University of Zambia Medical Library

HIV/AIDS in Zambia: June-July 2000

"UN Group Blames Zambia For Lack Of Emphasis On AIDS." By Mildred Mulenga
Pan African News Agency, July 19, 2000

The Expanded United Nations Theme Group on HIV/AIDS has blamed the Zambian government for giving inadequate emphasis on the HIV/AIDS pandemic. The UNICEF representative in Lusaka, Peter McDermott expressed the view as he chaired the Expanded UN Theme Group on HIV/AIDS at the just ended Consultative Group meeting in Lusaka.

According to McDermott, evidence of low priority to the incurable disease emerged when Zambia's three main papers presented at the meeting on poverty hardly mentioned HIV/AIDS as a major impediment to Zambia's overall social and economic development. He said the omissions of AIDS in these papers illustrated that Zambia has yet to recognise that AIDS needs to be considered as a negative factor in all programmes and plans on social and economic issues.

"The main paper presented to the meeting 'Mobilising for Sustained Economic Growth and Poverty Reduction', hardly mentions HIV/AIDS at all and certainly does not see the pandemic as a major impediment to Zambia's growth potential and overall social and economic development," the UN official said. "The Long Term Development Vision for Zambia paper cites HIV/AIDS as an incidental issue ... If one wanted to be cynical one could argue that this is somewhat indicative of how AIDS is really perceived in Zambia.

HIV/AIDS is omitted totally from the economic analysis, aid and external debt, education, medium term economic and long term vision," McDermott added. He, however, commended government for its efforts, which had led to a significant drop in the percentage of pregnant girls aged 15-19 infected with HIV. In Lusaka alone, McDermott noted, the infection rate has dropped on the average by almost half in the past six years. "Clearly, this is all good news but nonetheless only offers a small ray of hope. Women in particular continue to be at greater risk than men, infection rates in young Zambian women are far higher than young men for social, cultural and physiological reasons."

An estimated 20 percent of Zambians are said to be living with HIV/AIDS. Recent studies indicate that over 32,000 children are born infected with HIV/AIDS each year. The study predicted that between 575,000 and 700,000 children are or will be shortly orphaned and over 70,000 children are already living on the streets.

At its meeting in Lusaka Tuesday, the UN Expanded Theme Group pledged one million U.S dollars in addition to commitments by other agencies to provide more than six million US dollars in 1999-2000 to fund AIDS-related programmes in Zambia. UNICEF further announced a contribution of 50,000 dollars for the immediate use of the interim HIV/AIDS Council secretariat. McDermott said among the challenges and goals to be achieved in the next one year by government and her co- operating partners include putting in place a functional HIV/AIDS Council. Other objectives include the establishment of an effective national steering committee for orphans and vulnerable children and expanding the prevention of mother- to-child HIV transmission from 10,000 women now to 100,000.

The US ambassador to Zambia, David Dunn told the meeting that HIV/AIDS had a profound effect on Zambia's economy as well as its social and family structures. "To increase economic growth and reduce poverty, Zambia must make inroads on this problem. There is good news on infection rates among the young, yet, much more still needs to be done by Zambia, itself and by its friends abroad to address this issue," Dunn said. The US government pledged to provide 17.7 million dollars for HIV/AIDS prevention and improved child health delivery and family planning services.

"Government's Lack of Urgency Worries UN HIV/AIDS Group." By Chama Nsabika
The Post, July 20, 2000

The United Nations Expanded Theme Group on HIV/AIDS is concerned with the apparent lack of urgency that government has accorded to the pandemic as regards economic development. In its presentation to the just ended Consultative Group (CG) meeting, the group observed that while government has come up with and addressed a number of elements in the National Strategic Framework and the Scaling up of the Zambia HIV/AIDS and Orphans and Vulnerable Children Response to Accelerate Poverty Reduction paper presented to the CG, it was confusing to note the varying emphasis, and in some cases the lack of it, given to the scourge.

