University of Zambia Medical Library

HIV/AIDS in Zambia: October - November 2000

"Zambian Activists Urge Men To Fight AIDS." By Mildred Mulenga
Panafrican News Agency, November 30, 2000

Zambian society is dominated by men. The question now under debate in the country is: Will the men help stop the further spread of AIDS? With the advent the world's commemoration of the 2000 World AIDS Day which falls on 1 December, this year's theme of "Men Make a Difference" is a good point to start in the debate.

Zambian men are accused of having continued to be at the top of suppressing voiceless and powerless women to negotiate safe sex for themselves in the face of a widening impact of HIV/AIDS in the country's population.

"If you look at the cultural limitations towards the control of AIDS, men make a difference. In an African society the man is literally supreme. Most women do not have a voice and by that it means women are not able to actively and progressively negotiate sex," UNAIDS Country Programme Advisor in Zambia, Kenneth Ofosu- Barkoit, told PANA.

"If a man does not want to use a condom, it does not happen and these are some of the issues that ought to be addressed. Women must be taken in as equal partners in decisions of sex or negotiations of sex," he added. Ofosu-Barkoit stressed the importance of women being given a voice and a need to modify or eliminate some of the cultural practices which contribute to the further spread of HIV/AIDS, like inheritance practice where a widow or widower is forced to accept a member of the deceased family as a new spouse.

The context of the current HIV/AIDS epidemic in Zambia, with a population of about 10 million, is said to be alarming. The most distressing trend has been the drop in life expectancy from 54 years in the mid-80s to an estimated 37 years in 1998. According to the health ministry, 20 percent of the adult population is infected with HIV and it is projected that the number of HIV infected persons will increase to 1.1 million by 2010.

Transport and communications minister Nkandu Luo, however, attributes part of the increase in the number of people infected to the current HIV/AIDS interventions which have not been structured to help change people's thinking. "At the moment the way we have structured our interventions is to go into the community and start educating them about HIV/AIDS and giving them information. "But this information on a society that has got other deep rooted structures that drive it cannot help. What we need are other interventions that help change people's thinking and socialisation," Luo, Zambia's co-chairperson of the International Conference on AIDS/STDs in Africa, told PANA.

According to her, one of the things that is deep rooted in the Zambian society is the fact that people are socialised to think that a woman is a second class citizen and that the most important thing that can happen to any woman is to get married regardless of various circumstances. Consequently, the Zambian woman is prepared to take any risk just to be married so that she is seen as normal in society.

"We are socialised to think that to be seen to be woman enough is to be able to bear children. Now these views have consequences on HIV/AIDS," she said, adding that for most women, even those with university education, the ultimate in life was to get married. "This is why you find women are getting married to widowers who have lost wives as a result of AIDS. So if the cause of death is AIDS, it means the woman will be inheriting HIV through that marriage," she added.

She suggested that future generations should be talked to more on society's socialisation so that children now growing can have a different attitude to life. "They must be able to say what I need is a partnership and this partnership is something that I can cultivate without necessarily thinking that it is the ultimate in life," she said. She cited the after-death-cleansing ritual, which in some tribes involves sex. She noted that whereas in northern Zambia this involves smearing white powder or maize meal flour on the widow or widower's forehead, this was not the case in Southern Zambia where sexual cleansing was prevalent until health authorities intervened.

Luo said that this year's AIDS theme is appropriate because in the past, the HIV programmes and interventions have been mostly directed at women. Men, she felt, needed to get on board for them to realise that they were part of the AIDS problem. "Most importantly and without apologies they (men) are the major contributor of HIV. They are at the centre stage in terms of the spread of HIV while women are at the centre stage of solving this problem," she added.

Some critics blame the women themselves for allowing themselves to be used as concubines even when they were very aware the man they were dating had other women in his life. "If we can take out of our sights such men and all of us women boycotted such men, there would be no rapid HIV/AIDS spread at the rate it is now going. "The way we socialise in our society is to excuse men, under the traditional belief that promiscuity of a man will not break a home. Should this continue in the face of HIV/AIDS?" Luo, who is also the chairperson of the Society for Women and AIDS in Zambia, questioned.

Experts regret that the AIDS situation in Zambia is worse since the first AIDS case was reported in 1984. AIDS-specific child mortality is projected to increase from about eight per 1000 live births in 1990 to 33 per 1000 live births in 2000. It is estimated that by the end of 2000, more than 500,000 children will have lost their parents due to AIDS and the number of orphans is projected to exceed one million by 2010. An estimated 30,000 babies are infected with HIV each year due to mother-to-child transmission.

Brigitte Syamalavwe, a mother living with HIV/AIDS, thinks cultural beliefs should be addressed when dealing with the epidemic, noting that Zambian (and African) culture is still against people talking to their own children about sexual behaviour. "We call someone to come and talk to our own children about their sexuality and then refuse to acknowledge that our children are involved sexually. We are still in the denial stage," Syamalavwe, a UN volunteer attached to the education ministry, said. "AIDS is a big problem... Teachers are dying and there is a lot of absenteeism. We are losing about three teachers per day on average in the education sector. So the country is losing a lot of years of investment every day," she added.

Brian Bwalya, a Lusaka businessman, said while AIDS Day is focusing on men making a difference, it must be understood that it is not entirely the man's fault because society also plays a large role. "We have these cultural taboos that say a man cannot have sex with his wife in certain circumstances (three or six months after the birth of a child). So because of this, a man, who is a hunter, will look for (sexual) alternatives. But these are some of the issues which I think as a society we can collectively address," he added. He said as much as men want to take up this challenge and play a major role in the fight against AIDS, women should, however, assist and educate the children, especially the girl-child, as it is difficult for a man to talk to his daughter on sex.

According to recent statistics, one in four men in Zambia reported having had at least one casual partner in the last year, compared with only 1 in 20 women. So men are the problem and can make a difference in stopping the AIDS epidemic.

"Orphan Crisis in Zambia." By Michael Kelly, M.J: School of Education, University of Zambia
OneWorld Africa, November 28, 2000

BACKGROUND:
In the following article, Michael Kelly, S.J., looks at the devastating effects of HIV/AIDS on families and children, especially that the epidemic is occurring at a time of almost universal poverty. Michael discusses how the AIDS pandemic makes poverty even deeper and more dehumanising. He examines how the loss of productive adults and the costs involved in caring for the sick and burying the dead have eaten away at families' few resources, leaving survivors with their hearts torn out and their ability to cope almost shattered. The majority of these survivors are the children whom we call orphans. Hence the upsurge of the orphan population and the crisis that this brings about.

When the people of Japan awoke on the morning of 7 August 1945, they did not know that that was to be a day of catastrophic doom for one of their cities. It was on that day that an atom bomb devastated Hiroshima, taking 92,000 lives. When the people of Zambia awake each day, are they aware that because of HIV/AIDS they face an even more calamitous situation? The number of new HIV infections is believed to lie between 300 and 500 per day.

THE NATURE OF THE CRISIS:
More than fifteen years have passed since the first AIDS case was diagnosed in Zambia. Since then the epidemic has spread to all parts of the country. Some parts are worse hit than others, but no part is exempt.The current estimate is that one out of every five of those between the ages of 15 and 49 is infected. This amounts to almost 1,000,000 infected adults. In addition, 70,000 young children have been infected through their mothers.

The Ministry of Health's sober estimate is that almost all of these people will die within the next ten years, with the number of deaths due to AIDS rising from its current 200 per day to nearly 350 per day by 2005. Meanwhile, the number of new HIV infections is believed to lie between 300 and 500 per day. This is no longer leading to an increase in the prevalence rate because the rising number of AIDS deaths is offsetting the number of new infections.

The effects on families and children are devastating. The epidemic is occurring at a time of almost universal poverty, and its effect is to make that poverty even deeper and more dehumanising. The loss of productive adults and the costs involved in caring for the The large proportion of orphaned children gives Zambia the unhappy distinction of being the most orphaned country in the world. Sick and burying the dead have eaten away at families' few resources, leaving survivors with their hearts torn out and their ability to cope almost shattered. The majority of these survivors are the children whom we call orphans.

