University of Zambia Medical Library

HIV/AIDS in Zambia: June 1999

"Ignorance, Denial, Fear and Violence: Stigmatisation and Discrimination in African Communities - Zambia."
AF-AIDS, June 30, 1999

Samson Kondwelani (not real name) could not stomach the news that his expectant wife whose health was bad had been diagonised HIV positive. He only believed when the child was born but died soon after. "I was pregnant and did not feel well. I went to the clinic and a blood test was done. I was told to go back to the clinic together with my husband. There the news was broken that I was HIV positive. My husband said it was all lies and told me we were just alright," said Samson's wife. It did not take long Samson got ill too. His wife is also sick although they have been living a positive life since 1993. The couple has only revealed their HIV status to their 20 year old son, close relatives and community based workers from Family Health Trust.

What of the community members around them -do they know? "I don't know, maybe they just guess we are HIV positive. Some people will talk behind your back, others will be supportive. But looking at people's behaviour I can't come out in the open about my situation. I fear that if I open up people will talk too much," said Samson's wife.

Family Health Trust Executive Director and a social worker Mrs Elizabeth Mataka says, "Being HIV positive is considered deviant in African society. There is a general state of helplessness surrounding HIV/AIDS. People know that there is no cure. As a result they tend to deny their situation at a personal level especially that the disease is wrongly seen as bordering on a persons moral character. Initially there is an anger - why me? Then the negotiation with God for another chance and the despair of having no cure. All these result into violence. It is important to counsel before testing to avert violence."

Women are more subjected to violence. The Zambian experience shows that if a woman is diagnosed first, they risk being thrown away by their husbands. This happens when one partner is negative and the other positive. Often men think they cannot get the HIV virus.

However, having observed the epidemic in the last 10 years, Mrs Mataka notes a normalisation of the disease. She says stigmatization was high a decade ago, but with education, and as the disease grew a realisation that the epidemic affected everyone dawned on people.

"It's no longer a mysterious obscure kind of illness. Everyone's life has been touched by AIDS. Everyone has seen the face of AIDS," says Mrs Mataka. Now, people are forced into situations where they need other people's help. In other words, if stigmatization really existed, community based care programmes would not exist. Mrs Mataka believes that Home Based Care approaches -- visiting the sick and attending funerals -- are an indication of people's support.

Even at most work places, the HIV status of a person seeking employment is irrelevant. Family Health Trust believes people living with HIV/AIDS are entitled to work as long as they can. "Employers must make adjustments to work contents of the employee and make available counselling services within the work place or transfer to organisations doing counselling." A person living with HIV should be encouraged to train and develop their career.

Personal behaviour like eating and drinking habits, exercise, sexual lifestyles and seeking appropriate medical intervention at the right time without delay can contribute to the delay of the onset of AIDS. It is possible to enjoy quality life with HIV/AIDS. To encourage this, support groups have been formed in Zambia's townships.

Lusaka's Bauleni Self-Help Women's Support group was formed in 1998 to enable women living with HIV/AIDS share their experiences and give each other emotional and financial support. Catherine Nyirenda, Chairperson of the group says at the moment people are afraid of coming out in the open. They do not know what society will think of them. She says people can discuss within the family but not outside. "Initially I had problems because the women thought I wanted them to go public the way I have done. They wanted to understand the idea of coming together. So they were closed up until after intensive counselling," Catherine says.

Martin Chisulo is Programme Coordinator for People Living with HIV/AIDS on the Copperbelt working with the Health Education Project(CHEP) and looks after five support groups. He does sensitisation to remove stigmatization. Initially his members were discriminated but this has reduced. About 70 per cent of people on the Copperbelt are knowledgeable about AIDS. Thirty (30) per cent are still doubtful about whether AIDS is real because of the healthy looking appearance of people living with HIV/AIDS.

"Who Will Deliver the Military from High AIDS Figures." By Masautso Chipako
Times of Zambia, June 26, 1999

It might have come as a surprise for many, that AIDS figures in our defence forces are alarmingly high and therefore cannot be disclosed. This was said at a recent youth AIDS seminar. It is sad and the frequency of the plague-bite in the military sometimes shows at grave yards or just Maina Soko military hospital. And tragically to hide or withhold statistics is not a solution enough.

But what can be done to stop the scourge? For many, who are well-acquainted with the morality or lack of it among some, not all, of our servicemen, this was just a case of calling a spade a spade at a recent AIDS seminar. Our recent investigation revealed an almost official sanction of soliciting among servicemen, especially one unit of the country's defence forces. In the secrecy of night, some military vehicles can be seen in the city's major red light districts. Not only are there pool 4x4 Land Rovers and Land Cruisers with their high sky reaching radio communications antennae, but also a presence of posh vehicles driven by the military's top brass. Along the Church road and Suez road junction, it is not uncommon to notice a continuous flow of military traffic and servicemen soliciting; haggling with the prostitutes. And similar is the case at the gates of a nearby hotel.

What would be odd is the absence of these military transport on any given day, agree most pirate taxi drivers who operate at the Lusaka Play House car park at night. The taxi drivers say that the servicemen frequent this area with intensity, and it would not be surprising at all that high AIDS figures among the defenders of our borders have been recorded. It is not only this area set so close to the Cathedral of the Holy Cross, whose shadows are sometimes used for cover, that the servicemen are patronising.

A tour of the road that connects Church and Parirenyatwa roads, on which sits Fairview Hotel recently, revealed just how much the HIV might be eating away the core defences of the defence forces. On this night, three military Land Rovers were found parked by the road side, and the soldiers negotiating with the seemingly unco-operative prostitutes. Just round the corner, on Parirenyatwa, an official military Peugeot was also seen parked and the driver haggling with a sex worker clad in tight fitting body suit, accentuating her every bumps and grinds. And not long afterwards, some 20 minutes later, some soldiers were noticed coming back from some dark wall fence confines and some having managed to negotiate, were headed for the same dark corners.

A pirate taxi driver, who operates from the hotel called on Government to intensify AIDS awareness campaigns in the barracks "otherwise, they will not defend us in case of any instability as they will be too weak from AIDS." As there are no statistics to refer to, it can only be assumed that the number of infected soldiers is too high. This must be a source for all concerned, as a weak army cannot defend the country; its inhabitants nor its sovereignty.

Another taxi driver said that he had initially thought the soldiers were on security missions in light of the bombs that had rocked Lusaka a few months ago. The 15-years on the road driver said this view was, however, changed when he noticed the military vehicles parked along the small road. "I thought they were on operations of a security nature and yet they are actually on these despicable 'missions'. Aren't these people taught discipline?" wondered the driver. It's a question for some careless folks in the military to answer. Or else they will keep failing to account for high AIDS figures in the military. We are in this together and this is a call for abstinence for we can no longer wink at the rapid loss of loved ones in the military. It's time for military personnel to care how they live.

To live responsible lives. It was time the military people did all they could to avert the rapid succession of deaths. Flee all youthful lusts! That's the answer because they have loved ones to care for.

"Sub-Saharan Economies Affected by HIV/AIDS." By Joe Kaunda
The Post, June 29, 1999

AIDS and HIV related illnesses have cost sub-Saharan African nations a large part of their economic future, United States deputy commerce secretary Richard Mallet has observed.

Mallet, briefing the press on his coming trip to Nigeria and the Economic Summit in South Africa next month, said there was need for the business sector to get involved in campaigns against the spread of AIDS. He said a lot of progress had been made in resolving difficulties between US pharmaceutical companies and African nations with high incidence of AIDS.