"The main paper presented to the CG, 'Mobilising for Sustained Economic Growth and Poverty Reduction', hardly mentions HIV/AIDS at all, and certainly does not see the pandemic as the or even a major impediment to Zambia's growth potential and overall social and economic development. The Long Term Development Vision paper cites HIV/AIDS as an incidental issue," the group noted. The UN group further noted that HIV/AIDS was first mentioned under the Health Section in between malnutrition and health networks. "If one wanted to be cynical, one could argue that this is somewhat indicative of how AIDS is really perceived in Zambia. HIV/AIDS is omitted totally from the economic analysis, aid and external debt, education, social safety nets...and most worrying from the Poverty Reduction Strategy Programme," they observed.

They noted that this was rather surprising given the huge toll the pandemic is taking on teachers, medical staff and other workers. They stated that this was an indication that there was still need to yet fully internalise the macro-economic and development crisis posed by AIDS in Zambia. According to the UN group, government has equally given scant attention to the pandemic in the Interim Poverty Reduction Strategy Paper (I-PRSP) presented to the International Monetary Fund (IMF) and the World Bank earlier this year. The group, however, commended the government for completing the National Strategic Framework and hoped government would expeditiously disseminate conclusions of the costing exercise for the framework which was likely to receive the generous support of the international community. They hoped the recently established HIV/AIDS Council and Secretariat would function effectively.

The UN Expanded Theme Group also announced that in addition to the individual agency commitments in financial year 1999/2000 of over US$6 million for AIDS related programmes, an additional US$1 million had been secured from UNAIDS Geneva and would be used for the catalytic projects contained within the National Strategic Framework. UNICEF has further provided US$50,000 to be used by the interim secretariat to enable it complete work by the November deadline.

"Kitwe NGO Aims at Making Orphans Independent." By Mabvuto Zulu
Times of Zambia, July 14, 2000

The pain of losing a loved one will forever continue to haunt mankind. And in this era when societies, the world over, are at the mercy of innumerable life-terminating vices, the issue of death and all its facets become a bitter experience to contend with. Societies, now more than ever, are each day spending hours mourning their loved ones.

The HIV/AIDS pandemic has continued its rampage of indiscriminately claiming lives and funerals are the order of the day. The scourge has also been responsible for the soaring numbers of orphans in society. Tales abound of the emotional trauma that many children go through before and after the death of their parents.

'Many children have had to grow up against their years so that they could look after their ailing parents,' says Grace Mwanalushi, the executive chairperson for Children in Distress (Cindi), Kitwe chapter. Cindi is a non-governmental organisation that looks after orphans, and trains them so that they become self-reliant and grow up into responsible citizens.

And if a parent on the deathbed was the breadwinner, children are forced to face the reality of finding ways to feed themselves if they are to survive. Some girls have even been forced into prostitution or early marriage to make ends meet. And upon the breadwinner's death, 'some orphans are taken on by their extended families, while others are forced to turn to the streets and try to make a living from there.

'But those who join extended families go through a lot of emotional and physical torture,' Ms Mwanalushi continued. They go through torturous experiences including beatings, verbal and sexual abuse.

Recently her organisation organised a march in Kitwe that saw more than 10 schools participate. It was a march characterised by touching plays and poems. The moving poems were tales of the abuse orphans go through in their disrupted lives. They also warned against casual sex through which many people have contracted HIV/AIDS. It is a disease which has claimed more lives than any other single disease, leaving thousands of orphans in its wake.

'Cindi Kitwe marches forward into the year 2000 fighting for a future for our orphans, there is no turning back,' proclaimed one of the banners at the event. And indeed, the organisation has embarked on a campaign that raises hope for the lives of the 14,000 orphans that it has under its wings in its 11 demarcated zones of Kitwe.