ORPHANHOOD:
An orphan is a child who has lost one or both parents. A maternal orphan has lost the mother, a paternal orphan the father. A child who has lost both parents is sometimes referred to as a double orphan. It is very likely that a child who has lost one parent because of AIDS will soon become a double orphan, since the likelihood of the surviving parent being HIV-infected is also high.

Some children are multiple orphans. They became orphans through the death of one or both parents. This led to their being incorporated into the family of relatives. In several cases, AIDS claims these relatives also, and once again the child is orphaned. Some children have had repeated experience of this.

Estimates vary as to the number of orphans in Zambia. One estimate is that 1.656 million children, or more than one-third of those under the age of 15, are orphans who have lost one or both parents.

Less than one quarter of the orphans have lost their parent or parents to other forms of sickness or accidents, while more than three-quarters are orphans because of AIDS. The large proportion of orphaned children gives Zambia the unhappy distinction of being the most orphaned country in the world. Instead of getting smaller, or at least not increasing, the problem of orphanhood is increasing rapidly. Between 1996 and 1998, there was a national increase of over fifteen percent in the number of orphans. This was a very large increase in such a short time.

The situation was even worse in the Southern Province where there was a thirty percent increase. This continued rapid growth in the scale of the orphans problem means that Zambia is likely to retain its position as the most heavily orphaned country in the world for at least the coming ten years, with the proportion of orphaned children rising to more than 38%.

ORPHANS AND VULNERABLE CHILDREN:
The orphans and vulnerable children situation in Zambia is of such magnitude that it poses a national challenge which few other countries have had to face. Certain key factors have to be borne in mind when considering this challenge:

• the vulnerability of all children in Zambia is very high because of worsening economic and agricultural conditions;
• the proportion of children who have lost one or both parents is so high that considering them a target group may not be useful—the attitude of communities is that help should be given to the child in need, whether this need arises from being an orphan or from some other cause;
• apart from orphans there are many other vulnerable children in Zambia - street children (75,000 to 90,000), children who are physically or sexually abused (there has been a large increase in the media reports on these), child labour (on the increase as AIDS-related mortality pushes an increasing number of young children into income-generating activities outside the home), and disabled children (mostly invisible and anonymous, their number unknown, but almost certainly exceeding 150,000)
• there is little merit, and there are ethical problems, in drawing a distinction between those orphaned due to AIDS and those orphaned due to other causes. As far as possible, the term "AIDS orphan" should be avoided when dealing with individual children, with families, with communities, with pupils in schools, or with those being treated in health institutions.

THE NEEDS OF ORPHANS:
The needs of orphans are;

• the needs of households in poverty, for food, shelter, accommodation, clothing;
• the needs of any child under age 15, for health care and schooling;
• the needs of any young person for access to work; and
• the psychological needs arising from their orphan status.

Orphans suffer more deprivations than non-orphaned children. They may receive less food than others or be segregated at meal times. They are more likely not to be enrolled in school and not to have exercise books or pencils. They may be required to undertake a larger share of household chores. They are likely to lose the property they should have inherited from their deceased parents. Orphans who have lost their mothers are at a higher risk of sickness and are less likely to get immunisations.

Coming on top of the AIDS problem, the orphans crisis poses a serious threat to this future. Orphans are likely to have somebody to pay their school fees. Orphans who are living with grandparents, especially elderly grandmothers, are particularly vulnerable because of the inability of the grandparents, at their age, to provide for the material, social and psychological needs of another generation of children.

Orphans have unique psychological needs. The death of parents plunges them into grief and removes one of the basic anchors in their lives. Often this is made worse when they are separated from their siblings.

They experience deep trauma from the harrowing experience of seeing a parent suffering in the final stages of an AIDS death. In their new circumstances, they may not be able to find anything to replace the love, attention and affection which they received from their parents. They are in urgent need for the child counseling that would provide them with special psychological support.

There is also need for this help to be provided before the parent actually dies. Parents need to be helped to talk out with their children that they (i.e., the parents) or other close members of the family may die very soon. Children need to be helped face up to the real possibility that their parents or other loved ones may die very soon.

CARING FOR ORPHANS:

• The ideal situation is for orphans to remain with or be incorporated into a family with which they have blood ties, to stay with their own siblings, and to live in the familiar surroundings of a known community. In other words, the family is the first line of response to the crisis. Institutional care should be considered only in two circumstances: as a temporary arrangement while negotiations are under way for the within-family placement of an orphan; and as a reluctant arrangement of last resort, when all else fails.
• The brunt of the orphans problem is being borne by the extended family and communities, which despite the enormous pressures being placed on them are coping in truly heroic fashion. They have responded magnificently to the double crisis of losses to AIDS and increases in the number of orphans, standing fast in the face of the huge pressures being placed on them, and coping with the problems almost as part of their normal routine.
• Because the family and the extended family provide the most important response to the orphans problem, all policies, strategies and interventions should focus on strengthening their structure and operations, both as entities in themselves and as part of the community, so that they can adequately discharge their child protection and care roles.
• Income-generating activities and well-run micro-credit schemes are powerful tools for boosting the capacity of families and communities to manage their own problems. Assistance which is directed along these lines appears to work more effectively in generating employment and reducing poverty than other targeted non-credit schemes (such as food aid). However, for such schemes to work properly it is crucial that income-generating activities be treated as serious business ventures which are evaluated on the basis of their commercial feasibility and which are managed by persons with the time, skills and motivation to make them profitable.
• The bulk of activities directed towards mitigating the orphans problem are the work of civil society—NGOs and community-based organisations (CBOs). However, the current response of NGOs, religious institutions and donors is random, with little co-ordination or geographic focus.
• There is great need to strengthen NGOs and CBOs (in such areas as community mobilisation, participatory action, financial management, records management, financial planning) so that they can become even more responsive to local needs. As things stand, most of these organisations learn by doing and have had little opportunity or incentive to evaluate the impact of their approach.
• There is little evidence of active government involvement in responding to the orphans problem. Currently there is no national government mechanism for the co-ordination of support to orphans and vulnerable children. Consultation, collaboration and linkages between government ministries, and between government and NGOs working in this area are weak.

WHAT CAN WE, AS CHRISTIANS, DO?:
As with AIDS, no part of Zambia is exempt from the orphans crisis. It is found in every community and in almost every household. It is found in every parish. In the early church, the local Christian community took into its care any child who had lost one or both parents.

This was their way of recognising in practice that God is the Father of orphans (Psalm 68: 6). Given the scale of the problem, this is not possible in Zambia. But it is possible for every parish to set up structures, make collections, and establish income-generating enterprises that will support families and communities in looking after their orphans. Nothing works better here than strengthening the family, something that is excellent in its own right, and particularly so in the light of the exhortations of the African Synod.

On top of this, there is need for co-ordination of effort and for sharing of information on what works and what does not work. Without pinning too much faith on structures and committees, there seems to be need for some kind of overall co-ordinating activity at all levels - small Christian community, parish, diocese, nation. The health desk in the Catholic Secretariat may be able to deal with some of this, but something more may be required. Though the orphans crisis is largely due to thenumber of AIDS deaths, what is at issue here is care for the living and healthy.

More fundamentally, what is at issue is the future - the life, the hope of families, of communities, of the future for Zambia. Coming on top of the AIDS problem, the orphans crisis poses a serious threat to this future. What kind of response can we provide, as concerned Christians inspired by the special concern that the good Lord always showed for children?

"President Chiluba Faults Imported AIDS Drugs."
Panafrican News Agency, November 21, 2000

Zambian president Frederick Chiluba Tuesday said some of the imported AIDS drugs currently on the local market have proved to be "totally useless and highly dangerous and toxic." He made the remark at a Resource Mobilisation meeting for the National HIV/AIDS strategic framework for the year 2001-2003 in the capital, Lusaka. Chiluba said out of desperation and lack of affordable drugs, people are resorting to untried alternative remedies including herbal medicines whose outcome has been catastrophic.

