in the open that he was infected with HIV in 1990. Martin Chisulo, an outstanding educator and counsellor on HIV/AIDS and Dr Patrick Ngosa, a medical practitioner are also on the list of those working as NUNVs.

A total of 30 volunteers were short-listed for recruitment as NUNVs, out of which four have so far died over the past 10 months while two more have resigned from the programme. The short-listed volunteers have all been trained in areas such as HIV and development, peer counselling, bookkeeping, project proposal writing and project management and communication skills. The courses were offered by UNDP in collaboration with the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the United Nations Volunteers (UNV) programme.

Following are some examples of young women who have been short-listed for recruitment as volunteers on HIV/AIDS and the United Nations pilot project to support people living with this killer disease and who are willing to talk openly about their HIV status. Catherine Nyirenda, 27, a mother of two children and the first woman to "come out" in Zambia in 1991, said: "Coming out was a personal decision to raise awareness about the virus. "I believe it is our fundamental right as women which should not be compromised. We should be given the opportunity to express our views, opinions, feelings and personal experiences freely." The openness of Catherine has been inspirational to other Zambian women to break the silence.

Doreen, a widow and teacher had this to say: "I tested HIV positive in 1995 and after the death of my husband in 1997, I decided to follow in his footsteps as an AIDS Activist."

Linda Shikabonga, another outstanding anti-AIDS woman campaigner believes that the more women who are diagnosed to be HIV positive come out in the open freely to share ideas and discuss their serostatus openly, the lesser would be chances of the transmission of HIV infections among married couples knowingly and maliciously. "Most women, I mean those who are married usually get infected from the promiscuous husbands but though we fall victims to such killer infections, we should bury the past and instead focus more on preventive methods of transmissions and rely on a nutritious diet and positive living to live longer," she adds.

Musa Njoko, a 25-year old South African, shared her personal experiences of being a young woman with a child, living and working for the National Association of People Living with HIV/AIDS in Kwazulu-Natal. Listening to the stories of her Zambian sisters, Musa added: "The time to just think about HIV is over - it's time now for action because if women do not stand up and fight for their children, nobody else will." She encouraged other women to get involved, support one another and speak with one voice so that they can been heard.

Unemployment, the rising cost of living, and political uncertainly are experiences by most of such young women living with this epidemic in the country. Yet despite these personal hardships, people's spirit and bravery continue to bring light and hope to get upon and be counted an HIV positive person. Revealing one's HIV status can be both a personally painful and liberating experience. If more people did so, it would help towards getting acceptance and building a society where differences are recognised, supported and respected.

These positive individuals and others exemplify the inspirational, words from "Alone and Frightened" by the late Ugandan Philly Bongoley Lutaya, an Ugandan singer who died of AIDS in 1991:

"Take the message, across the frontiers
Break the barriers, we will fight together
The Doors are open, we will lead the struggle.
We don't bow down in defeat, we will fight on..."

"Journalists Cautioned Over AIDS Reports."
Times of Zambia, March 22, 1999

Group of journalists and people living with HIV/AIDS during a recent workshop resolved that there was need to be selective with the words and terminologies used in the media when reporting on the HIV/AIDS pandemic to avoid hurting some people.

During the two-day workshop on AIDS and the media, the participants noted that words such as "AIDS victim", "AIDS suffer," "innocent babies" and "AIDS orphans" were in bad taste and should never be used they suggested powerlessness and apportion blame.

It was resolved during the two-day workshop from March 18 to March 19 that there was need for the continued sensitisation of the media personnel to influence their attitudes towards HIV/AIDS and ensure positive coverage of the disease.

"There is need for the media to use positive language, terminologies and words acceptable to all the people. Some words and phrases tend to alienate some people," the participants noted.

It was found out that there was need for the media to have access to HIV/AIDS activities and experts and the creation of an HIV/AIDS data bank for effective coverage of the pandemic. There was also need for the media to adhere to professional ethics and ensure fairness, accuracy and respect for privacy of people living with HIV/AIDS.

It was also resolved that there was need for specialisation among journalists on HIV/AIDS and other health issues for better and consistent coverage. The media should also be mindful of the legal implications when reporting on the pandemic to avoid defaming people or creating social problems for others. The workshop was organised by the Network of Zambian People living with HIV/AIDS (NZP+).

Speaking at the same workshop earlier, NZP+ chairman Winston Zulu said people living with HIV/AIDS were at the mercy of the media. "The media can help change perceptions and attitudes; it can help change behaviour for those who are serious about not getting infected. In short, little can be achieved in this area without active participation of the media," he said.

"Albright Advises Nations to Recognise Impact of AIDS." By Reuben Phiri
The Post, March 19, 1999

With more than 33 million persons infected worldwide, the growing prevalence of HIV/AIDS requires nations to recognise the political and economic security implications of the pandemic, United States Secretary of State Madeleine Albright has said.

According to the latest edition of the Washington Line, Albright said this when she announced the release of a report entitled 1999 US International Response to HIV/AIDS. "We need to focus urgently on the devastating impact of HIV/AIDS as a national and international priority," Albright said.

She explained that as part of a US diplomatic initiative aimed at enhancing the global commitment to combating HIV/AIDS, the 1999 US report calls upon other governments to support a vigorous and sustained response to the disease as priority. The report also underscores the importance of international partnerships to address the pressing challenge of HIV/AIDS.