The colourful event, which was more of an attempt for the participating schools to show solidarity against the dreaded pandemic, was held under the theme: 'We have been affected, we refuse to be infected. This, Ms Mwanalushi explained, is the collective cry that orphans, whose parents died of HIV/AIDS, share countrywide. 'And our campaign is aimed at reducing the number of orphans by creating awareness,' she said.

To make the campaign more effective, Cindi is using the youth under their care to appeal to their counterparts who may still doubt the effect that the scourge has on the lives of those who have fallen victim. Daniel Mwansa from the Cindi's youth wing said the march was held to 'enlighten and educate our fellow youth on the extreme dangers of the HIV/AIDS pandemic.'

Mwansa, who was recently offered a place to study at the University of Zambia (Unza), is the longest serving member of the organisation and has been with them for six years. He said of the pandemic that is threatening to turn Zambia into one big funeral house: 'I have seen the misery, and there is more in the townships than what is really being portrayed by the statistics.' He further said that highlighting the plight of the poor in the townships will bring the problem to the fore and enable the concerned organisations and individuals address the situation. During the march past, Mwansa also reiterated that the best way to champion the fight against HIV/AIDS is to target children who are the future, but now at risk of infection. 'Let us, with one voice and integrated action, direct our commitment to save the children as the most vulnerable and powerless in our society,' he said.

Ms Mwanalushi disclosed that to encourage the orphans to be self reliant, the organisation sends them to train in careers like journalism, pottery, mat making, chicken rearing and farming. 'We also get bursaries for those who qualify for higher learning, like those who are selected at the two universities.'

Last year, Cindi sent five orphans to university. This year, the organisation has, through the Ministry of Community Development and Social Welfare, secured bursaries for 11 of its orphans to go to university. 'it's an achievement for us to see our members qualify for higher education. This shows that they are hardworking and would like to use their trauma as a driving force to achieve something in life.' However, Ms Mwanalushi appealed to the communities, individuals and potential charity donors to come to the aid of her organisation so that it can adequately provide for its 14,000 orphans.

The HIV/AIDS time bomb is ticking, and fast. Zambia's projected orphan population by next year is worrying, and it's time to prepare for the inevitable. Time to give a hope to the orphan.

"`Joiner Girls' is Changing Life for Ex-sex Workers." By Joy Sata
Dail Mail, July 3, 2000

Until Chitaninge saw her friend die after she was gang-raped by the infamous 14" boys, a gang of armed robbers known for terrorising Lusaka residents, she had no intentions of leaving the lucrative and oldest profession in the world - prostitution. Chitaninge's friend was hooked by an elderly man who took her to one of the small hotels on the outskirts of Lusaka, but when they got there, she opted for a younger man who seemed to have more money. Little did the young lady know that the man she had opted for was a member of a gang of armed robbers. The man took her to a room where she found 13 other men and these men raped and sexually abused her until she passed out. Later, they dumped her near the police post. She died a few weeks later.

There are many other stories that may have happened in a similar manner but have not been told. But one may wonder how many such acts could accelerate the infection rate of the HIV/AIDS virus. The rape of one woman by more than a dozen men is an extreme but vivid example of how sex without using a condom poses a high infection rate for sexually transmitted disease including HIV. From the time the first HIV/AIDS case was reported in Zambia in 1984, according to the World Health Organisation (WHO) report, educational campaigns on the dangers of unprotected sex have been mounted by both the government and non governmental organisations dealing in these matters.

Despite vigorous educational campaigns on the dangers of unprotected sex, commercial sex workers and their "clients" continue with the scourge regardless of the high risk factor of contracting the virus. The UNAIDS December 1999 report puts the number of people infected with HIV in Zambia at 770,000 while the Central Board of Health has pegged the number at 1.1 million. The report also puts HIV/AIDS as the leading cause of deaths at 95 percent. According to PANOS, the chances of contracting HIV in a single unprotected sexual encounter is at 0.2 percent from men to women and 0.1 percent from women to men.