"In one case, a remedy widely touted as a cure-all has failed scientific tests; in fact studies have shown the drug to be highly toxic even at very high dilution" the president told the crowd. "This drug is being offered to the unsuspecting public who are unaware that it is not only useless in combating the disease, but is very dangerous because of its high toxicity," Chiluba said.

"What I find most regrettable is that in Zambia, like the rest of the developing world, a diagnosis of AIDS is a virtual death knell for an individual" he continued. "The lack of affordable medicines, consigns many otherwise hopeful cases to early terminal stages and death," he charged. "Paradoxically, Chiluba noted, the same disease does not pose the same finality in the developed world where adequate affordable drugs are available, and medical advances have allowed those infected to manage the disease."

He said people in sub-Saharan Africa, which he described as the epicentre of the pandemic, have no access to the drug cocktails "that have turned AIDS from a virtual death sentence to a controllable disease that infected people can live with - all because the drugs are too expensive." Chiluba said Zambia's strategy should now include shifting from being a passive recipient of external medical, social and scientific initiatives to an active participant in advocacy, research and prevention.

The President outlined his government's effort to accelerate and scale up the national response to the AIDS disaster. He said the measures would include the formation of a committee of cabinet ministers on HIV/AIDS and also the establishment of the HIV/AIDS/STD/TB council and a National HIV/AIDS secretariat.

The Resource Mobilisation meeting was organised by government to solicit funds from partners for the implementation of the National HIV/AIDS Strategic Framework project estimated to cost about 558 million US dollars for a three-year period beginning 2001. Chiluba, who said Zambia has found herself in a desperate situation in regards to AIDS, said his government needs to find the money in order to implement various programmes for HIV/AIDS prevention, care, support and impact mitigation.

"We cannot afford to continue borrowing money for each and everyone of our critical needs, including HIV/AIDS control programmes" he said. "It is for this reason that I am personally appealing to each and every one of you and your constituencies, to hear our plea for more resources to fight the epidemic" Chiluba pursued. The problem, he said, is very urgent and we need to begin to do something very serious about it now.

Tomorrow, he continued, will definitely be too late. "A large proportion of the Zambian population is living with HIV and AIDS", Chiluba said, adding, current data suggests that nearly one million Zambians are living with HIV/AIDS and that infection levels approach 20 percent of the adult population."

"State Urged to Set Up HIV/AIDS Desk." By Mildred Mulenga
Times of Zambia, November 27, 2000

A medical practitioner has called for the establishment of an HIV/Aids desk at State House to give the Aids problem a presidential seal. The desk would also give the global problem a new dimension needed to raise the profile of anti-Aids campaigns. Dr Boniface Kawimbe, who is former Minister of Health, said this on Friday night when he addressed the Lusaka Press Club at Lusaka Hotel on the theme, financing HIV/Aids treatment in Zambia.

'HIV/Aids is not a Ministry of Health problem but a national one. It is against this background that you will agree with me that the Head of State should give the HIV/Aids desk a Presidential seal of support,' he said. He added that there was enough room at State House to accommodate one more desk, in addition to the Religious and Vendors desks.

Emphasising the need for free treatment of children afflicted with Aids, Dr Kawimbe told the audience that it was not realistic to expect the Ministry of Health which was struggling to acquire other drugs, to fund the treatment of about 400,000 people at a cost of five trillion Kwacha. He said there was need to set up a national health fund to finance HIV/Aids treatment. There was a growing realisation that just as transport companies insured their vehicles, Airlines insured their aeroplanes, factory owners their plant and equipment, there was an equal, if not overwhelming need to insure the drivers, pilots and factory workers as a vehicle without a driver or a plane without a pilot was almost as useless.

'Health insurance is the only rational way of financing health care because there are very few people anywhere in the world who keep enough money to pay for health care when the need arises, hence this should be compulsory so that the health insurance pay for the sick,' he said.

Dr Kawimbe urged Government to take advantage of the offer of 80 per cent price reduction in the preferential pricing for public sector Aids programmes in developing countries, bulk buying of Aids drugs by the same countries and setting up of monitoring facilities. The offer was made eight months ago by the World Bank, UNAids, WHO, UNICEF and UNFPA in conjunction with five internationally recognised pharmaceutical companies.

"Local anti-AIDS Herb Not Safe." By George Chomba and Thomas Zgambo
Daily Mail, November 22, 2000

President Chiluba has warned Zambians afflicted with HIV/AIDS against being prescribed a local herbal remedy famed as the cure because scientific tests have proved that it is not only a failure but highly toxic as well. The President said yesterday that the drug being offered to the unsuspecting public was not only useless in combating HIV/AIDS but also dangerous.

Dr Chiluba said this at the official opening of the National HIV/AIDS strategic framework workshop at the Mulungushi International Conference Centre in Lusaka whose theme was "Resource Mobilisation." "As you may be aware, Government last year established a technical committee to evaluate some of our local herbal remedies. In one case, a remedy widely touted as a cure-all has failed scientific tests. In fact the studies have shown the drug to be highly toxic even at very high dilution," he said.

Dr Chiluba, who was addressing a number of anti-AIDS activists, cooperating partners and Government leaders, said that since the cure for the AIDS pandemic had become elusive while access to the cocktail drug was expensive, it was time for Zambians to adapt to measures of advocacy, research and prevention. "Through my visits to hospitals, homes, funeral homes and through letters of appeal from orphans and widowed spouses, I have witnessed pain, devastation and fragmentation because of what the disease has brought," he said.

The President said the strategy must therefore clearly focus on giving the disease a human face, and not the academic rhetoric that had so far characterised the approach. He said the country should aim for effective education and community activism to reduce or eliminate new infections.

According to projections, at the end of 1999 over 34.3 million adults and children were living with AIDS and that 18.8 million people around the world had already lost their lives. Most of the victims were from sub-Saharan Africa while poverty coupled with a huge external debt were cited as barriers to efforts to mitigate the pandemic.

Dr Chiluba however, said paradoxically the disease does not pose the same fatality in the developed world as there were adequate and affordable drugs. He said since drugs were not affordable in the country, people in desperation resorted to untried drugs, including herbal medicines which he termed as highly toxic. At the same function, United Nations resident representative Ms Olubanke King Akerele, affixed a red ribbon on Dr Chiluba's jacket. The ribbon signifies commitment to the fight against HIV/AIDS.

"Chiluba Calls for Cheap AIDS Drugs."
Times of Zambia, November 22, 2000

President Chiluba has challenged Third World countries to find affordable AIDS drug cocktails that will allow those infected to manage the disease. Dr Chiluba said yesterday in Lusaka that it was possible to turn AIDS from a virtual death sentence to a controllable disease that infected people could live with if the drugs were affordable. He said lack of affordable medicines such as the cocktails had consigned many hopeful cases of HIV/AIDS to early terminal stages of the disease and even death.

The president said this when he officiated at a resource mobilisation meeting for the national HIV/AIDS strategic framework for the years 2001 to 2003. He said it was regrettable that in Zambia like the rest of the developing world, a diagnosis of AIDS was a virtual death knell for an individual.

‘Paradoxically the same disease does not pose the same finality in the developed world where adequate and affordable drugs are available,’ Dr Chiluba said. He said the situation in Zambia and other third world nations was so bad that people in desperation were now resorting to untried alternative remedies like herbal medicines. He said the use of untried herbal medicines had proved equally catastrophic as a good number of the so-called remedies were found to be totally useless while they were highly dangerous and toxic.

Dr Chiluba said a technical committee set up by Government to evaluate some local herbal remedies found one drug to be highly toxic even when diluted. ‘This drug is being offered to the unsuspecting public who are unaware that it is not only useless in combating the disease but that it is very dangerous because of its high toxicity,’ he said.