"To underscore the global battle against HIV/AIDS, the report also identifies the respective roles of the pharmaceutical industry, international Non-Governmental Organisations and International Organisations," said Albright

"WHO Donates to Health Board." By Dickson Jere
The Post, March 19, 1999

The World Health Organisation (WHO) has donated five motor vehicles and office equipment to the Central Board of Health (CBoH) and the Ministry of Health to help in the fight against polio and HIV/AIDS. Making the donation at Ndeke House yesterday, WHO representative Dr. E. T Maganu said the donation was aimed at making the surveillance officers mobile to carry out their planned activities.

"As you may be aware, the goal of polio elimination is targeted at the year 2000 which is just around the corner," Dr. Maganu said. "Therefore, it is of utmost urgency that surveillance officers intensify their efforts to maximise on the short period remaining." He said WHO had supported various organisations involved in activities aimed at either preventing or controlling HIV/AIDS. Dr. Maganu said WHO was now supporting an NGO -network of people living with HIV/AIDS.

"Today, we are pleased to continue our support by handing over a computer, printer, photocopier, fax machine and other accessories to assist them in communication and capacity building," said Dr. Maganu. Health Minister Nkandu Luo received the donation on behalf of her ministry and the CBOH.

"Don't Relent on AIDS Fight, Urges Minister."
Times of Zambia, March 19, 1999

People should guard against laxity in the fight against HIV/AIDS now that its prevalence rates in the country have stabilised, Information and Broadcasting Minister Newstead Zimba has said. And Health Minister Nkandu Luo also called on people living with the disease not to continue living on sympathy. Mr Zimba said yesterday that although the HIV/AIDS prevalence rates had stabilised and even declined among adolescents, such reports should instead spur people to strengthen the fight against the disease.

"This is good news should not, however, make us relax. It should spur us to even double our efforts in the fight against HIV/AIDS. More, in fact, needs to be done towards supporting between 400,000 and 600,000 children orphaned by the HIV/AIDS in Zambia," he said.

He was speaking when he opened a two-day workshop on HIV/AIDS and the media organised by the Network of Zambians Living with HIV/AIDS (NZP) at Kara Thornpark Training Centre. Mr Zimba said the media was the best weapon in the fight against the pandemic because of its ability to reach a wider population including people who could not read or write.

"The success of other methods to fight the scourge is dependent on the media. I wish to add that even if a cure or a vaccine for HIV/AIDS is found, which is possible with the advances researchers are making, information dissemination on the new drugs would still be cardinal to the achievement of positive results," he said.

And when the World Health Organisation (WHO) donated vehicles and equipment worth more than $92,000, Professor Luo urged the network of people living with HIV/AIDS not to continue living on sympathy. Prof Luo challenged the people living with HIV to show comparative advantages to the society and speak about the disease themselves as she was not the right person to talk about the pandemic. "I am giving you one year to show me the difference you have made," she said. She was speaking a the same function.

"Media Has Vital Role in Fight Against AIDS." By Bridget Katebe
The Daily Mail, March 19, 1999

The success of the fight against the AIDS scourge is dependent on the fundamental role of the media, Information and Broadcasting Minister Newstead Zimba said yesterday. Mr Zimba added that the ability to reach a wider population makes the media a superior weapon to fight the spread of HIV/AIDS. Mr Zimba was speaking at the opening of a two day workshop organised by Network of Zambian People Living with HIV/AIDS (NZP+), and funded by the United Nations Development Programme in Lusaka.

He said the choice of the theme for the workshop was very appropriate, because the media had a vital role to play even if a vaccine or cure was found. "Even if a cure or a vaccine for HIV was found, which is very possible with the advances researchers are making, information dissemination on the new drugs would still be cardinal to the achievement of positive results," Mr Zimba said.

The minister acknowledged government's concern about the disease, saying his presence at the workshop showed that the problem was not for the health departments alone, but all institutions, citizens and residents in Zambia. NZP chairman Winstone Zulu said there was need for the HIV/AIDS infected people to come together because organisations were willing to assist HIV positive people.

UNDP representative Margaret Mutambo said her organisation had many other programmes that dealt with the fight against the deadly disease. She said like in many other projects, UNDP was obliged to have a friendly working relationship with NZP+. Ms Mutambo urged the participants to consider with seriousness the importance of such an occasion. She praised the media for their efforts, especially in translating a book by NZP+ launched in March last year.

"HIV/AIDS Book Launched."
Times of Zambia, March 12, 1999

The Network of People living with HIV/AIDS has launched a book on food for people living with the virus to improve and prolong lives of those infected. Copperbelt deputy Permanent Secretary Darius Hakayobe launching the book in Ndola at Chinika House said food provided a medicine that was cheap and easy to get.

Treatment of opportunistic infections resulting from AIDS was expensive and was a considerable strain on the delivery of health services in Zambia. He praised the group for their innovation in coming up with a book that emphasised on nutrition as the beginning of clinical self restoration.

National chairman of people living with AIDS David Chipanta said the book was a brainchild of the African network of people living with HIV/AIDS with the help of the United Nations Development Programme who funded the project. The Zambian chapter reproduced the book to suit the Zambian environment and it has been translated into the seven local languages for it to reach a cross section of society.company's investment in the country.

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Last updated April 2, 1999

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