Chitaninge, who is now a former sex worker and a group member of the "Joiner Girls," told her story against a background that depicted an orderliness around her, a sign that she was now in full control of her life. In the one-roomed flat, which she shares with her cousin, one could not fail to notice how dishes and other cooking utensils are packed neatly on an improvised cupboard. Two suitcases are stacked neatly in one corner while the double bed takes up most of the space in the flat. But a frilled curtain suspended in mid air by a string separates what she calls the bedroom from the living room. On walls are posters which read: Hate me but you will never change my life; Money cannot buy a ticket to heaven; and "More problems but still living."

Chitaninge, who speaks with a hoarse voice, claims she is now born again and congregates at one of the Protestant churches. She has a steady boyfriend and hopes to get married one day. She advises commercial sex workers that they risk getting infected with the dreaded HIV virus which brings AIDS because most of them go for unprotected sex to make more money.

However, in developed countries where commercial sex worker are recognised, they demand to have sex using condoms so that they do not infect their clients or vice versa. They are also found in "legalised" brothels and not roam the streets. This is not the case in Zambia where commercial sex workers can be found anywhere.

Some NGOs have teamed up to try and educate commercial sex workers on the dangers of AIDS. One such organisation is Tasintha, which is headed by Professor Nkandu Luo, an Aids researcher and a Cabinet Minister. Said Prof Luo: "Tasintha had outreach activities which promote safe sex and distribute condoms. Some former sex workers help in such programmes and are an example to help those who are still on the streets that their kind of work is not only risky, health wise, but could try alternative ventures which could bring them money." Prof Luo says condoms are not 100 percent safe to protect anyone from getting HIV infections, but, as a Catholic, she advises abstinence from sex as a better approach to the matter.

However, during Chitaninge's time, she opted to go for unprotected sex so that she could get more money. On a good night, she could sleep with as many as ten men which meant that she could even go home with about K200,000. "Even if I am not feeling well, I could find a way of going to the street to ensure that I made some money. I would not be worried if I was menstruating because I would insist on having anal sex with a client," said Chitaninge, who spoke with her hands to illustrate a point.

Mercy Khozi, who is programme officer with PANOS, said education on the importance of safe sex was crucial because unprotected sex was the common way in which HIV could be contracted. Ministry of Health education specialist Sikwanda Makono, however, stated that commercial sex workers were aware of the dangers of contracting HIV, but practised this because they had to make money to survive. Mr Makono cited poverty as one of the contributing factors to the high levels of the HIV infection. He also mentioned media influence and lack of mitigating factors to help children learn how to protect themselves from unsafe sex.

Even commercial sex workers and those who have quit like Chitaninge know what it entails to practise unsafe sex. "During our days, I knew of HIV, but I brushed aside the advice since I was working for money. "I made a point that even if I was practising unsafe sex, by the time I contracted AIDS, I would have enjoyed myself and benefitted from men materially," said Chitaninge.

"Theatre, Music and Arts Responses to HIV/AIDS in Zambia."
Health-L, June 3, 2000

The Theatre section of the Royal Tropical Institute (KIT), based in Amsterdam, the Netherlands, is currently preparing its 2001-2002 programme cycle. The KIT Theatre focuses on exchanging western and non-western cultural expressions and creating cross-cultural linkages between countries and cultures worldwide.

Against the background of the HIV/AIDS pandemic, the KIT Theatre, in conjunction with the Dutch AIDS Co-ordination Bureau wants to organise a series of 6 programmes dealing with the HIV/AIDS pandemic. These programmes will include various cultural and artistic expressions addressing HIV/AIDS, such as film and video-programmes, theatre productions (including street theatre), music, exhibitions (e.g. educational materials, photos on AIDS and other art forms), public discussions and debates, for which we need the participation of groups and individuals from different countries, including Zambia.