He said the strategy against HIV/AIDS needed to shift from that of Zambia being a passive recipient of external medical, social and scientific initiatives to an active participant in advocacy, research and prevention. There was need to eliminate new infections while at the same time strive to mount even greater activism to provide adequate medical support for those infected to ensure they lived positively.

Dr Chiluba said Zambia needed to find and spend between $300 million and $500 million for the next three years for various programmes for HIV/AIDS prevention, care, support and impact mitigation. He said the amount of money required may appear colossal but reflected both the complexity and magnitude of the problem as well as the value of human life. The president urged the international community to donate generously towards Zambia’s fight against the AIDS pandemic.

"AIDS Worries Mwansa." By Amos Malupenga
The Post, November 20, 2000

It's either we are all infected or affected by HIV/AIDS, deputy health minister Ernest Mwansa told Parliament last Thursday. Mwansa, contributing to debate on the Committee on Community Development and Social Welfare Report, said the AIDS problem was too big to ignore. He urged the members of parliament and general citizenship to take precautions because AIDS could wipe out the nation if that was not done.

"We are all affected by HIV/AIDS, it affects everyone," he said amidst shouts of approval from the House. "In fact, the safest way to say it is if we are all not affected by it then we are infected." Mwansa urged people to take precautions particularly for the unborn children and those who are young. "A law should be enacted to deal with people who, knowing their HIV/AIDS status, proceed to deliberately infect other people especially the young boys and girls," Mwansa said. "There is no difference with those who willingly kill other people, murderers. Action must be taken against those who willingly ruin human life."

And Mwansa said government had no intentions to start disclosing the cause of death in cases of highly profiled official whether or not it related to HIV/AIDS. He was answering Kapiri Mposhi independent member ofparliament MacDonald Nkabika who suggested that government should make it a policy to announce the cause of death in cases of senior government officials. He said this could be one of the best ways to sensitise the people about serious diseases like HIV/AIDS, tuberculosis or cancer.

"Zambia Needs Over 500 Million Dollars to Fight AIDS."
Pan African News Agency, November 19, 2000

Zambia, one of the countries hardest hit by the HIV/AIDS epidemic, has estimated that it will need about 558 million US dollars to implement a three-year national programme to combat AIDS. The government is expected to put in 126 million dollars, most of which would be expended on personnel costs to support hospital care and other government salaries, while donor partners are expected to contribute 414 million dollars.

According to the costed national HIV/AIDS Strategic Framework for 2001-2003 document to be presented to Zambia's co-operating partners this week, about 31 million dollars is currently committed by donors to support the framework. "The gap between the estimated total cost for implementing the Framework and the financing known to be available is 382 million US dollars. Approximately 39 percent of this gap is attributable to the estimated cost of drugs for Highly Active Anti-Retroviral Therapy (HAART)," the document says.

About 67 million dollars would be needed as cost of drugs for treatment of opportunistic infections and about 61 percent of the total budget would be channelled to hospital care of AIDS patients and to HAART. "The costs to be borne by the Zambian government for hospital care - 116 million US dollars, are by far the predominant amount among all the costs to be borne by the government. Approximately 93 percent of funds committed by the government for activities to combat AIDS would be expended on hospital care of AIDS patients," it adds.

A roundtable meeting is scheduled to take place Tuesday where the HIV/AIDS Council is expected to present the costed national HIV/AIDS Strategic framework to co-operating partners as a basis for scaling up the national response to the HIV/AIDS epidemic in Zambia. The meeting would provide a forum at which co-operating partners could pledge financial or other assistance towards the realisation of the vision for more effective HIV/AIDS programme in Zambia.

An estimated 700,000 adults and children in Zambia have already died due to AIDS, and with an estimated one million persons currently living with HIV - one in five adults - another 1.6 million Zambians are likely to die if the current trend of the epidemic continues. The 1999 prevalence studies showed a decline in HIV prevalence among young people aged 15 to 19 between 1993/94 and 1998. The decline, more marked in urban areas where the response to the epidemic had been more intensified, is said to be an indication that the investment made in HIV/AIDS prevention is beginning to yield dividends.

The HIV/AIDS Council said it faces a major challenge in making the best decisions for Zambia's future. It noted that while the proximate cause of AIDS is the HIV virus, the extent and impact of the epidemic are rooted in underlying causes, including poverty, the unequal status of women, lack of knowledge and information. "A downward spiral has developed where the root causes lead to increase transmission of the virus and the impact of the virus aggravates the root causes. AIDS is indeed a fundamental obstacle to the future development of Zambia," it said in the document.

"Spare Youths from AIDS."
Times of Zambia, November 17, 2000

Health Deputy Minister Ernest Mwansa has strongly appealed to adults to stop infecting young people with HIV/AIDS. Mr Mwansa said in Parliament that the spread of the killer virus which caused AIDS could be contained if only adults avoided infecting young people. He said statistics showed that the infection levels among the young were very low and these people could grow up without catching the virus if they were spared by infected adults. 'Those people with the infection should realise this. Let us not infect these young people,' a visibly concerned Mr Mwansa said. Solwezi Central MP Ludwig Sondashi (NP) riled Mr Mwansa when he questioned his adult-to-teenager theory on the spread of the killer disease.

'Elders don't have that sexual appetite which young ones have. What does the minister mean by saying that elders are infecting the young?' asked Dr Sondashi. But Mr Mwansa urged the MPs not to deny the obvious, stressing that the AIDS pandemic was not among the young as they only got infected by adults when they reached their twenties. He said Zambia was already implementing the resolutions of the last International Conference on AIDS and STDs in Africa (Icasa) in Lusaka but the AIDS council and secretariat would hasten this. On the infection levels after Icasa, he said in response to a question raised by Zambezi East MP Rosemary Yikona (MMD) that the rate had gone down but there was need to further reduce the levels. Earlier, the deputy minister who was answering a question raised by Mambilima MP Patrick Kalifungwa (MMD) said HIV/AIDS counselling should not be left to medical practitioners alone.

"Zambia's Future Lies in Children." By Kennedy Gondwe
The Post, November 8, 2000

The future of Zambia no longer lies in the mines but children, said United Nations Children's Fund (UNICEF) resident representative Peter McDermott yesterday. In an interview during the ongoing Eastern and Southern Africa regional workshop on orphans and vulnerable children, McDermott said government needed to invest in children now that the privatisation exercise was over. "Most of the things have been focused on the mines and the privatisation issue. We have to invest in education, invest in health care and more should be done on immunisation programmes,'' McDermott said. He said while the mining sector was important in the growth of the economy, equally important was addressing the plight of children in the country. He said many children in Zambia were vulnerable.

"In a country like Zambia where poverty is so high, even without AIDS there is vulnerability,'' McDermott said. He commended government's stance on children refugees. McDermott said despite Zambia's limited resources, the country had continued accommodating refugees from war torn neighbouring countries.

Geoff Foster, a Zimbabwean based researcher on AIDS and orphans, said the extended family structure was weakening. He said the loss in its strength was mainly because of AIDS which had continued killing the children's parents. Foster said in the 10 years that he had been doing research on the subject, the response societies were developing towards orphans was amazingly changing.

Serve Children Fund (SCF) HIV/orphan adviser Doug Webb said governments should recognise children's needs and opinions. Webb, whose organisation is based in the United Kingdom, said it should be obligatory for countries to protect and promote the rights of children. He said many governments have been pledging to promote the rights and needs of children though no commitment had been there. The workshop which has been organised by UNICEF and United States of America International Development (USAID) has attracted participants from 15 different countries in the region.

"AIDS Wrecks Havoc Among Teachers." By Sara Longwe and Angela Gondwe
Times of Zambia, November 9, 2000

Teachers across the country are manning a number of schools single-handed because a shortage of staff mainly because of the high rate of deaths due to HIV/AIDS, Parliament heard yesterday. Education Deputy Minister Betram M'membe said Government was concerned about the problem and was in the process of increasing the capacity of teacher training colleges to boost the staffing in the affected schools.