He said the main problem identified was that US companies were fearing for their patent rights of AIDS drugs in Africa after spending large sums on their research and development.

"We have been in dialogue with pharmaceutical companies, one biggest problem we face is that of patent protection," Mallet said. He said the US government was exploring how best to involve businesses in the campaign against AIDS by providing high level health and safety for their workers through education and prevention.

Mallet said the commerce department was trying to induce US companies to invest in Southern Africa on condition that the Africans provide a viable market atmosphere to attain economic success.

"One way to accomplish this is by encouraging democratic and economic reforms through independent courts, fair and open government procurement, product patent security, lower trade tariffs and privatisation opportunities," Mallet said.

He said the US government fully supported regional unified African markets such as Economic Community for West African States and the Southern African Development Community.

"Luo Criticizes HIV/AIDS Coverage." By Douglas Hampande
The Post, June 24, 1999

Health minister Nkandu Luo yesterday accused the Zambian press of costing the country donor funding for AIDS/HIV projects. Luo said the Zambian press does not understand the importance of public relations in crucial national programmes like AIDS/HIV and as a result reported carelessly on the implementation of such projects. She said because of this negative reporting donors were discouraged from fully releasing funds for fighting AIDS in Zambia.

"The Ugandan media has one of the best public relations tactics around. They will tell you how successful their government has been in containing AIDS even when it is not really so," Luo said. "I was in Uganda sometime back but the only AIDS thing I saw was the Uganda Aids Commission. In Zambia we are better off because if you go to Mtendere compound you'll find some anti-AIDS groups." Luo thinks there's something wrong with Zambia as a nation. "One day we'll all find ourselves buried at Leopards Hill Cemetery because of the insensitivity of a few individuals," Luo warned.

She said it was the responsibility of all Zambians to build the nation through avoiding negative remarks. "The press can build or destroy. In Zambia it has done more destruction than building when it comes to AIDS related matters," Luo said. "The press should set a good agenda for the nation regarding AIDS issues."

"Editorial Comment - AIDS Lies."
The Post, June 24, 1999

We agree with health minister Nkandu Luo that there is something wrong with Zambia as a nation, especially its political leadership. We also agree with her very timely warning that "one day we'll all find ourselves buried at Leopards Hill Cemetery because of the insensitivity of a few individuals". But we don't agree with her observation that the Zambian press is costing the country donor funding for AIDS/HIV projects because of its negative reporting which was discouraging donors from fully releasing funds for fighting AIDS in the country.

We would, however, have no problems in accepting criticism if Luo's criticism was about the inadequacy or shallowness of our coverage AIDS/HIV issues. We cannot claim to possess the sum total of human knowledge on AIDS/HIV coverage. And in recognition of this deficiency in our work on this very important issue, in conjunction with other institutions, we have organised and attended workshops and seminars to raise our understanding of AIDS/HIV and how to best report and comment on it. In our view, this is one issue almost all Zambian media institutions have covered with no sensation, or very little if any. We can only give what we have. And after all we have lost many of our own professional colleagues and family members and many of our friends may not see the year 2000 as a result of AIDS.

President Frederick Chiluba's cabinet is equally affected, if not worse. We have lost many politicians through AIDS since 1991 and some are surviving only because they can afford the US $1,000 required for drugs monthly just to remain alive. AIDS/HIV is a tangible reality that no Zambian can today ignore or should insult others for. We have deliberately avoided even criticising what we feel has been a very poor approach to the AIDS/HIV problem by our government - especially cabinet ministers, including President Chiluba. A look at what our government has allocated to the AIDS/HIV fight in this year's budget clearly reveals this irresponsibility. And how much has President Chiluba contributed to the fight against AIDS from his presidential discretionary fund as compared to other things he has more than generously 'donated' to?

While we may not be competent to speak on behalf of Ugandan journalists, we are not public relations officers of anybody or anything - as Luo would like us to be. Our duty is to report truthfully and ensure that we provide citizens with as many facts and opinions on AIDS as we possibly can. We will not report, as Luo tends to suggest, untruthfully about the problems of our country just to get money from donors. Our duty is not only to our country and its people but to the entire humanity in its diversity and complexity. And this includes donors - whether we agree with them or not. We don't want to be like the Ugandan press that Luo accuses of exaggerating the achievements of its government in combating AIDS when what is on the ground is different.

Moreover, we don't believe the battle against AIDS/HIV should be looked at in such a narrow-minded and chauvinistic way. The achievements of Uganda in combating AIDS/HIV, if real, do not belong to the Ugandan people alone, they belong to all humanity as AIDS knows no borders. The battle against AIDS/HIV is not about simply getting donor money through cheap public relations or lies, it is about preservation of human life. We, however, know that the AIDS/HIV campaign is proving to be a very good business for some people, especially with the forthcoming September AIDS conference in Lusaka - whose financial scandals may soon emerge.

Nobody is likely to benefit from the approach Luo is advocating - not the country, not the patients or donors. It is a prescription for pouring more and more money into a bottomless pit, to no effect. There can be no substitute for honest and constructive criticism or highlighting of programmes that do not work. Too much is at stake. HIV/AIDS has cost this country dearly. We agree with Luo that there is need for more international assistance to contain the pandemic. But it should be well targeted assistance to well managed programmes.

"Thousands of Zambian Babies Born with HIV." By Douglas Hampande
The Post, June 24, 1999

Thousands of Zambian babies are born infected with the Human Immunodeficiency Virus (HIV) that causes the deadly Acquired Immuno Deficiency Syndrome (AIDS), disclosed United Nations Children's Fund (UNICEF) representative Peter McDermott yesterday. According to McDermott, these children have a five to six years life expectancy thus creating more social problems for a developing country like Zambia.

Addressing a Mother To Child Transmission (MTCT) of HIV Initiative in Lusaka, McDermott said, this puts the country among the world's worst affected in this regard. He warned that if not checked the problem would eat up the nation's political, and socio-economic fabric. "We should not underestimate what this problem can do to a country. Unless something serious is done, urgently, HIV/AIDS will affect the country in all spheres of life," McDermott warned. He said African and other developing countries should not feel discouraged from fighting the disease because of its scarce financial resources.

Citing polio as an example of a disease now contained in most countries, McDermott said the same determination used in vanquishing the disease should be employed in overcoming AIDS. "People thought Africa could not control polio because of its scarce resources but with zeal the third world has proved the world wrong. Even AIDS can be controlled if we unite and put all we have in the fight against this problem," he said. "It's expensive, there are no resources, people will say. But Zambia is an excellent example of how polio has been contained despite the earlier pessimism when the campaign against it started."

MTCT-HIV co-ordinating team member Dr. Chewe Luo said three sites have been opened countrywide to identify HIV positive expectant mothers so they can be injected with an anti-AIDS viral to prevent transmission of the disease on to their babies. "We'll start with 10,000 expectant mothers and then reduce to 3,000 whom we'll use as a sample for this project," she said. Dr. Luo said Zambia would use US $400,000 from the Turner Foundation in the United States to implement its MTCT-HIV programme.

"Drugs Firms to Exhibit During XI-ICASA Meeting." By Chitalu Kalunga
The Daily Mail, June 19, 1999

International pharmaceutical companies would exhibit their products during the XI-ICASA conference on AIDS and STDs which Zambia would be hosting this September. Deputy coordinator Simon Mphuka told the Mail that over 18 international pharmaceutical companies were expected to exhibit products they had to offer in the fight and control of AIDS. Dr Mphuka named Glucowelcome, Blonal, and Roche as some of the big international pharmaceutical companies that would exhibit during the conference.