The programme explicitly focuses on ALL continents, as we consider HIV/AIDS to be a global, not just regional, problem. The programmes will initially take place in the Netherlands, but we also intend to work together with the participating groups/individuals, in supporting them to set up similar initiatives in their own countries including Zambia.

At this moment, KIT Theatre and AIDS Co-ordination Bureau are trying to make an inventory of professional or community groups, networks, companies and individuals who are active in any of the following fields, worldwide, including in ZAMBIA:

• (street) theatre and drama
• puppetry
• film or video productions (including soap serials)
• photography
• music productions (recorded or unrecorded)
• art (paintings, sculpture etc.)
• exhibitions
• any other type of artistic expression

We would also like to get information on existing materials (films, videos, soap serials, music (CDs, cassettes etc.) and especially information on where/how to obtain them. So please send us full contact information (address, telephone, fax, e-mail) on the groups and individuals indicated above

Looking forward to your responses. Thanks in advance

Ilse Egers & Joost Hoppenbrouwer
AIDS Co-ordination Bureau
Royal Tropical Institute (KIT)
P.O. Box 95001
1090 HA Amsterdam
THE NETHERLANDS

"MS-Zambia Calls for Affordable AIDS Drugs." By Kennedy Gondwe
The Post, June 28, 2000

The treatment of HIV/AIDS should be affordable, accessible and appropriate if many people are to be saved from dying, MS-Zambia, a Danish Association for International Co-operation organisation has suggested. According to MS-Zambia Information officer Jorgen Christensen, the proposals were made at a conference held in Denmark two weeks ago at which Zambiaıs civil society was represented by University of Zambia (UNZA) lecturer Martin Kalungu Banda and Mary Ngoma.

³Existing forms of Structural Adjustment Programmes contribute to the continuation of the vicious circle of poverty and thereby perpetuating the spread of HIV. These programmes, therefore, should be target-specific and go beyond awareness raising and get into long term education processes that promote changes in values, attitudes and behaviour,ıı said Christensen. He said it was also observed that the private sector and civil society should develop and implement programmes oriented towards prevention, education and treatment of AIDS. Christensen said the conference also resolved that governments needed to put more emphasis on the education of men and women in reproductive and sexual rights.

"Lusaka Casual Sex Declines."
Times of Zambia, June 26, 2000

Casual sex among both men and women in Lusaka significantly declined between 1996 and last year, a study has revealed. This is according to a contraceptive availability, exposure to mass media and sexual behaviour study done by the Society for Family Health (SFH) and the Population Services International (PSI). SHF media and public affairs specialist, Mpundu Mwanza, said at the weekend that the study findings had been presented to various non-governmental organisations (NGOs) and members of the international donor organisations.

The objectives of the study were to assess the impact of the social marketing intervention on contraceptive availability to determine the exposure of men and women to different mass media activities and behaviour changes. The study also revealed that a higher proportion of those who engaged in casual sex in 1999 were poor while weak evidence also showed an increase in condom use among men.

It was also revealed that less than two per cent of non-traditional outlets stocked Government or commercially supplied condoms while 17 percent of traditional outlets stocked condoms from the two sources. In contrast, the social marketing condom brand Maximum which was stocked in 39 per cent of all outlets in urban areas was also available in 92 percent of all outlets that sold condoms. When presenting the findings to the NGOs and donors, SFH official Sohail Agha described as surprisingly positive the finding that the poor had more access of within 10 minutes walk to the source of the condoms in urban areas.

'Our initial reaction to this finding was that there was a data problem. However, further analysis showed how this finding was consistent with condom purchasing patterns and with social marketing emphasis on traditional outlets,' said Dr Agha. Explaining the concept of social marketing, Dr Agha said that by going into non-traditional outlets where condoms were not sold, social marketing expanded the universe and increased physical availability of condoms.