Mufumbwe MP Bert Mushala (MMD) wondered why there was a shortage of teachers when several college graduates were roaming the streets. Mr MÕmembe said the teachers could not be assigned schools before they were put on the pay roll and almost all those who were asked to wait had now been given stations.

Mr M'membe said Government had introduced stiffer penalties and sensitisation workshops to curb the rampant leakage of examination papers. The new measures included the deregistration of examination centres found to be encouraging examination malpractices.

"AIDS and Gender Discrimination in Zambia." By Sara Longwe and Angela Gondwe
GENDER-AIDS, November 6, 2000

Introduction: AIDS and Gender Discrimination

It might be thought that AIDS in Africa, as it affects heterosexual adults, would be a gender neutral disease. However, figures in this paper, collected from a AIDS Home Care Scheme in Ng'ombe township in Lusaka, show that AIDS impacts more severely on women in various ways, both in rate of infection and in the home care of AIDS patients.

In terms of the contraction of the disease, the figures show a higher prevalence of AIDS amongst women, and a clear tendency to contract the disease at a younger age than men. This is part of a general global pattern which is known to arise in part from women's increased biological vulnerability to the infection. (In other words, a woman is at higher risk, by comparison with a man, from infection by sexual contact with an infected partner. Pregnancy also accelerates the onset of AIDS in an infected person).

However, sexual difference accounts only partly for the larger numbers and younger age of female AIDS patients. Part of the variance is known to be due to the effect of gender differences in sexual behaviour: men's tendency to seek sexual partners younger than themselves, and their tendency to have several sexual partners. In short, the predatory behaviour of men is a main factor behind the rapid spread of the disease, the larger numbers of women amongst AIDS patients, and their younger age.

These figures on gender differentials in AIDS prevalence follow the pervasive pattern in Zambia, and in Africa as a whole. Perhaps more interesting are the figures from Ng'ombe showing the gender discrimination against women in the provision of home care. The figures show that female AIDS patients are less likely to be looked after by their spouses. Some women are even 'chased' from their homes by their spouses, and have to seek care in their mothers' homes, or with other relatives.

Widows of AIDS patients are also discriminated against in various ways. Although often suffering from AIDS themselves, they are often 'chased' from the homes by their deceased husband's relatives, following the (illegal) tradition that the husband's relatives inherit the property left behind. Due to gender discrimination in perception, all of the property, with the exception of household chattels, is regarded as having belonged to the husband.

Widows are left with less income than widowers, and are very often left destitute. Despite this, they are more often left with the responsibility of looking after their children. Very often this means that a widow and her children have no option but to go to live with the widow's parents, who are likely to be very old, and to have little or no income.

AIDS and Home Care in Zambia

The figures in this paper were compiled by Angela Gondwe, who works as one of the volunteers providing home care to AIDS patients in Ng'ombe, which is one of the smaller townships which have developed on the outskirts of the city.

In Zambia, home care is the most that an AIDS patient can expect. The government's Health Service is in a virtual state of collapse, after the massive cuts in government health expenditure under 'structural adjustment'.. Such policies of structural adjustment have been imposed by the IMF and World Bank, as part of the conditions for continued funding for balance of payments deficit and for development aid.

Structural adjustment policies have also included 'cost-sharing' in the provision of public services, which in practice means that the families of sick patients have to pay hospital fees and also pay for the medicines prescribed. Amongst the generally poor population of Ng'ombe, as for 80% of the rest of the Zambian population, the payment of such hospital fees is completely beyond their means. Home care is the only alternative.

In addition, the AIDS pandemic is now so massive in Zambia that there would be no prospect of providing hospital beds as a form of public care for all AIDS patients. If there were government funds provided for the care of AIDS patients, most of this would have to be used for supporting home based care.. However, home based care is very inadequately supported. The little support available comes almost entirely from churches and NGOs, supported to some extent by international charitable organisations.

Home Based Care in Ng'ombe

The Catholic Church is the organisation which is providing support for home home based care in Ng'ombe, and Angela Gondwe is one of the volunteers assigned to provide home visits to AIDS patients in this township. The figures in this paper therefore do not arise from any special research study, but have instead been compiled by Angela from the routine case records for the township.

One limitation of these figures is that the identification of AIDS patients does not arise from any survey or examination of all the inhabitants. On the contrary, patients are self-selected in that they (or their relatives) come forward to ask for assistance, and inclusion in the home care scheme.

Therefore it has to be borne in mind that the figures in this case study must fall somewhat short of representing the full extent of AIDS cases in Ng'ombe. This is partly because the numbers represent only the serious cases requiring home care. It could also be partly because there are some patients who need home care, but have not requested it. However, the volunteers consider that the great majority of the serious AIDS cases are represented in these figures, since the home care scheme is generally well appreciated and utilised.

In summary, it has to be appreciated that the figures reported here do not emanate from a scientific research design, but rather from a very small-scale epidemiological report. From this arises two major weaknesses: firstly that AIDS patients are identified by self-selection rather than medical survey; secondly that there are no figures, only a rough estimate, for the larger population of Ngombe.

The authors are of the opinion that self-selection is not likely to much affect the gender differentials observable in the figures. If anything, considerations of gender discrimination might be expected to increase the number of males amongst the patients, due to preference being given to males when seeking support for home care. If so, this tendency to male preference has been masked by the much larger number of females needing home care, since females are amongst the majority of adult AIDS patients reported in this case study.

It is also possible, but extremely unlikely, that the larger number of females in the adult group arises from a larger female population in Ng'ombe. Figures on AIDS patients themselves show some tendency for the male adult to be missing from the household, but in most cases this is because a sick woman's husband has deserted her during her illness. There is no evidence available, nor good reason to suppose, that the adult population has a male:female ratio which is markedly different from the national average of 48:52.

It therefore seems very likely that the larger part of the gender differentials in the figures arise from the different treatment of of female AIDS patients, by comparison with male AIDS patients, rather than other underlying factors. This paper therefore identifies some of the well known forms of gender discrimination which which very probably explain the larger part of the gender differentials seen in the figures.

Gender Differentials Amongst AIDS Patients in Ngombe

Table 1 shows that there are more females amongst adult AIDS patients in the scheme to provide support for home care, but more males amongst the children.

NUMBER OF AIDS PATIENTS RECEIVING CARE IN NG'OMBE, DIVIDED BY CHILD/ADULT AND GENDER

Age	Male	Female	Gender Gap*
Children (0-14)	43	26	-25%
Adult (15 +)	89	129	45%
Total	132	155	17%

* Gender gap is here defined as the difference between numbers of females and males, expressed as a percentage of the number of males

Given that the population of N'gombe is estimated at about 2000 people, in about 400 households, the above figures indicate a high level of AIDS prevalence of about 14% of the total population. Assuming that half the population is below the age of 15 years (the average Zambian proportion), then some 22% of the adult population are AIDS patients requiring home care.. These estimates tally with the reports from the care givers in Ng'ombe of high AIDS prevalance: they report that about 90% of households have at least one AIDS patient.

Given the different (mother to child) mode of AIDS transmission to children, it might be expected that the male:female ratio amongst children in the above table would be 1:1. The much higher number of boys in the above case load is difficult to explain, and undoubtedly deserves research. One probable explanation is male preference in seeking home-care assistance. Such male preference may be exacerbated if mothers are reluctant to admit that girls are infected, for fear of suspicion that such infection arose from sexual abuse of girls within the family.

It is unlikely that the gender differential amongst children arises from differences in sexual activity for two main reasons: firstly, most HIV infection in children arises from mother to child transmission; secondly, where HIV infection arises from children's sexual activity, it is unlikely that AIDS symptoms develop below the age of 15 years. (We may discount either drug use, or homosexual activity as important causes of AIDS transmission in Zambia).

Age and Gender of Adult AIDS Patients

Table 2A shows the age distribution for AIDS patients, comparing the different pattern for men and women. This follows the long established global tendency for more women to be infected in heterosexual populations, and for women to be infected at earlier age.