He also said over 26 international organisations had shown interest in facilitating meetings during the same period of the conference and the request was being considered. "These meetings will take place in venues we are looking for and these 'satellite' meetings will be mostly outside the conference programme," he said. Dr Mphuka further said the meetings to be facilitated by interested organisations like UNAIDS and PANOS Institute would be attended by the conference participants.

Meanwhile, ICASA secretariat is considering to sponsor at least 250 participants to the conference. And the deputy coordinator said a media centre would be set up within Mulungushi International Conference Centre where the meeting would be held.

"Tembo advises African states to fight HIV/AIDS." By Amos Malupenga
The Post, June 16, 1999

Vice-President Christon Tembo has urged African governments to provide better and more effective leadership in the fight against HIV/AIDS. He was speaking on Tuesday night at Lusaka's Hotel Intercontinental at a dinner he hosted for the International Steering Committee of the Eleventh International Conference on Aids and STDs in Africa (ICASA). He said African governments should begin to commit more resources as a concrete expression of their political will and commitment to a more meaningful and concerted response to the AIDS epidemic.

"With better collaboration and consultations, I am confident that we all can do better to address this epidemic even in the face of the economic downturn and fiscal difficulties that continue to confront us on the African continent," the Vice-President said. "A 1996 study conducted by UNAIDS found that just over US$ 140 million was reported as having been spent on AIDS prevention by 25 African countries that were surveyed and that out of this amount under 10 per cent came from national governments."

Ministry of Health permanent secretary Dr. Kashiba Bulaya said problems of HIV/AIDS could not be handled single handedly but required collective efforts of all nations in the world. He said there was therefore need to fight the AIDS problem across the boundary "because the virus knows no boundaries."

" Plough More Resources in AIDS Fight."
Times of Zambia, June 16, 1999

President Chiluba yesterday called for more resources to fight Aids as delegates to the 11th International Conference on Aids and STDs in Africa (ICASA) have hailed Zambia for exhibiting political goodwill by hosting an international Aids conference. The delegates were cheered by the country's commitment shown through the hosting of the first ever international aids conference in the Southern African Development Community (SADC) region.

United Nations Aids (UNAIDS) director of policy, strategy and research Awa Coll-Seck said praised Zambia at a reception hosted to welcome delegates of the international steering committee of the eleventh International Conference on Aids and STDs (ICASA) in Lusaka on Monday night. Dr Coll-Seck said the country had scored a first the world over for exhibiting massive political willpower to host the conference. She said international organisations were pleased with the country's political drive and commitment towards hosting the ICASA conference scheduled for September this year. She hoped that the conference aimed at seeking ways of finding solutions to the Aids epidemic would be a success.

"We are grateful to see the high political commitment towards the hosting of the conference," Dr Coll-Seck said. And President Chiluba in a speech read for him by Vice-President Christon Tembo attributed the high prevalent levels of Aids in Africa to fewer resources committed to fight the scourge. He said there was an urgent need by all governments on the continent to marshal both political will and resources to effectively fight Aids. Mr Chiluba noted that African governments would sufficiently tackle Aids even under economic turmoil if they worked together. Africa should engage in a introspection process to identify strengths, weaknesses and opportunities to prevent the further spreading of HIV and Aids. "Resources available to respond to the epidemic on the African continent have remained marginal."

This scenario calls for Africa to provide better and more effective leadership in the fights against HIV/Aids. He also appealed for more educational campaigns among people at the grassroots to combat the infection of HIV/Aids-related diseases. Earlier Health Minister Nkandu Luo urged Africans to help change the poor projection of Aids cases on the continent by the West. Prof Luo said the conference would seek solutions to the Aids scourge and called on individuals to change their negative perspective on HIV-related issues.

"African Child Day Offers New Hope for Orphans, Street Kids." By Amos Chanda
The Daily Mail, June 16, 1999

Today, there is a summit with a difference which President Chiluba will host. Away from summits for warring factions, this is a peace summit for children. It is intended to raise public concern for the vulnerable children. Under the appropriately drawn theme "Voices of orphans and street children on their plight" children hope the President will hear their voices and lead a lobby to improve their lot as they commemorate the day of the African child, marked every June 16.

The 1999 Children's Summit comes at a time when government and service organisations are seeking to work out what they call a "permanent solution" to the problem of street children. Government has announced that it would take definitive measures to control the growing problem of street children, an exercise government bureaucrats say would include all stakeholders to avoid friction and overlapping of functions in implementation. As opposed to numerous other commemorations, the "Day of the African Child" is a solemn one, both in reality and origin. The reality is that many children are in distress on the streets. The genesis of the commemoration is a horrendous act by the racist regime of South Africa which massacred school children who revolted against the iron rule of the imperial powers. This was on June 16, 1976. To silence the uprising, authorities thought it appropriate to kill children. The civilised world was appalled and under the Organisation of African Unity (OAU), African fathers declared June 16 as the day to remember the departed souls of young people who perished in the incursion. At different times, countries have acceded to the declaration and started to observe the day, as a moral obligation.

On June 16, national governments which acceded to the declaration are expected to pay special attention to children's views. The children on the other hand are expected to speak out on their welfare while leaders take note and hopefully act. Governments, the philosophy of the declaration says, are supposed to reflect on the needs and rights of children.

Zambia began to observe the day of the African child in 1991 and in 1994, President Chiluba thought it fit to expand the commemoration in the form of a summit for children. At a consultative meeting held at Mulungushi on Monday, representatives of street kids, service organisations and government agreed to develop a closely-knit network to reduce the problem of street kids. Last month, Community Development and Social Welfare Minister Dawson Lupunga announced that government would continue to repatriate street kids to their home villages where they would be engaged in farming.

Mr Lupunga said although some street kids had no parents, many of them were still in the custody of their mothers and fathers. They only "migrated" to the streets because of economic deprivation. Even before the summit opens at the Mulungushi Conference Centre today, the voice of the street kids is already clear. Their problems are so evident for everybody to see. The cry of the street kids evolves around lack of food, shelter, broken family, a bleak future, disease... the voice of a street kid is as loud as that. How does a country with reduced social sector investment help street kids? This should be the voice of stakeholders who began consultations on June 11 to discuss the woes of orphans and street children.

From Monday to only yesterday, 36 orphans and street children held a mini-summit to ponder ways out of their dilemma. Children will march from the Lusaka town centre to Mulungushi Conference Centre where they are expected to present their resolutions to President Chiluba. The summit will seek to lobby for increased participation by government and non-governmental organisations (NGOs) in addressing the issues of street kids and orphans. "This year Government realises that the plight of street children is of paramount importance and it was out of this recognition that the authorities are trying to uplift their welfare," acting director of the Department of Child Affairs at the Ministry of Sport, Youth and Child Development, John Zulu said.

The "Day of the African Child" has over the years gone beyond the commemoration of the 1976 Soweto massacre and now includes more critical issues of child welfare, whether in distress or not. "Children are the most delicate category of human beings and their welfare determines the future of any nation," Mr Zulu said. It is for this reason that President Chiluba pays special attention to them by elevating the commemoration. In 1994, the day was commemorated in grand style.