"AIDS, Debt: Africa's Deadly Combination."
Times of Zambia, June 10, 2000

The AIDS crisis has slipped off radar screens in the West thanks to heightened awareness on prevention and improved drugs to treat the disease However the disease is laying waste to the continent of Africa, weakened by a decade-long debt crisis that has systematic undermined the health and education system. The combination of AIDS and Debt has been deadly - and has highlighted more than ever the scandal of the debt crisis which has extracted scarce resources from impoverished people.

Recent research by the United Nations AIDS programme in Geneva have shown that the worldwide total of people infected with HIV is 33.4 million, up from 27.6 last year. There are 16,000 new HIV infections every day while 95 per cent of the infections have occurred in regions with the highest debt burdens in particular Africa but also Asia and Eastern Europe.

The worst hit regions is sub-Sahara Africa, where 70 per cent of all new infections and 80 per cent of deaths occur. UNAIDS estimates that there are 22.5 million people with HIV/AIDS in the region. Since the first AIDS deaths were recorded in the 1980s, 83 per cent of the world's AIDS deaths have been in Sub-Sahara Africa, and 95 per cent of the world's orphans are African. Carol Bellamy, executive director of the United Nations Children's Fund said that 'the virus is already wiping out almost at a stroke, the substantial reduction in child mortality that were achieved in the 1980s and the first part of this decade. AIDS is well on its way to producing tens of millions of orphans.'

In four countries - Zimbabwe, Botswana, Namibia and Swaziland- more than one in five adults are now infected with HIV. In Zimbabwe it is 26 per cent, in Botswana 25 per cent and in Namibia, Swaziland and Zambia 18 to 20 per cent. Uganda has the heartbreaking distinction of having the largest population of orphans in the world, 1.7 million children have lost their mother or both parents to AIDS.

Janat Mukwaya, Minister for Gender, Labour and Social Development in Uganda said: 'Like a vast thresher, AIDS has churned through our fertile land with ruthless force, cutting down the young, the educated, so many of our people in the prime of their productive life. She stated that the human tragedy was compounded by a social welfare crisis - as people were forced to go without treatment for AIDS, because of the high cost of antiretroviral drugs that have kept patients in industrialised countries alive and healthy.

It is no coincidence that the AIDS crisis has exploded most dramatically in highly indebted countries. The impact of the debt over the last two decades is systematically diverting resources from health and education towards unproductive debt servicing has had devastating results. Many countries in Africa spend four times as much on servicing their debts as on health.

Tanzania spends nine times more on servicing its debts than on basic health. The fall in expenditure and health has undermined the basic preventive measures needed to address the scale of the diseases- such as health, education, supplies of reliable condoms or ante-natal drugs treatment needed to prevent the spread of HIV.

A fragile health-care system has then been unable to cope with the ensuing spread of infection. The sudden influx of patients has brought many hospitals in indebted countries to the brink of collapse. 'The AIDS crisis thrives on poverty, social disruption and ignorance. Debt and structural adjustment have been instrumental in creating this situation through falling investments in health, the introduction of user fees for health and education and growth in unemployment,' said Dr Dorothy Logie of Madact, an organisation of health professionals in the UK. 'AIDS is also a marker of injustice and lack of human rights, especially women's. AIDS has spread dramatically as men have been forced to migrate to the cities in search of work -and have exploited women selling street sex in order to stay alive and feed the family.'

Zambia is a typical example. Zambian GNP per capita is $390, but each Zambian owes $720 to foreign creditors. Each year the Zambian government spends $17 per person on heath and $30 per person on debt service to western financial institutions. Contrast that with the nations of the G7 (the US, UK, Canada, France, Italy, Germany and Japan) where governments spend $2,300 per person on health care.

