Your daily Selection of IRIN Africa PlusNews reports, 10/29/2004

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U N I T E D N A T I O N S

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CONTENT:

1 - CAMEROON: HIV/AIDS New survey shows lower HIV prevalence rate of 5.5

percent

2 - SUDAN: Fears over increase in HIV/AIDS as calm returns to the south

1 - CAMEROON: HIV/AIDS New survey shows lower HIV prevalence rate of 5.5

percent

YAOUNDE, 28 October (PLUSNEWS) - A new survey released by Cameroon's

health ministry indicates that only 5.5 percent of the country's adult

population is infected with the HIV virus that causes AIDS. The government

had previously used an estimate of 11.8 percent, which was based on the

testing of pregnant women at health clinics.

Preliminary results of the Demographic and Health Survey (DHS-III) of

11,400 people between October 2003 and August 2004 reveal an overall HIV

prevalence rate of 5.5 percent, ph Tedou, the Director of Cameroon's

National Institute of Statistics, told reporters on Wednesday.

Women showed a higher infection rate of 6.7 percent, whereas men were

lower at 4.1 percent, he added.

The new figure is less than half the 11.8 percent HIV prevalence rate

extrapolated from last year's Sentinel survey of pregnant women who

underwent voluntary testing at ante-natal clinics throughout the country.

But it is close to the figure of 6.9 percent used by UNAIDS, which bases

its own calculation on information from several different sources.

" The study that put Cameroon's prevalence rate at nearly 12 percent was

carried out by monitoring pregnant women during their pre-natal

consultations in clinics and AIDS-screening centres, " Tedou said.

" The DHS-III survey is more scientific and more broadly based, with men,

women and children of both sexes involved in the study, " he stressed.

The survey was carried out jointly by Cameroon's National AIDS Control

Committee, the National Institute of Statistics, Centre Pasteur, the

United Nations Children's Fund (UNICEF) and the Washington-based

consultancy ORC/MACRO International.

Tedou said it targeted 11,400 individuals throughout the country, 91

percent of whom agreed to be tested for AIDS.

The survey showed that HIV prevalence rates were much higher in the

southern Cameroon and in the capital Yaounde, than in the north.

The English speaking North-West Province, around the highlands town of

Bamenda, showed a prevalence rate of 8.7 percent, the highest of

Cameroon's 10 provinces.

It was followed closely by the densely forested Eastern province, around

the town of Bertoua, with 8.6 percent, while Yaounde showed an HIV

prevalence rate of 8.3 percent.

But the country's dry and staunchly Muslim North and Far-North provinces

recorded rates of less than two percent.

Doctor Valere Mve Koh, a gynaecologist and obstetrician who heads the AIDS

committee at the Yaounde’s university teaching hospital, said the new

DHS-111 survey appeared closer to reality than the previous sentinel

survey.

" Every year, at the end of November, there is a Cameroonian week to fight

against AIDS, during which free screening is available throughout the

country, and the figures we get from that are similar to those revealed in

the survey, " he told PlusNews.

But Health Minister Urbain Olanguena Awono warned that the new lower

figures provided no grounds for complacency.

" We shouldn't feel that we have won the war against HIV/AIDS, " he

stressed. " The government intends to intensify the battle to mitigate the

effects of the HIV/AIDS epidemic, a disaster which constitutes a serious

threat to the country's development. "

[ENDS]

2 - SUDAN: Fears over increase in HIV/AIDS as calm returns to the south

NAIROBI, 28 October (PLUSNEWS) - Following progress in negotiations

between the government of Sudan and the rebel group SPLM/A, the

anticipated return to peace in the embattled southern Sudan could lead to

a further spread of HIV/AIDS, which already affects 2.6 percent of the

adult population in the region, the UN Population Fund (UNFPA) warned in a

recent report.

Sharing UNFPA's concerns, the regional adviser on HIV/AIDS for the UN

Children's Fund in eastern and southern Africa, Alnwick, said: " In a

nut-shell, southern Sudan is a disaster waiting to happen. "

He added, " Unless something fundamental is done about the situation, HIV

prevalence might go up considerably. "

Alnwick explained that increased mobility as calm returns to the region

could raise the threat of HIV infection among rural communities, which had

remained isolated during the war and retained low infection rates. He

feared this could be exacerbated by the lack of HIV/AIDS awareness among

the population, coupled with the already high HIV prevalence in some

garrison towns.

HIV/AIDS prevention efforts are also likely to be influenced by social

bias, attitudes towards condom use, a poor availability of general health

services and a lack of trained counsellors. The health workers, UNFPA

added, are often unmotivated, lack the necessary knowledge and are ill

supplied with blood-testing equipment to protect them from cross

infection.

The HIV-infection rate in Sudan as a whole is already considered epidemic,

according to UNFPA. Ishmael Gulliver of the Sudan Evangelical Mission,

which has been running HIV/AIDS awareness-raising programmes in southern

Sudan since 2000, told IRIN that the situation in the region was indeed

severe.

" Sudan is on the verge of an HIV/AIDS epidemic, " Prof Ali Biely of Ahsad

University in Omdurman, near Khartoum, told PlusNews. Little was " being

done about it because of the urgency of the humanitarian crisis and the

need to respond to those that are immediately dying from curable

diseases " , he added.