A children's summit under the theme "Hope for Africa, let the children speak" was held. From 1994 to date, "The Day of the African Child" has been observed on the lines of a summit and the commemoration has been gaining momentum. The general aims of the national children's summit include offering an opportunity to children to share views on their rights and needs; ensuring public awareness on the needs and rights of children and above providing an opportunity for children to speak directly to the president.

Lessons to be learnt from the presentations would be drafted into an action programme designed to increase government and NGOs' participation in addressing the issues of street children and orphans. The "Day of the African Child" has over the years gone beyond the commemoration of the 1976 Soweto massacre and now includes more critical issues of child welfare, whether in distress or not. "Children are the most delicate category of human beings and their welfare determines the future of any nation," Mr Zulu said.

It is for this reason that President Chiluba pays special attention to them by elevating the commemoration. Humanitarian organisations dealing with street children in Zambia are worried that the ever increasing number of street children was posing a monumental social crisis which threatens the future of millions of children - and of the nation. They are particularly concerned with the fact that behind the colourful commemoration of the "Day of the African Child" today, an estimated 70,000 street children are in anguish in Zambia and remain separated from acceptable living standards. The voice of the average African child, particularly orphans and street children, is squeaking with pain. Their plight needs to be addressed.

"HIV Counselling: The African Context." By Mildred Mpundu
ZIMA Press Resource Center, June 15, 1999

In most African societies, rarely do individuals go for HIV/AIDS testing of there own free will. They do so only when required to travel overseas or when getting into employment. AIDS came with a stigma - It was until recently linked to promiscuity and homosexuality. AIDS is also associated with death.

As a result knowing one is HIV seropositive can be an extremely traumatic experience. Passing through stages of denial, coping with acceptance of ones status, guilt, anger and depression. "It's like the world has passed a death sentence on you when you have tested for HIV/AIDS," said Zulu, (PWA) and chairperson of the Network for Zambian People living with HIV/AIDS (NZP+).

Counselling intended to discuss, provide emotional support, information and give advice on a person's problems unfortunately does not help much. Zulu says the counselling provided nowadays is damaging. Clients are being counselled as though there is no hope. He believes that poor counselling has at times contributed to the increased number of AIDS-related deaths. It is African to hide disease. "Disease is a community responsibility. The community has the right to know what is wrong - this contrasts directly with the western way of keeping confidentiality," Zulu says.

Stanley Chama, Kara counselling and Training Trust Assistant Co-ordinator for Voluntary counselling and Testing, said counselling has always been there. But one of the problems today is that "in the Zambian context, elderly family members like grandparents, uncles and aunts that were relied on for counselling are no longer there". Counselling then was more prescriptive and was done according to the wisdom of the elders. Today, things are different. Communities are crumbling. People do not trust each other any more. So clients seek a shoulder elsewhere.

Chama said other than training, Kara provides counselling around testing of HIV/AIDS and other psycho-social problems. "Now people appreciate individual and systematic counselling unlike before when they were closed up. They were cautious of being asked questions. Todays counselling is more facilitative. Counsellors work together with the client to identify resources and how to sort out problems," he said.

This is an important aspect of the counsellor's work because this matures and empowers the person to explore and handle their own problems. Chama who is also living with HIV/AIDS and went through counselling himself says (It has actually come to our notice that Mr Chama is actually not HIV positive and we would like to apologize for the inconvinience caused to him and his family), "One is confused at first. You need outside eyes to see you through. You think you think you are an expert of your own life, but another person helps you see through life. Finally you realise how blind you had been. Counselling is an eye opener."

It is difficult for people who find out they are infected with HIV to share with close family members because emotions are shared and they are equally confused. Independent counsellors are different. They take and understand problems on a level head. Kara Counselling respects what the client believes (religion etc) and helps them with their spirituality.

"We go along with the thinking of a person. Sometimes it is not that someone does not want to understand. Their background plays a role too," says Chama. The institution looks at every person's situation equally. Homosexual or not they are given the same hearing. Is there confidentiality in HIV counselling? The fear of being abandoned if ones positive status is discovered is high. Because of the sex and death connotations that HIV has, people are unwilling to cooperate. Counsellors should not push clients. This already puts a barrier to communication. Also, health providers feel they have a duty to inform and protect the uninformed partner who should in turn keep confidentiality.

Chama asks, "Is information confined to people who should know? It is not a matter of keeping secrets but informing people at the right time." There are times when clients choose to come with their spouse, friends or entire families. People s choices such as this have to be respected. A person should be assured that the discussion is relevant to the two, and will be disclosed only with the permission of the client. It is encouraging that women now come on their own for counselling without their spouses, unlike before when they were intimidated by their husbands.

Chama believes that counselling which takes into account the interest of those around is good compared to the locked up kind. It does not just look at individuals but surrounding forces too. For example, Family Health Trust, a non-governmental organisation responding to the impact of HIV/AIDS in Zambia provides counselling for family members and children. The organisation offers, among other forms of counselling, clinical home-based care for PWA's and AIDS education to communities for stigma minimisation and mobilisation of lay/professional volunteers to render care to people with AIDS.

If disease is a community responsibility, does the community have time to do the counselling? With increased deaths from AIDS in Africa we begin to ask questions. Is the counselling that is provided appropriate? Is group counselling part of the solution? It could be. There could be counsellors within families at community level. HIV/AIDS affects not just the individual but families. One thing is certain - there is a need to train more people in interpersonal skills to cope with HIV counselling.

Mildred Mpundu
ZIMA Press Resource Center,
P.O. Box 32295,
Lusaka, Zambia
Tel: 260-1-229936, 260-1-229929

Note: Mildred Mpundu is one of four AF-AIDS 'Key Correspondents' who will be contributing views from around the region during the pre-ICASA discussions

"ICASA Blocks Hotel Bookings in Lusaka." By Amos Malupenga
The Monitor, June 14, 1999

No one will be allowed to book hotels, lodges and guest houses in Lusaka, Chisamba and Kafue without the permission of the managing team of the Eleven International Conference on Aids and Sexually Transmitted Diseases in Africa (ICASA) during the conference period in September.

ICASA deputy coordinator Dr. Simon Mphuka said last Friday the move was aimed at ensuring that all international delegates to the conference which will be held from September 12 to 16 this year at Lusaka's Mulungushi International Conference Centrewere adequately accommodated. "We have blocked all bookings during the conference time in all hotels, lodges and guest houses from Chisamba through to Lusaka and Kafue. Whoever wants to book during this time should go through ICASA," Dr Mphuka said.

He said this will be supplemented by accommodation from higher institutions of learning like the University of Zambia, Evelyn Hone College, Natural Resources Development College and private accommodation. "The response on offer for private homes and flats has been good so far," he said. Dr. Mphuka said officials from hotels will soon inspect and grade all these premises. He said as at last Wednesday, there were a total number of 3,435 beds offered in various hotels, lodges and Catholic Seminaries. He said about 5,000 delegates, a thousand of whom are locals, will attend the conference.

"Face to Face With Dr Moses Sichone." By Mervin Syafundo
The Monitor, June 14, 1999

Zambia will from 12 to 16 September this year host the largest ever International Conference on AIDS and STDs in Africa (ICASA). In an interview with Dr Moses Sichone from the Central Board of Health who is currently the Coordinator for ICASA, The Monitor staffer Mervin Syafunko finds out more about the conference, which will be the eleventh in Africa.