Zambia's weak health service has been unable to cope with the rapid spread of AIDS. The treatment of AIDS is very costly. The average cost of treatment in the North amounts to about 10,000 per person each year. In Zambia 20 per cent of the population is now HIV positive, and it is estimated that around nine per cent of Zambian children under 15 have lost a mother or both parents to AIDS. Yet the Zambia government has only $17 per person to spend on health. Life expectancy has now dropped to 43 years, and is expected to decline still further as AIDS continues to take its toll. Zambia is not alone. The expenditure on health-care throughout Africa is pitiful. The astounding figures in Africa include: Kenya $8; Uganda $9; Cote D'Ivoire; $25; Burkina Faso, $54, Ethiopia $3.

Ann Pettifor, Director of Jubilee 2000 Coalition, said, 'Continuing to demand debt payment above health-care is a scandal-even more so in the context of this appalling AIDS epidemic. 'Creditors in the west must recognise that every dollar they take in debt service is another dollar that could be spent dealing with AIDS' deadly toll. 'While rich countries are beginning to cope with the AIDS crisis, the poorest countries are unable to afford simple measures that would limit the spread of the disease and care for the those who are suffering.

"AIDS, Sexual Trafficking Raises Concern at UN!"
The Post, June 8, 2000

In Africa, women infected with the HIV virus now outnumber infected men. Nearly two-thirds of the worldıs illiterate people are women, and more than 70 per cent of women live in poverty, according to advocates for women attending a UN-sponsored conference this week. The trafficking of women as sexual slaves is also among top issues at the conference. Trafficking of women and girls is estimated to be an US$8- billion-a-year industry.

UN Secretary-General Kofi Annan characterized the practice in an address to the conference as "an outrage dating back to biblical times" which "has now become a worldwide plague." Annan said he will ask world leaders who attend the Millennium Summit in September to launch an international campaign to reverse the spread of AIDS.

The disease is killing tens of thousands of young mothers, especially in southern Africa. On that continent, women infected with the HIV virus now outnumber infected men, said Adrienne Germain, president of the International Womenıs Health Coalition. But thatıs not because African women are promiscuous or ignorant of the disease, Germain said. ³"tıs because men have sex with any number of women and they bring it back to their wives." Germain said both trafficking and the rapid increase of women with AIDS "are driven by menıs demands for sex." "If weıre going to deal with that issue we have to deal with both ends of the equation, namely we have to recommit ourselves as we did in Beijing to recognizing womenıs sexual rights and menıs responsible sexual behaviour," she said.

The conference is informally being called "Beijing Plus Five" because it is a 5-year follow-up to the UNıs Fourth World Conference on Women, held in the Chinese capital in 1995. Participants aim to review progress made since then and to agree on a final document they hope will lead to additional improvements. But the question of violence against women has become a sticking point in negotiations over the content of that document. Representatives from some of the roughly 180 participating nations dispute the notion that practices such as wife-beating, so-called ³honor killings² and female infanticide are violations of human rights that should be punished by law.

Before the conference began, U.N. High Commissioner for Human Rights Mary Robinson expressed concern that the review process could undo some of the gains won at Beijing. Just a few nations could block any real progress, she said. "The few that donıt want progress are very effective, and thatıs a problem. A problem because the gains made are still fragile," she said during a symposium in New York sponsored by Rutgers Universityıs Centre for Global Womenıs Leadership.

Figures released by the U.N.ıs Statistics Division paint a picture of the progress made since 1995 and the problems that remain. Fewer women die in childbirth, but pregnancy-related deaths vary widely by region. The rate is 1-in-16 in Africa, 1-in-65 in Asia and 1-in-1,400 in Europe. More girls are gaining access to education. However, enrollment for girls in primary and secondary schools is less than 80 per cent of enrollment for boys in 22 African and nine Asian countries. And nearly two-thirds of the worldıs illiterate people are women.