" The fact that many Sudanese will return to their homes from countries

where HIV/AIDS rates are high might increase the likelihood of a further

spread of the epidemic, " UNFPA said in its Sudan newsletter for August.

It added that while many of the returnees had heard about the disease,

access to information on prevention was not universal.

The head of the HIV/AIDS programmes for the Office of the UN High

Commissioner for Refugees (UNHCR), Spiegel, acknowledged the

potential risk of an increase in HIV infections in southern Sudan, but

strongly urged not to jump to conclusions with regard to HIV frequency

among returning refugees.

" While it is true that conflict-affected populations and refugees are at

greater risk for HIV infection - because of sexual violence and disruption

of health services - this doesn't necessarily translate into higher

infection rates, " Spiegel said. " Actual infection rates are highly context

specific.

" Key factors include the HIV prevalence in the area of origin, infection

rates of the population surrounding refugee camps and the time the

refugees have spent in the camp. "

In addition, Spiegel said, the increased risk of HIV infection in a time

of conflict can be offset by a decreased risk as refugees’ mobility is

reduced and their level of HIV/AIDS awareness is raised through

educational programmes in refugee camps.

The regional HIV/AIDS adviser for the NGO Save the Children, Rena Geibel,

confirmed the mixed picture with regard to HIV rates among

conflict-affected populations.

" In eastern DRC [Democratic Republic of the Congo], sexual violence is so

widespread that the region now has a higher prevalence rate than the

country as a whole " . In contrast, chronic conflicts in Sierra Leone,

Angola and southern Sudan actually kept HIV infections at a lower rate

than otherwise would have happened.

In Kakuma camp in northwestern Kenya, home to about 60,000 Sudanese

refugees and 20,000 refugees from other countries, a UNHCR study found the

infection rate in 2002 to be five percent, while in the nearby town of

Lodwar, Kenya it was 18 percent.

Although significantly lower than the surrounding population in Kenya, the

infection rate of refugees in Kakuma seems slightly higher than the

infection rate of 2.3 percent among pregnant women in the southern

Sudanese towns of Rumbek and Yei, as revealed in a 2003 survey from the US

Centre for Disease Control and Prevention.

Rather than perceiving the return of Sudanese refugees as a potential risk

for increased HIV infections in southern Sudan, both Geibel and Spiegel

prefer to see the return of refugees as an opportunity.

" Given the lack of information and well-functioning health services in

south Sudan, the returning refugee population - who have been educated

about the risks of HIV/AIDS and some who have been trained as

health-workers or nurses - might actually help to reduce the spread of

HIV/AIDS in southern Sudan, " Geibel said.

The programme manager for south Sudan of Save the Children-UK, Patience

Alidri, confirmed the increased level of HIV/AIDS awareness among many

returning refugees, but was more sceptical about its effects. " Increased

awareness does not necessarily lead to changes in actual behaviour, " she

said. " Behaviour doesn't change overnight. "

Conflict in Sudan has displaced millions of people and sent hundreds of

thousands fleeing across borders. In the south, a 21-year war between the

government and the Sudanese People's Liberation Movement/Army (SPLM/A) has

displaced an estimated four million people internally, with over 500,000

Sudanese living in neighbouring states as refugees. The bulk of these

refugees live in Uganda, Ethiopia and Kenya, according to UNHCR.

The conflict in the western Darfur region, between the Sudanese military -

supported by Janjawid militias - and rebels fighting to end alleged

marginalisation and discrimination of Darfur residents by the state, has

displaced about 1.45 million people and sent another 200,000 fleeing

across the border into Chad.

However, hope for a peaceful resolution to the southern conflict has grown

with ongoing negotiations between the SPLM/A and the government that are

going on in Kenya. In May, both sides signed six key protocols covering

power-sharing arrangements. They also agreed to the creation of an

administration to control three contested areas during a six-year period,

at the end of which, a referendum will be held to determine whether the

south would remain a part of Sudan.

The protocols outlined the arrangement of a decentralised government of

national unity and devolution of power to Sudan's individual states. The

south would, during the interim period, have its own constitution that

would conform with the transitional national constitution.

Analysts believe the negotiations in Kenya, which resumed two weeks ago,

could be successfully concluded in the near future. The conflict in

Darfur, however, could take longer to resolve, analysts noted, delaying

the return of the refugees in Chad.

On Wednesday, Sudan's Ministry of Health announced that African Union (AU)

peacekeepers entering Sudan to monitor the ceasefire in Darfur would be

screened for HIV. According to the Sudanese Media Centre, Health Minister

Ahmed Bilal Osman said every member of the AU contingent would have to

produce a certificate proving they were not HIV-positive.

Osman noted that the measure was purely precautionary and aimed at

" safeguarding the health of the people of Darfur " .

The AU is expected to deploy more than 3,000 troops from five countries

over the next few weeks in an expanded mission aimed at containing the

Darfur conflict.

[On the Net: PlusNews special report on HIV/AIDS in Southern Sudan:

http://www.plusnews.org/webspecials/PNsudan/default.asp ]

[ENDS]

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