Question: Will you briefly tell us all about ICASA, what it stands for and the background to it?
Answer: ICASA stands for International Conference on AIDS and STDs in Africa. The eleventh ICASA Conference is a vehicle and platform for Africa to revitalise and expand the response to the HIV/AIDS epidemic. It provides an opportunity to review our past efforts with a view to providing alternative and more effective strategies to fight the HIV/AIDS epidemic. The conference is increasingly becoming a platform for dialogue, resource mobilisation and generating the required political leadership and commitment to respond to the HIV pandemic on the African continent. To sustain the momentum gained in this process as we enter the new millennium, Africa needs to undertake a critical appraisal of past efforts in order to determine areas of success and where more work needs to be done to bring the epidemic under control.The previous Conferences held in Arusha (1989), Kinshasa (1990), Dakar (1991), Yaounde (1992), Marrakech (1993), Kampala (1995) and Abidjan (1997) made a big contribution to the African effort to better understand and develop responsive programmes to the evolving HIV/AIDS epidemic

Q: Why has Zambia been selected to host the eleventh session of this conference?
A: This is because two thirds of all the adults and children living with HIV world-wide are in sub-Saharan Africa, which still has the fastest growing epidemic in the world. There is clear evidence of the mounting devastating socio-economic consequences of the epidemic on the continent, Zambia included.It is a well known fact that Zambia played a pioneering role in the conception and establishment of the first Home Based Care (HBC) Programme in Chikakanta as an early response to deal with one facet of the epidemic. This resulted in the formation and consolidation of a myriad of NGOs participating in providing home or community based care for HIV/AIDs patients. In addition, the organising Chair of ICASA (in this instance Hon. Professor Nkandu Luo) has to have international recognition in the area of HIV/AIDS work.

Q: Similar conferences on AIDS and other STDs have been held in Zambia and elsewhere before, what difference will this particular one make?
A: It is intended that the eleventh ICASA be a unique meeting that will maintain maximum focus on the issues that are relevant and urgent to the HIV/AIDS epidemic on the African continent. In addition, a unique features is the incorporation of the "village concept" focusing on women, youth, People Living With HIV/AIDS (PLWHAs) and NGOs. This is where dialogue, exchange of experiences and exhibitions will take place.

Q: What are the major issues this workshop is bound to address?
A: These include care and support for people living with and affected by HIV/AIDS, the socio-economic dimension of the epidemic, community responses and a critical analysis of the determinants of HIV spread in Africa. The themes and tracks are weighted in such a way that they permit participants to discuss the major lessons learnt and how this will inform future policies, strategies and interventions. Past conferences have tended to be more medical or health-focussed in approach.

Q: In total how many participants -both local and international- are you expecting for this conference?
A: It is expected that about 2 500 international delegates and 2 500 Zambian participants will attend the conference.

Q: What criteria are you using to select the participants, have you got special target groups and individuals?
A: There is no specific criterion or criteria to select participants to the conference. It is open to all those that are interested in HIV/AIDS/STD issues and these may come from diverse backgrounds since this is a multisectoral problem.

Q: Although the conference will address other STDs, why is there so much emphasis on AIDS/HIV during the run-up?
A: We are endeavouring to achieve a balance across all the different dimensions of the HIV/AIDS and STD epidemic. We now know that HIV and other conventional STDs are inextricably linked and so that connection will be greatly discussed.

Q: How would you rate AIDS in Africa?
A: The Joint United Nations Programme on HIV/AIDS (UNAIDS) estimates that globally there are over 33 million HIV infected adults and children out of which 22 million are in Africa.

Q: And how would you rate Zambia as compared to other countries in the region?
A: As in many countries on the African continent, Zambia has continued to face the multiple dimensions and challenges of the HIV/AIDS epidemic. The epidemic has evolved fairly rapidly since 1984 when the first case was identified in Zambia as a consequence of which the Government, Non-Governmental Organisations and the private sector have gone through different cycles of planning to prevent and mitigate the impact of HIV/AIDS.

The epidemiological situation of HIV in Zambia remains worrying; nearly 20% of the sexually active adult population is estimated to be infected in urban areas (compared to 13% in rural Zambia). These HIV infection rates are comparable to those obtaining in the Southern African region. It is not uncommon to find HIV seroprevalence of over 20% in most urban settings in Malawi, Zimbabwe, Botswana, Namibia and South Africa.

Q: What measures have you put in place to ensure that all the ICASA participants from abroad are safe in terms of accommodation, transport, health, personal security and other basic needs?
A: ICASA is a serious and major national undertaking. It requires a co-ordinated approach that is multisectoral in nature. The National Organising Committee is the body charged with the responsibility of preparing for this conference. There is also an Inter-Ministerial Committee comprising Deputy Ministers who are involved in the preparations. Other committees include those specifically dealing with the Scientific Programme, Accommodation, Transport, Finance, Publicity, Reception and Protocol, Social and Tours, Scholarships, Venues, and Exhibitions. The venue (Mulungushi International Conference Centre) continues to be refurbished and will have facilities for banking, postage, freighting, exhibitions and clinics.

Q: We gather about US $4.5 million will be spent by the time the conference is over, just where are you going to get that kind of money?
A: We have received tremendous support from many local and international agencies including UNAIDS, WHO, UNICEF, UNFPA, Norad, Sida, CIDA, USAID, DFID, the Japanese Government, the Netherlands Government, French Co-operation, Irish AID, and many others.

"Beware of Imported Ideas, Warns Luo." By Bershom Ndhlovu
The Daily Mail, June 12, 1999

Health Minister, Professor Nkandu Luo, has called on the Zambia Counselling Council (ZCC) to involve as many people as possible when developing an HIV/AIDS counselling policy. Professor Luo, who was speaking at the official opening of the national consensus workshop on HIV/AIDS counselling policy development in Zambia, said it was important to involve the general public so that it could start seeing HIV/AIDS as a serious epidemic. She took a swipe at the involvement of only selected people, some of whom she said lived off workshops, moving from one hotel to another, saying there would be no cross fertilisation of ideas about the epidemic. She urged the participants to borrow from traditional counselling practices and try to develop a policy that would be sensitive to every one's needs regardless of their background or age. Prof. Luo, who was accompanied by Central Board of Health director, Dr Gavin Silwamba and AIDS programme manager, Dr Moses Sichone, warned against the importation of a lot of ideas into the counselling policy because it would not be implementable.

The Health Minister said time had come for Zambia and other countries to declare war against HIV/AIDS which she said was an unseen enemy which kept on devastating the population. "We need to tune our minds to seeing that enemy. A lot of us have not tuned our minds to see that enemy. When we sit down to develop important policies, it is important to get people from the general public to be part of the process so that people's minds are armed to see the enemy," she said.

Participants of the two-day workshop being held at Ndola's Savoy Hotel are drawn from government ministries and some NGOs involved in HIV/AIDS activities from all over the country. Meanwhile, Professor Luo said in an interview that government was reviewing the performance of district health boards which were recently dissolved before new ones could be appointed. She said the exercise would take a few weeks more before the new boards were put in place. She said there was no shift in government's policy regarding the existence of district health boards. Prof. Luo dismissed claims that hospitals were facing financial problems and attributed such problems to mal-administration in the institutions.

"Women Become More Vulnerable to HIV/AIDS Pandemic."
The Daily Mail, June 12, 1999

On the threshold of a new millennium, the HIV/AIDS epidemic still remains a complex problem. Our reporter GEORGE JAMBWA reports that more women are becoming more vulnerable to the scourge and some Non-Governmental Organisations (NGOs) have begun to help women out of the dilemma. THE deadly HIV/AIDS pandemic has in the last decade claimed millions of lives in Africa. The latest World Health Organisation (WHO) statistics show that AIDS is killing six million people in Africa annually.