TABLE 2A: AGE DISTRIBUTION OF AIDS PATIENTS, DIVIDED BY GENDER

AGE GROUP	MALES (N=89)	FEMALES (N=129)
15-19	6.7%	9.3%
20-24	11.2%	32.6%
25-29	14.6%	14.7%
30-34	20.2%	12.4%
40-44	11.2%	8.5%
45-49	7.9%	3.1%
50-54	6.7%	5.4%
55 and over	4.5%	3.1%

Table 2A shows that there are 89 males amongst AIDS patients, and 129 females. Based on the number of males, this represents a gender gap of 45%. In other words, there are 45% more women than men amongst the AIDS patients, or approximately 3 female patients for every 2 males.

Table 2A also shows that women show symptoms of the disease at an earlier age. This is revealed in the gender difference in average age of an AIDS patient: the average age of a male patient is 35 years, whereas the average age of a female is 31 years.

However, the gender differentials in pattern of age profile is not fully revealed in the gender difference in average age. Table 2B collates the figures from Table 2A, to show the pattern of age difference in terms of the proportion of AIDS patients who are below and above the age of thirty years:

TABLE 2B: PERCENTAGE OF ADULT AIDS PATIENTS BELOW AND ABOVE THE AGE OF THIRTY, DIVIDED BY GENDER

Age	Male	Female	Gender Gap*
15-29	34.8%	62.1%	27.3%
29 and over	65.2%	37.9%	-27.3%
Total	132	155	17%

* Gender gap is here defined as the percentage of the female patients who are in the age group, subtracted from the percentage of the male patients who are in the same age group.

Table 2B shows that 62.1% of the women patients are below the age of 30 years, by comparison with only 34.8% of the male patients who are below the age of 30 years. Thus Table 2B shows more clearly how AIDS is more dangerous to women in its life-shortening effect.

Spouse's Care of AIDS Patients

Table 3 identifies the category of person providing care, divided by whether the patient is male or female. The figures are fairly self explanatory. Sick male patients are far more likely to be looked after by their spouses than is the case for women. The gender gap is 32%. The figures also indicate that a husband his far more likely to desert his sick wife, than a wife is likely to desert her husband.

These figures arise especially from the traditional pattern that the wife is regarded as the care giver in the home, for both husband and children. When wives become sick, nearly half of them have to seek the assistance of their mothers, or other relatives, to provide care.

TABLE 3: CATEGORY OF CARE GIVER FOR MARRIED AIDS PATIENTS,
DIVIDED BY GENDER OF PATIENT (omitted)

These figures also provide some insight into the extent that structural adjustment policies impact particularly upon women. It shows the transfer from public health care to home care serves to put the burden of labour mainly upon women, as wives and mothers. This is part of the 'hidden' gender discrimination within structural adjustment.

Situation of AIDS Widows and Widowers

Table 4 suggests that the over-burdened wife's problems are only beginning when she is nursing her sick husband. Her problems become more serious after her husband's death. Although very likely sick with AIDS, she is more likely than a widower to be chased from her house, more likely to be given the responsibility of looking after the children, and more likely to be very poor or even destitute.

Most widows who have to leave the matrimonial home have been 'chased' because the house has been possessed by the deceased husband's relatives. Others may simply have to leave the matrimonial home because their is no means of paying rent. The figures in Table 4 indicate that the most desperate victims of AIDS are AIDS widows, 35% of whom have to return to their parents, who are themselves likely to very poor and unable to look after them. The great majority of these destitute widows are themselves AIDS patients. The general pattern is that many of them will soon die of neglect and starvation, and that their children will become abandoned orphans.

TABLE 4: CARE OF AIDS WIDOWS AND WIDOWERS - (omitted)

* These three levels of poverty have not been very quantitatively defined. They represent Angela Gondwe's assessment of whether the surviving partner has adequate income for family subsistence, whether there is income for partial subsistence, or whether the surviving partner has no income at all, and is therefore destitute.

Sara Longwe and Angela Gondwe, Lusaka, 15 May 2000
Author's email for clarifications: Sara Longwe

++Please note that it was not possible to reproduce all tables and apologise for the poor reproduction of those that are included++

"Finance Minister Hopeful Of World Bank AIDS Cash."
Times of Zambia, October 27, 2000

Finance Minister Katele Kalumba is hopeful the World Bank will provide up to $50 million to Zambia out of the estimated $500 million required to combat HIV/AIDS in the next three years. Dr Kalumba in a statement said Government was interested in the new facility the bank through its soft window facility, the International Development Agency (IDA), has just launched to assist poor sub-Saharan countries fight the AIDS pandemic.

Dr Kalumba last week held discussions with a World Bank team that was invited to Zambia. The World Bank has set aside an initial $500 million emergency facility for IDA eligible countries seriously affected by AIDS. "The World Bank funds would be used over a three to four years period by Government for funding dozens of community-driven projects across Zambia, for improving hospital care, including provision of drugs for people already affected by HIV/AIDS especially in rural communities," he said.

The funds will also see an increase in awareness programmes and preventive efforts. The recently established National HIV/AIDS/STD/TB Council and its secretariat will be funded to strengthen it. National AIDS Council experts have costed the combating of HIV/AIDS under the new national strategic framework at between $400 million and $500 million. Dr Kalumba said the IDA soft terms of 40 years, with a 10-year moratorium at less than one per cent interest per annum was the best facility Zambia could access presently.

While welcoming the World Bank loan, Dr Kalumba said it was important for Zambia to tap other soft loans from bilateral partners. Government recognised the a lot of resources were required to combat HIV/AIDS. The minister regretted the confusion caused recently in the media concerning the new soft loan terms the bank was offering which were reportedly rejected by some countries. He said Kenya and Ethiopia had between them committed to drawing $100 million of the first tranche. The bank was also processing other applications including one from Uganda.

Dr Kalumba added a national multi-sectoral team headed by staff from the population and social unit of the Ministry of Finance, also involving key line ministries like that of Health was currently working with an HIV/AIDS specialists team from the World Bank to process Zambia's request. He hoped the money would be secured within the next five months. Zambia will push for cheaper drugs alongside sourcing funds to mitigate the impact of the killer disease. "Investing in human capital by preventing new HIV infections and improving access to cheaper drugs by those HIV-infected and strengthening our institutional capacity are mutually reinforcing objectives shared by the entire Zambia," he said.

"Zambia Finally Accepts World Bank AIDS Loan."
Panafrican News Agency, October 26, 2000

The Zambian government has now accepted to take a World Bank emergency loan of between 40-50 million US dollars to combat the growing HIV/AIDS problem in the country. Finance Minister Katele Kalumba said Thursday that the bank's proposed HIV/AIDS emergency facility was the best possible loan possibility for the time being.

Two weeks ago, health Minister David Mpamba had announced that Zambia had joined 12 other Southern African Development Community countries in rejecting a World Bank anti-AIDS loans. It rejected the pre-condition that the money be directed to AIDS research and consultancy.

Mpamba had argued that the country had already done a lot in this field and suggested the money be redirected to acquiring cheap drugs. According to him, the AIDS loan would only deepen Zambia's debt burden, at a time when African countries are calling for debt cancellation.

However, Kalumba said government welcomed the World Bank loan and recognised that the resource requirement for effectively combating HIV/AIDS in Zambia were so vast that it would be highly unrealistic to expect such level of grant support from other partners. He added that efforts to negotiate for cheaper AIDS drugs must go along side with an aggressive fund-sourcing approach.

"Investing in human capital by preventing new HIV infections and improving access to cheaper drugs by those infected and strengthening our institutional capacity to do both are mutually reinforcing objectives shared by the entire Zambian government," he said.

Kalumba's statement came after a World Bank mission concluded a visit in Lusaka last week during which the two sides held initial discussions on how Zambia might access the AIDS loan facility. The bank has initiated a 500-million-dollar loan package to assist poorest countries in fighting the HIV/AIDS pandemic in sub-Sahara Africa and other developing countries.