Other issues discussed at the conference include:

• The repeal of laws that discriminate against women, including those that allow rapists to escape punishment by marrying their victims. Some 60 countries have made changes recommended at Beijing, but many others have not.
• The economic situation of women. More than 70 per cent of the worldıs women live in poverty, US first lady Hillary Rodham Clinton said in her address to the conference.
• The increase in domestic violence and sexual abuse in families, across all classes of society.
• The importance of getting men involved in efforts to end violence against women and improve womenıs situation in society. ³If we want transformation, we need transformation in both men and women,² said Sreelakshmi Gururaja, senior adviser on gender and development at UNICEF.

"HIV Infections Decline Among Young Zambians" By Bivan Saluseki
The Post, June 5, 2000

The Joint United Nations Programme on HIV/AIDS (UNAIDS) says HIV/AIDS prevalence among young people in Zambia is declining. Addressing the ninth programme co-ordinating committee for UNAIDS in Switzerland last week, executive director Dr. Peter Piot said the achievement were due to the vigorous campaign by NGOs and other bodies working to fight the pandemic.

According to a dispatch from UNAIDS Dr. Piot ³this movement in national and international agendas is mirrored by new success stories - in the Bahamas; in Zambia, where prevalence is declining among young people; in Botswana, where falling rates of syphilis and gonorrhoea are likely to be the precursor to a fall in new HIV infections; in evidence of behaviour change in Tamil Nadu in India; and in Brazil, where major steps in access to care are being achieved".

He said only governments can take the tough decisions to create more favourable conditions for others to play their role and also protect the poorest and the most vulnerable. ³There is an absolute need to translate global political mobilisation into country level action. While international political mobilisation is key to raising additional financial, human and technical resources, it can never substitute for work in countries," Dr. Piot said.

He said developing countries should question how international commitments translate into practical actions, to countries, communities, and individuals. "³I am sometimes challenged that the policy prescriptions of UNAIDS donıt work. Some say that their epidemics continue to worsen. I reply that we are not offering magic bullets: every country, every community, must find its own way along these and also letıs not forget that it may take five years or longer for effective prevention campaigns to show up in incidence data," he said.

He further said the international community has been spending about US$200 million a year in preventing HIV infection in Africa despite UNAIDS current estimation that the continent alone would need between $1.6 billion and $2.6 billion a year to achieve prevention levels at least comparable to what has been achieved in Uganda and Thailand.

"Whither UTH? As Impasse Takes its Toll." By Mildred Mpundu
Times of Zambia, June 3, 2000

(note: this excerpt of the article deals with the HIV/AIDS impact on health institutions in Zambia)

Between 1998 and 2000 the National Health Strategic Plan was put in place but proved difficult to deliver with very little resources and the rising demand for service provision. The report states further reasons such as the impact of a demographic and epidemiological transition most affected by the HIV/AIDS.

HIV/AIDS according to the report has brought disruption and change in social networks and support systems. There has been a significant movement of people from urban to rural areas mainly due to retrenchments in Government and parastatal organisation. The impact of HIV/AIDS has resulted in large numbers of orphans, increased child and adult mortality rates, increased cases of TB, increased burden of care on households (especially women), and increased cases of TB.

'This has vastly increased the burden of care on the health sector, communities and households. The prevailing patterns of HIV infection were never envisaged in the early stages of the health sector reforms.' 'However, they have now become an over arching issue within health and other sectors. Other issues setting the agenda for a discussion of the social context of health are poverty, equity issues and gender inequalities,' the report states. It has been found that there is a link between poverty and AIDS. Health officials explain that HIV is absorbing a large share of the health sector budgets and human resources.

'The direct and indirect costs of illness can be significant, with data from Zambia suggesting that AIDS illness and death consumes 200-400 per cent of annual household income, depleting savings and pushing the marginal or transient poor into absolute poverty and indebtness.' The 'Proposed Health Sector Support Investment Programme (2001 -2005) says 'It (HIV/AIDS) may also be the case that it is distorting some of the objectives of the health sector reforms. People with HIV/AIDS are more likely to go to hospitals than clinics because they think they will get better service.

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Last updated July 31, 2000

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