Although it is affecting both sexes (men and women), women have become more vulnerable to the killer disease world wide. Although there are no immediate statistics to illustrate how vulnerable the women have become, the mushrooming number of Widows Groups whose husbands have died of AIDS underlines the impact of the problem. Several NGOs have realised the need to invest in widows as a way of helping them overcome the challenges of life as single parents and bread winners after their husbands have died.

In Kafue, the Catholic Church is working with a group of widows. In Lusaka, AFRICARE, an American international NGO dedicated to improving the quality of life in rural Africa has been working with a widows group known as Misisi Compound Widows Group. Their husbands died of AIDS-related illnesses. The NGO has since trained the women's' group in the production of edible oil. The project is also practiced in neighbouring Zimbabwe and Mozambique by women groups.In Zambia where the programme started a few years ago, the widows are now netting more than K2 million per year.

"They were left with families to support when their husbands died. It was very difficult for them to survive considering that they were very poor," explained Africare country representative Phyllis-Jones Changa. Today, having developed their oil production business, the widows are relatively secure. "Because profits have grown, the women have improved their work and they are also giving back something to the community," she adds. The Misisi women donate nutrient rich oil to community families in need - especially the sick, and those afflicted by HIV/AIDS. Ms Changa believes that the only way to reduce the suffering of women widowed by AIDS is through economic empowerment. "I believe the only way to help is to empower them. Help them venture into some economic activities so that they can sustain their families too," she says.

She noted that the Misisi women are expanding the objectives of the programme. "This venture is meant to empower them and they have worked hard to sustain it. The profits are not only being shared among the women themselves, they are even helping other people affected by the disease," she says.

"Involve Public in Anti-AIDS Work: Luo." By Amos Chanda
Times of Zambia, June 12, 1999

Health Minister Nkandu Luo has advised participants to HIV/Aids workshops to involve the general public in their deliberations instead of always crusading among themselves. At a national consensus workshop in Ndola on HIV/Aids counselling policy development yesterday, Professor Luo said Aids activists had been talking to each other for a long time leaving out the general public who were critical in the fight against the disease.

"Some of us live in workshops. We move from one hotel to another attending workshops, but there has been no cross-fertilisation of ideas," she told the participants drawn across the country from Government ministries and non-governmental organisations, (NGOs). Prof Luo who described Aids as a difficult enemy to fight because it was invisible, said the major problem was that people had not tuned their minds to confronting the virus.

The minister, flanked by Central Board of Health director-general Gavin Silwamba and CBoH public health and clinical systems manager Dr Moses Sichone, said apart from involving the public, it was also important to incorporate policy experts and come up with a situation analysis to develop a policy that will be accepted nationally. She said the policy document would give direction on how to go about counselling and voluntary testing of HIV/Aids. Prof Luo said it was important that the document be culture-sensitive and take into account what norms obtained in every province.

"One of the tragedies of Africa and Zambia in particular is that we think everything Zambian is bad, in the process we destroy our culture. If you import too many ideas, the document will not be implementable," she said. And Dr Sichone said one of the areas Zambia had lagged behind was policy development for HIV/Aids counselling and voluntary HIV testing. He said HIV/Aids was a complex and dynamic disease hence the need to come up with a document that would stand the test of time.

"K3 BN Needed for INCASA Venue Rehabilitation." By Chitalu Kalunga
The Daily Mail, June 8, 1999

An additional K3 billion is needed for further rehabilitation of Mulungushi International Conference Center and other expenses as part of preparations for this year's International Conference on AIDS/STDs in Africa (XI-ICASA) being hosted by Zambia scheduled for September this year.

ICASA Deputy coordinator Simon Mphuka disclosed in an interview in Lusaka that an amount of K9 billion had already been spent on the renovations and more was needed for the second phase of renovations for this year's ICASA venue. Dr. Mphuka said 60 percent of the budget had already been spent but more funds were needed for the second phase of renovations at Mulungushi and other logistical arrangements for the conference.

"Over 1,000 international and local participants have confirmed their participation but we expect at least 3,000 outsiders and 2,000 local participants," Dr Mphuka said. He said there were already 600 registered participants from outside and was optimistic a larger number would confirm taking part before the deadline on August 12.

Meanwhile, a delegation of 30 scientists from different parts of the world are expected in the country to make final preparations for the XI-ICASA meeting. Dr Mphuka told the Mail the scientific committee to meet at Lusaka's Intercontinental Hotel next week from Monday to Friday was to finalise the ICASA programme. He said the delegation which would constitute mostly Africans will among other things carefully select scientific papers to be presented during the conference. "It is important that we set priorities concerning AIDS in Africa after reviewing what has worked and what has not worked," the doctor explained.

He noted that this year's conference on AIDS/STDs should be given priority as it was the last in the millennium. He said the theme "looking into the future" needed to be given priority as it was a climax to ICASA's past efforts.

"Getting Ready for XI-ICASA and Battle Against AIDS." By Amos Chanda
The Daily Mail, June 8, 1999

From September 12th to 16th this year, Zambia hosts the XI- International Conference on AIDS/STDs in Africa (XI-ICASA). This announcement was made twelve months ago and much has been said and done. But a lot more work is in progress, organisers said at a media sensitisation workshop in Chisamba last week. Medical experts and journalists discussed ICASA's significance in the battle against one of humanity's most horrifying dilemma -- AIDS.

TO the uninitiated, it is just another conference, but the XI-ICASA to be held at the Mulungushi International Conference Centre (MICC) in Lusaka is more than just that. It is a conference about life -- and death. It is about a disease killing six million Africans annually. As Africa's most premier forum on AIDS and other STDs, the XI- ICASA, by virtue of its timing presents itself as Africa's watershed gathering set to provide a platform high enough to enable the continent look into the future with some ray of hope.

The theme of the conference "looking into the future" would be a monumental phrase if African countries come out with priorities which would help control the spread of the disease. An estimated 5,000 delegates will attend the meeting. Organisers of the Lusaka ICASA see the meeting as perhaps the most significant opportunity to re-focus goals and re-arrange efforts against the AIDS epidemic by coming up with new strategies of fighting AIDS in the next century.

The XI-ICASA will be a major shift from the scientific emphasis to a more broad based approach taking into consideration that the disease is a multi- sectoral disaster, said Dr Moses Sichone, coordinator of the XI-ICASA. As the last ICASA this century, the Lusaka conference will be used as a stock-taking forum and a starting point for the new millennium with new dimensional approaches added to the already existing methods to fight what Dr Sichone called "a great human disaster disrupting the very foundation of human civilisation."

Of an estimated 33.4 million people infected with HIV, 22.5 million are in sub-Saharan Africa, making the continent the most critically hit. For Zambia, it is estimated that by the year 2000, around 1.5 million people will be infected and there will be about one million orphans directly as a result of AIDS. Such statistics are closely representative of other countries in Africa. In some countries the figures are in fact higher, in others lower, but the picture points to the same thing -- AIDS has reached epidemic proportions, WHO figures indicate.

This is what makes the ICASA, an all-important forum against AIDS, Dr Sichone told the meeting of journalists, medical doctors and scientists. Behind these AIDS statistics, are horrific experiences illustrating how millions of people have suffered because of AIDS. The social consequences of the disease are visible in the break up of many family structures; economic losses are just as a nightmare as the hurdles medical experts are enduring to contain the disease-- and loss of human resource sky-rocketing.