"UNHCR to Help Refugees Fight AIDS At Camps."
Panafrican News Agency, October 26, 2000

The UN High Commissioner for Refugees has set aside more than 100,000 US dollars to be used in the fight against HIV/AIDS in five refugee camps in Zambia. UNHCR information officer in Zambia, Kelvin Shimo, said Thursday that the agency has budgeted the money for the 2000-2001 programme to help address the problem of HIV/AIDS in the camps.

According to him, 55,000 dollars will be used in Mwange, Northern Zambia, which hosts 23,000 Congolese refugees, while another 42,000 dollars will be allocated to Meheba refugee settlement in north western with a total population of 38,000 refugees, mainly Angolans. Mayukwayukwa settlement in Western Province, which hosts 14,000 Angolan refugees, is expected to receive 37,000 dollars; while 18,000 dollars will be allocated to Nangweshi, also in Western Province, which has 11,000 Angolan refugees, and Lusaka urban area will receive 28,000 dollars.

Shimo said the money would be used for training, buying teaching materials, equipment and education activities. "Due to the socio-economic situation of young people in camps, most of the young refugees are at risk of acquiring sexually transmitted infections, including HIV/AIDS. "We want the refugees to benefit from a multi-sectoral programme that addresses the broader reproductive health needs of the refugees community related to the spread of HIV/AIDS," he added.

"More Than One Million Zambians To Die From AIDS." By Chisenga Kabuswe
Panafrican News Agency, October 25, 2000

About 600,000 Zambians have died from the deadly HIV/AIDS and by 2015 another 1.5 million will have died from the disease, World Health Organisation Representative in Zambia, Edward Maganu, disclosed Wednesday.

Maganu, quoting the recent estimates released by the country's Central Board of Health, said 20 percent of the adult population in the country are infected with HIV and that 300 Zambians are infected daily.

As a result of the epidemic, life expectancy in Zambia has dropped from 56 years to 38 years. "Male infections peak at 30 to 39 years and female at 20- 29. A very worrying trend is that girls 15 years to 19 years are four times more likely to be infected with HIV as males are in that age group," Maganu said at the opening of the Family Health Trust Strategic Planning workshop in Lusaka.

He said the groups that are most vulnerable and most adversely affected by the epidermis are the youth and young children who bear the burden of disease directly passed on via mother-to-child transmission. Maganu noted that although estimation of the mother-to- child transmission stood at 29 percent in 1997, figures may be as high at 40 percent now.

He, however, said it was encouraging to note the decreasing prevalence among the 15-19 years olds in the urban areas, which he said suggested positive behavioural change in this group. "The indications that HIV infection in youth between 15 and 19 years in urban areas is declining in Zambia should compel us to identify the HIV prevention information/strategies and practices that are contributing most to behaviour formation and change," Maganu said.

He called on the government, non-governmental organisations and the international community to close ranks and invest in efforts aimed at securing a better future for the children who he said 13 percent of those under the age of 15 were orphaned by 1996. He said the other challenge which needed to be addressed through advocacy campaigns and innovative strategies is the high infection rates among girls relating to the power relationship between male and female which is highly embedded in culture and tradition.

Maganu said this has greatly contributed to the male/female distribution of infection. "The cost of and access to essential drugs for the treatment of opportunistic infections in a country where over 70 percent of the population is in poverty are issues that have no easy solutions," he said.

"Zambia Must Find Affordable AIDS Cure." By Kennedy Gondwe
The Post, October 23, 2000

Zambia must find effective and affordable cures for the HIV/AIDS pandemic, Mikwa Pharmaceuticals executive chairman Dr. Henry Musenge has advised. Speaking at the launch of the immune system supportive supplements on Friday evening, Dr. Musenge observed that most Zambians cannot afford HIV drugs.

"Unfortunately for us in Zambia and other poor nations, the antiretrovirals are extremely expensive, estimated at a minimum of K39 million per patient per annum. Thus, whether we like it or not these drugs are beyond the reach of the majority of sufferers in Africa,'' Dr. Musenge said. "In Zambia, I would be surprised if more than 4 per cent of our population can afford these products at such exorbitant prices.''

Dr. Musenge, whose company will solely distribute the drug, said AIDS patients only needed to spend K 950,000 per annum. Biomox pharmaceuticals (PTY) managing director Dr. Roy van Brummelen whose firm manufactures the immune system supportive supplements said the drugs were effective. He disclosed that the drugs were tried in South Africa, Botswana, Zimbabwe and Namibia.

"Govt Promises to Work with Anti-AIDS NGOs." By Chisenga Kabuswe
The Post, October 16, 2000

The government is ready to work with organisations that help in coping with people living with HIV/AIDS, mines minister Syamukayumbu Syamujaye has said. Speaking at the occasion to mark the World Hospice Day at the Jon Hospice on Saturday, Syamujaye said although the Hospice and palliative care is new to Zambia it was necessary as there are a lot of sick people in the communities.

"Hospice and palliative services encompasses pain and symptom management, physical, emotional and spiritual care and the provision of an opportunity to die with dignity to those who have to answer the call of death," he said. Syamujaye, who pointed out that he was not only representing government but also attending the occasion as a citizen who has a heart for the work Jon Hospice is doing, called on individuals and donors to support the noble work Kara Counselling is doing.

Kara Counselling director Ignitus Kayawe called on the government to consider Hospice and palliative care a priority. He noted that people have been made to believe that a hospice is a place where you go to die saying that was not true. He said it was a place where the quality of a patient's life is improved so that they can be integrated back into the communities.

"All About AIDS: From One Woman to Another." By Chilekwa
Times of Zambia, October 17, 2000

Ever used the Internet to conduct research for your work? Africa Women's Media Center (AWMC) recently conducted training for both media and non-media personnel on how to use the Internet for research, with emphasis placed on reporting on HIV/AIDS and Women in Africa.

Women are the most vulnerable to HIV because of their subordinate position, which makes it difficult to protect themselves. Women are at risk too because of cultural and economic practices that increase their chances of catching the disease. The other reason that makes women more vulnerable is that the burden of care in AIDS affected households falls on women and children.

Important factors concerning the issue of HIV/AIDS in women were highlighted, giving participants an insight into how the problem can be tackled. Participants learnt that the media plays an important role in creating awareness on the pandemic, how women can protect themselves and be empowered economically so that they are able to be less dependent on the men folk.

For the media to be effective there is need for more awareness. The more information is disseminated the more enlightened women will be on issues affecting them. Therefore media coverage on women and HIV/AIDS can be effective if all parties involved cooperate with the media. It was observed that the media needs to be better informed about HIV/AIDS, particularly women and AIDS in Africa, so as to report on it more comprehensively, ethnically and regularly.

The idea is to be able to build the readers' sensibility concerning the issue, figure out what to do with statistics and how to report on the issue constructively. Participants got to learn more about the cultural, economic, gender, human rights, policy/political aspects of AIDS and how other countries are coping with AIDS. Participants also discovered new and creative ways of reporting, sharing opinions, insights and experiences with other journalists. Non-journalists who also took part in the training learnt how to give information to journalists in a way that is useful.

Two AIDS experts presented a sharp picture of the way social and cultural attitudes, beliefs and customs influences transmission of HIV/AIDS, treatment and care for women with HIV/AIDS. HIV/AIDS information has to reach women at the grassroots because they are affected mostly because of social cultural norms and beliefs. Cultural practices and beliefs should be revisited (in terms of their relevance) in modern society. Government, traditional leaders and community leaders should sit down and discuss the issue.

For example, in April 2001, Society for Women and Aids in Africa (SWAA) will run it's 8th Conference in Uganda on the theme: 'Children and HIV/AIDS in Africa'. This will bring front-line community workers, parents/guardians, women, affected and infected children and many others to discuss pertinent issues relating to children and HIV/AIDS in Africa. The challenge that the media faces is to deal with gender dynamics that currently exist. Empowerment of women will only succeed if men are included.