"The ICASA seeks to address the immense social and economic impact of AIDS. This problem is multi-dimensional and cross-cutting. The epidemic is still hugely unstable and at different levels. Responses have evolved with the epidemic. There is some progress but we need to do a lot more. It is on this premise that we see the significance of the Lusaka ICASA," Dr Sichone said.

The purpose of ICASA is to put together a forum for exchanging knowledge, ideas, experiences and advances, said Dr Doreen Mulenga, a member of the ICASA organising committee. She is from the United Nations International Children's Fund (UNICEF). Dr Mulenga said the ICASA brings together a diversity of disciplines such as clinical sciences, sociology, anthropology, economics and pharmaceuticals. It is a regional conference with specific approaches for Africa, she added. "ICASA is also about networking among governments, the United Nations (UN) agencies, bilateral organisations, NGOs, private sector, researchers, and pharmaceuticals. It's about suggesting new approaches and strategies in the HIV/AIDS response," she said.

The foundation stone of the ICASA subsists in the discovery that scientists and researchers lacked a forum for sharing knowledge. It was this realisation which led to the creation of this meeting in 1987 and in 1989, the first ICASA was held in Arusha, Tanzania. From then on the meeting has been held in Kinshasa in the former Zaire in 1990, Dakar, Senegal (1991),Yaonde, Cameroon (1992), and in 1993 in Marrakech, Morocco from where it was transformed into a bi-annual conference. The 1995 conference was in Kampala, Uganda while the previous one was in Abidjan Cote' de Ivoire in 1997. Zambia is hosting the 1999 conference, the eleventh in the series.

Deputy XI-ICASA coordinator Dr Simon Mphuka said Zambia was chosen as the host because of various factors among them: the leadership and scientific contribution of the organising chair, Health minister Professor Nkandu Luo, geographic position, facilities, accessibility, political stability and the country's experience with the AIDS epidemic.

Zambia stands to benefit enormously from the conference, said Dr Mphuka as he singled out scientific and economic opportunities which would arise from the meeting. He said apart from the obvious scientific benefits, there would be increased cash inflows, a surge in tourism business, increased business activity in the transport and communication industry and catering and lodging businesses. He said the organising committee has an initial budget of about US$ 4.5 million to put the conference together. Pharmaceutical companies will have to pay US$ 7000 for advertising space. Delegates will pay US$ 550 participation fee.

The Lusaka conference will set priorities for AIDS' fight in Africa. The new millennium requires a re-appraisal and re-focusing of strategies, said Dr Mulenga. "What lessons have we learnt so far on priority setting and resource allocation? Have we allocated resources efficiently and for those interventions? What is the place of new treatments in Africa?" asked Dr Sichone. A multi-sectoral disaster that AIDS is, Dr Sichone views the Lusaka ICASA as an inevitable point of a major shift from the clinical scientific approach to an whole encompassing onslaught. This shift has impressed donors, he said in a key note address. He said rich nations and pharmaceutical firms should consider the AIDS epidemic as social crisis. He said it was a matter of morality for them to make available drugs which reduce the impact of AIDS by reducing prices so that the majority poor can afford.

"They should be socially responsive by making affordable, anti-viral drugs which help to reduce the impact of AIDS." "The AIDS epidemic is more of a moral and ethical issue. Prices of anti-virals which are known to reverse the development of AIDS should come down," he said.

Participants agreed with Dr Sichone that it was immoral for pharmaceuticals to see people continue dying while life-saving medicines are on the shelves. It also puzzled him that all governments in Africa have a total spending of only US$ 140 million on anti-AIDS programmes annually. On a continent where six million lives were lost annually due to AIDS, the amount was too little to make a notable impact. If governments can commit much higher amounts to war, he does not see any reason why they should not increase spending on AIDS. According to UNAIDS, AIDS was killing more people than a combined death toll from Malaria, TB, diarrhoea and cancer.

Increased advocacy on prevention, treatment and care systems was seen as a crucial aspect of ICASA and this medical experts said, the media was uniquely placed to do. "The media has a special position to push the crusade against AIDS, we need informative writing on the scourge because careless reportage can undo many years of research achievements. Just by a stroke of a pen, substantial amount of progress can be reversed," observed Dr Sichone.

Advocacy for an expanded national response to AIDS; social value change in traditions promoting risky practices; emphasis on positive trends in the epidemic are some of the aspects the media could tackle, he said. The meeting resolved that journalists should disseminate information on HIV transmission; on safer sexual behaviour; de-stigmatisation of those infected; community partnership and keeping high on the national agenda, efforts to fight the pandemic. Like the Biblical writing on the wall, the Lusaka ICASA, Dr Sichone said, is message to the continent to take stock of the epidemic and develop new ways to enable Africa stand the AIDS epidemic.

"Women's Village Hosts AIDS/STDs Conference." By Amos Chanda
The Daily Mail, June 5, 1999

Women participants to the XIth International Conference on AIDS/STDs in Africa (XIth-ICASA) will hold a pre-conference meeting called the Women's Village where various skills and information will be offered. According to an information package released at a media sensitisation workshop held in Chisamba last Wednesday, women participants to the Xith ICASA will attend a two-day meeting ahead of the actual conference to take place at the Mulungushi Conference Centre.

The Women's Village will include poster presentations of NGO activities; crafts from income generating activities; video shows; traditional counselling; youth and reproductive health among others. Womens' rights such as inheritance and property grabbing, illiteracy and poverty, violence against women, mother-to-child HIV infection will be highlighted for the benefit of some women who may not be in the know. There will also be lessons on cultural practices which fuel the spread of AIDS. The Women' Village will also include skills training workshops, training on assertiveness, traditional crafts training, self defence training and womens' rights as well as human rights. The XIth ICASA is Africa's premier AIDS forum.

The Lusaka conference, to be held from September 12 to 16 will be attended by 5000 delegates. It will be held under the theme "Looking into the future."

"Media Challenged to Break AIDS Silence 'Conspiracy.'" By Amos Chanda
The Daily Mail, June 4, 1999

A medical expert has asked the media to lead society in breaking what he called a conspiracy of silence on the AIDS epidemic. Coordinator of the XIth International Conference on AIDS and STDs in Africa (XI -ICASA).

Dr Moses Sichone made the call at a media sensitisation workshop held at Ibis Gardens in Chisamba. Dr Sichone said the power of the media was the whole important aspect which the XI-ICASA conference scheduled for September 12 to 16 needed for desired results. He said the issues to be raised at Africa's most premier forum on AIDS, would only be useful if the media carried them over to the masses.

"The media should help society undo the silence on AIDS. Even with so many years of this global disaster there is still a conspiracy of dangerous silence on AIDS. Let us talk about it so that we identify the dangers and bring out safeguards," he said. Dr Sichone noted that the AIDS dilemma has worsened the already weak social support systems in poor nations which was why the Lusaka conference was a major shift from the scientific approach to a moral broad-based one. "The previous ICASA Conference in Abidjan was a disaster and we have had a lot of difficulties convincing donors to support this one. We have put too much together and we want the media to move with us along this global cause for human survival," he said.

The government of Zambia has given ICASA tremendous support financially and otherwise. So far we are making great progress, although much still remains to be done," he said. Dr Sichone regretted that despite the big threat which AIDS was posing to Africa, combined expenditure on the fight against AIDS by all countries on the continent amounted only to a meagre US$140 million. "This is too little for a continent where AIDS was killing about six million people annually. We need more investment in this sector," he said.