The challenge made to journalists is to ensure that articles they write are gender-balanced. This is to enable the two sexes to identify with the story and get to understand the message. To change the negative portrayal of women in the media, the media should avoid gender biases in AIDS reporting. Women in the media, irrespective of their beats should be involved in portraying the positive image of women. Cultural values hamper the activities of social worker and of course the media in changing certain practices of the indigenous.

Media has a big role to play, but one wonders if those glued to the traditional practices are prepared to change. It is not a matter of being prepared. We are all at risk. Chiefs and traditional rulers who should set examples too are victims of the pandemic. Change of moral and social issues should not be seen as women's affairs but as human issues. Emphasis should be placed on male responsibility in Reproductive Health.

The effect of using certain language and concepts on public attitudes, for example 'the terms prostitutes' is derogatory ('sex workers' is appropriate). The media should discourage derogatory statements about women that undermine their social status and encourage men to segregate them when they are HIV positive. All gatekeepers need to be exposed through constructive sensitization programmes so that they gain a full appreciation of the socio-economic factors surrounding HIV/AIDS. Particular focus should be placed on women so that they may begin to protect themselves.

It's important to understand why PLWHAs (People Living With HIV AIDS) are so sensitive about many of these issues. PLWHA want is to be treated like normal human beings and a build up trust has a lot to do with it. For instance the official term for 'Aids sufferers' is a person living with HIV/AIDS, or a PLWHA. The use of this term is appreciated a lot. It empowers people with AIDS. They have a right to not be portrayed as victims or sufferers, irrespective of anyone's opinion.

The use of the Internet provides objective information about HIV/AIDS that every journalist in Africa should have at their fingertips. Clearly, the media's role in reporting on HIV/AIDS is a critical component to reversing the deadly escalation of the virus. The good news is that, through this training session an enormous sense of commitment was made to make the media's role an effective one. It gives the world a sense of hope for the future.

Below are eight steps for taming the Internet 'By Sarah Cohen' for anyone interested in becoming a good Internet reporter.

• Surf in advance
• Resist the urge to catalog the Internet
• Consider alternatives
• Learn how to us e-mail and join some Listserv (i.e. people with different information ideas)
• Read any instructions you can find
• Ask whether it's worth the effort
• Ask who would post what you want and why
• Organise your bookmarks, and keep them organised (ie relevant sites)

NOTE: Once you have found a resource that you want to use, you need to evaluate the web site, just as you would any source that you use for an article. Remember anyone can put information up on the Internet, you must try to determine the reliability and validity of the source of information.

'Evaluating Internet Resources: Factors to consider' By Gale Dutcher. Some factors to consider are:

• Currency: Is the information up-to-date?
• Authority: What are the author's credentials?
• Affiliation: Does the institution offering the information guarantee the quality?
• Purpose: What is the web site's purpose?
• Audience: Who is the intended recipient of the information?
• Accuracy: Is the information reliable and valid?
• Objectivity: Is there bias?
• Coverage: What is the breadth and depth of coverage?

"Zambia Rejects $3.8 bn. Anti-AIDS Loan." By Mukula Mukula
Daily Mail, October 11, 2000

Zambia has joined other Southern African Development Community (SADC) countries in rejecting a US $3.8 billion World Bank loan to 12 African countries meant for the fight against AIDS. Health Minister David Mpamba, said in an interview in Lusaka on Monday that the loan if obtained, would deepen the country's debt burden amidst calls by African countries for debt cancellation. "We want to move away from the debt problem and getting the loans would simply deepen the debt problem of the country," he said.

Mr Mpamba, however, said Zambia would get loans from the World Bank for other programmes it had committed itself to implementing. He said the SADC countries were for the idea that the World Bank facilitates the price reduction of AIDS drugs to make them more affordable to as many afflicted countries as possible.

Malawi also rejected a US $40 million for the fight against the AIDS pandemic. Malawi's Health Minister Phillip Bwanali, said it was practically unthinkable for the country to get such a loan for non-productive usage like the fight against AIDS.

Meanwhile, Mr Mpamba has said all people who claim to have the cure for the HIV/AIDS pandemic should go through the National Technical Committee (NTC) for approval of their drug. Mr Mpamba was reacting to reports that a businessman had discovered some herbal medicine with the ability to prolong the life of HIV/AIDS patients which would be on the market next month. The minister, who expressed ignorance on the latest claim by a company to be called Authentic Remedies, said it could only begin to market its drug after approval by the NTC. Mr Sid Kabaso, formerly of SDK Essential Oils of Kitwe, has partnered with Macmed Healthcare to form Authentic Remedies. The company would be engaged in the manufacturing and marketing of the AIDS drug called Mraa. The immune booster drug is said to have been tested on 50 University Teaching Hospital patients out of whom 30 are said to have responded positively.

"Archbishop Mazombwe Seeks Compassion for With AIDS." By Bivan Saluseki
The Post, October 9, 2000

MONDAY People suffering from HIV/AIDS have a right to die with dignity and honour, Archbishop of Lusaka Merdado Mazombwe has said. Officiating at the 50th anniversary celebrations of Mother Theresa's works in Lusaka's Mtendere compound, Archbishop Mazombwe said AIDS people can only be honoured if they are loved and not despised.

He said if each one of the Zambians had love for one another there would also be a decrease in the number of children on the street. "There are so many street kids in this country who have no place, have no home and no houses," Archbishop Mazombwe said. " They are only hoping that someday someone will give them love like Mother Theresa."

Archbishop Mazombwe said currently Mukobeko Maximum Prison has more than 500 inmates living in almost dehumanising conditions. He said prisoners have a right to be fed and visited. "Some of them have only one pair of trousers," Archbishop Mazombwe said. "We should take this opportunity to repent because we have not done enough to help the needy."

Archbishop Mazombwe said "so many people are living in hatred". "So many families are broken. So many people are divided," Archbishop Mazombwe said. "We should reconcile and love each other." Archbishop Mazombwe said in times of problems a person can either run away, crush the enemy or dialogue but many people have taken to crushing one and the other.

"AIDS Claims 650,000 in Zambia Between 1996-99." By Kennedy Gondwe
The Post, October 2, 2000

About 650, 000 people have died from HIV/AIDS in Zambia between 1996 and 1999, a survey jointly conducted by Society for Family Health (SFH) and Population Services International (PSI) has revealed. The research which was carried out principally by Sohail Agha, a research officer at PSI, disclosed that about one million people are infected with the disease. The report disclosed there was a decline in casual sex among wealthier people in Lusaka resulting in the disease being concentrated on the poor. "These findings emphasise the importance of intensifying the efforts aimed at promoting behaviour change among the poor.

Changing the behaviour of persons who are living under conditions of high economic stress may be particularly difficult," the report reads in part. "Improvements in economic conditions are likely to be of critical importance in reducing vulnerability to HIV among poorer residents of Lusaka.'' The survey was conducted to ascertain changes in casual sex and condom use in Lusaka between 1996 and 1999. The survey estimated that 20 per cent of 15 to 49 year old Zambians were HIV positive.

The report said in Zambia, as in other countries of Southern Africa, the HIV virus was thought to spread mainly through unprotected heterosexual intercourse. It added that women's lack of control over economic resources were intimately tied to the spread of the epidemic. The report said sexual behaviour norms that sanctioned men to multiple sexual partnerships had contributed to the spread of the disease. It, however, said there had been significant declines in casual sex between the period because of reductions in casual sex among wealth men and women. The report also said casual sex was concentrated on persons who were not in stable partnerships. It stated that a comparison between the 1996 Demographic Health Survey (DHS) and the 1998 Zambia Sexual Behaviour revealed that unmarried men reported having fewer sexual partners although there were no changes among women.

The report said HIV/AIDS' prevalence among pregnant women who were between 15 and 19 years dropped from 28 per cent in 1993 to 23 per cent in 1994 and 15 per cent in 1998 in Lusaka. In Ndola, HIV/AIDS prevalence between the same age group dropped from 21 per cent to 16 per cent between 1994 and 1998.

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