He said the AIDS epidemic was ruining the social-economic infrastructure at fast rate. The sensitisation workshop drew participants from medical and media personnel from various institutions. It would be followed by more meetings to fully prepare Zambia as a host country for an estimated 5,000 delegate-conference.

"AIDS Toll Figures 'Top Secret.'"
Times of Zambia, June 4, 1999

The Ministry of Health since has stopped releasing figures of soldiers and other uniformed officers including nurses who die or are affected by AIDS as they are alarmingly high. This adds to a disclosure that 1,500 teachers in Zambia died of AIDS in 1998 in the ravages of the pandemic. The statistics were released yesterday at a media briefing workshop towards the International Conference on AIDS and STDs in Africa (ICASA) to be held in Lusaka in September.

Medical experts who attended the workshop disclosed the HIV/AIDS epidemic was affecting social-economic development as employees in key sectors like education were dying from the disease. Journalists and some media heads who attended the workshop at Ibis Gardens in Chisamba on Wednesday learnt at least $4.5m would be spent on organising the five-day ICASA conference scheduled for September 12-16.

More than 5,000 delegates from all over the world are expected to attend the conference. Government has already released more than K9bn towards renovations at the Mulungushi International Conference Centre (MICC), the venue of the meeting. The conference has attracted a number of African heads of State.

Statistics also indicate by the turn of the century over one million children would be orphans as a result of parents dying from AIDS. Coordinator of the ICASA conference Moses Sichone regretted that Africa only spent $140m annually on HIV/AIDS mitigation programmes and yet billions of dollars were channelled into civil wars across the continent. Sub-Saharan Africa still accounts for 70 per cent of HIV/AIDS cases. Of the 34 million people infected with HIV/AIDS worldwide, 22.5 million were in sub-Saharan Africa. HIV/AIDS related tuberculosis (TB) cases were on the rise and it was projected there would be 40 per cent of such cases by the year 2,000. Over six million people died of AIDS in Africa last year. Dr Sichone said it was now a question of morality for big pharmaceutical companies to avail Africa of HIV/AIDS drugs which reduce effects of the disease considering the high prevalence of the disease on the continent.

Many pharmaceutical firms had indicated interest in exhibiting their drugs and would be charged $7,000 for exhibiting. Modifications would be made to the MICC to accommodate the 5,000 delegates for meetings. Huge television screens would be placed in all committee rooms and other rooms to be created to enable participants who would not sit in the main conference room follow the proceedings. Other plenary discussions by different groups would be held at the showgrounds and hotels. ICASA deputy coordinator Simon Mphuka said the secretariat had received over 9,000 abstracts for the conference 7,000 of which had been reviewed.

"Contraceptives Take Root in Eastern Province."
Times of Zambia, June 4, 1999

A senior official of Petauke District Health Management Team (DHMT) has revealed that there is a remarkable increase in the number of people using modern methods of family planning in the area. District director of health Winford Lungu disclosed this in Petauke over the weekend when he received five bicycles from Planned Parenthood Association (PPAZ) regional manager Florence Phiri.

Dr Lungu attributed the high acceptance levels of contraceptive use to the collaboration in educating people about the importance of family planning between Government and non-government organisations such as PPAZ. He praised PPAZ for being a committed partner of the ministry of health in matters of family planning and reproductive health. And making the donation, Ms Phiri said the bicycles had been donated to the DHMT to ease transport problems for health workers who supervised the 40 community-based distributors of contraceptives in the area. Ms Phiri said the donation had brought to 49, the number of bicycles that PPAZ had given to the DHMT for family planning and reproductive health. She said 44 bicycles were presented to the district recently.

The bicycles were bought for PPAZ by the British government through Department for International Development (Dfid). In a related development the PPAZ has donated five bicycles to Nyimba DHMT to be used by supervisors of community -based distributors. Presenting the bicycles to Nyimba hospital, medical officer-in-charge Dr Daniel Zulu, who received the donation on behalf of DHMT, PPAZ regional manager Florence Phiri said the bicycles were now the property of Government. She said a total of 25 bicycles had been donated to the district since last year for family planning work.

Receiving the donation, Dr Zulu said the bicycles were the best means of transport for Nyimba as most areas could not be accessed by motor vehicles. Dr Zulu praised PPAZ for its commitment to the improvement of people's life through the provision of modern family planning methods.

"Peri-natal AIDS: Real Nightmares in Third World Countries." By Larry Njugu
The Daily Mail, June 1, 1999

Mercy Maklahemena, a middle-aged South African woman, minced no words about her HIV/AIDS status when the world AIDS community met in Geneva. When she narrated her personal experience as an HIV positive mother, some participants could not help shedding tears.

Mercy's experience is a touching, but perfect example of "peri-natal AIDS." Peri-natal AIDS has not only become a scientific jargon often uttered by AIDS practitioners but a real nightmare in developing countries. Many children in developing countries are silent victims of peri-natal AIDS. Peri-natal AIDS simply refers to children who acquire the HIV virus from their mothers, eventually developing AIDS and die innocently. Today many deaths among children aged between one and five years, in developing nations are HIV/AIDS related. Needless to mention that in some of these countries HIV/AIDS has become the single greatest contributor to child mortality.

However, grave as it may seem, peri-natal AIDS is now effectively being controlled in industrialised countries, a trend which demands to be urgently transferred to poor nations. In response to the threat that peri-natal AIDS poses to the next generation, the world AIDS community which met in Geneva during the World AIDS Conference debated heavily on strategies of reducing HIV transmission from mother to child.

"Many of these strategies socially and scientifically are already paying dividends in developed countries and may offer a solution to developing countries where 90 percent of mother-to child HIV transmission occurs," Lynn Mofenson, a United States-based researcher contends. Mofenson insists peri-natal AIDS is now a preventable disease as long as HIV positive mothers are exposed to several intervention strategies which dramatically reduce the transmission of the fatal virus to children. She elaborates that since 1994, studies have shown that an AIDS drug known as AZT, given to pregnant women reduces HIV transmission to infants by more than 50 per cent. "Combined AZT and HIV immune globulin (HIVIG) regimens are effective, even in cases of advanced infection," Mofenson emphasises.

Mofenson's contention is solidified by the findings of Dr Laurent Mandelbrot of the Cochi-Port Royal Hospital in Paris. According to Dr Mandelbort a research conducted on nearly 2,000 French women showed that combined treatment reduces the rate of mother to child transmission by nearly two-thirds. Dr Mandelbrot goes further by pointing out that cesarean delivery by pregnant women who are HIV positive may go a long way in stemming transmission of the virus to the newly born. He states that in this case cesarean delivery must be performed before a woman goes into labour when her membranes are still intact.

Elective cesarean delivery combined with AZT treatment may be the best way to prevent HIV positive women from transmitting the killer virus to their babies. "However," Dr Mandelbort adds,"timing is important because the HIV virus is transmitted either during birth, late in pregnancy through the placenta which nourishes the foetus or through the woman's membranes into the amniotic fluid which surrounds the foetus. Mandelbrot stresses that caesarean delivery must be performed before the woman goes into labour when her membranes are still intact. There are several other ways being explored of reducing mother to child HIV transmission. The forthcoming conference on global strategies for the prevention of HIV transmission from mothers to infants, to be held in Canada in 1999, will certainly offer improved solutions of stemming this type of infection. - The author attended the Geneva conference -

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