Your daily Selection of IRIN Africa PlusNews reports, 12/31/2004

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

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CONTENT:

1 - BURKINA FASO: Government needs help to increase numbers on ARV, aid

workers say

2 - SOUTH AFRICA: Tired of the " same old " AIDS messages

3 - SWAZILAND: Prominent traditional leader condemns AIDS drugs

1 - BURKINA FASO: Government needs help to increase numbers on ARV, aid

workers say

OUAGADOUGOU, 31 December (PLUSNEWS) - Health authorities in Burkina Faso

have already admitted they will not be able to meet global goals for

providing antiretroviral (ARV) drugs to people living with AIDS, but aid

workers say even the government's scaled-down target will be under threat

if grassroots groups are not drafted into the fight.

Burkina Faso, one of the world's poorest countries, has pledged that

15,000 people will receive the life-prolonging ARV drugs by 2007. That

would be a five-fold increase on the 2,700 patients that currently access

treatment, but would fall short of the 27,000 people which the World

Health Organisation said should receive medication by the end of 2005.

Aid workers in this impoverished country say if the new target is to be

realised, the contribution of grassroots AIDS organisations needs to be

cranked up because the public health system is ill-equipped to shoulder

the burden alone.

For example, statistics from UNAIDS show that there are just 400 doctors

in this country of 13 million - or one doctor for every 32,500 people.

And there are only 23 regional and local health centres that are set up to

hand out treatments for HIV/AIDS or to cure the secondary illnesses that

often spring up in tandem with the virus.

" A lack of healthcare infrastructure and qualified medical personnel means

that the government can't take charge of everyone, " explained Luc Derlet,

who works for Medecins Sans Frontieres (MSF) Luxembourg.

The HIV/AIDS prevalence rate in this landlocked country is estimated at

1.8 percent by government health officials and around 2.7 percent

according to UNAIDS.

MSF has been handing out free ARV drugs in Burkina for the past two years

in four centres across the capital, treating more than 1,000 people a

year.

ARV drugs and the laboratory tests needed to prove treatment is necessary

cost as much as 33,000 CFA (US $69) a month for patients that go to state

clinics.

But Derlet says that in another two years, the free MSF projects will be

not be able to keep up with demand.

" We have to find solutions to decentralise the healthcare so we can refer

people who need treatment to health centres or groups in their local

areas, " he said.

It is a message echoed by Mamadou Sakho, the head of UNAIDS in Burkina

Faso.

" Even if there is real political will to improve the care, there is the

problem of access to treatment and care because of structural and

financial reasons, " he told PlusNews.

CLANDESTINE OPERATIONS

Local organisations complain that they are being sidelined in the fight

against AIDS, limited to information campaigns and efforts to destigmatise

the disease, or else forced to administer drugs clandestinely.

The REVS+ organisation (Responsibility, Hope, Life and Solidarity) is a

case in point. Director e Somda explained that thanks to foreign

donors, her group is able to provide free ARV treatment to 79 people in

Burkina's second city, Bobo Dioulasso.

But it is doing so without the necessary government permit.

In September the government authorised four grassroots groups to provide

general treatment, out of the 20 or so that offer help to people living

with AIDS, but none were authorised to prescribe ARVs.

" The government is thinking about giving us provisional approval for six

months, but we're still at the discussion stage and nothing has been

signed, " Somda said.

Nevertheless the group gives out the drugs, without the desired

facilities, and has a waiting list of some 700 people.

" We work in great uncertainty because we're not equipped to hand out

medication, " Somda said.

" But we're obliged to do it. The hospital in Bobo and its four doctors are

swamped. They have not had ARVs for the past six months and they send

people here. We are the last chance for these people. "

Support for local groups may come next year when the World Bank is due to

dispense around $4.6 million to help speed up access to treatment. The

funds are destined for a dozen local non-governmental organisations

involved in the fight against AIDS.

For UNAIDS' Sakho, it is imperative that the government realises

grassroots groups can be powerful allies.

" They are very mobilised and call us on a daily basis, letting us know the

problems they face on the ground. For that reason they should be included

in the government's action plan, " he said.

[ENDS]

2 - SOUTH AFRICA: Tired of the " same old " AIDS messages

DURBAN, 31 December (PLUSNEWS) - AIDS activists in South Africa have

called for the revision of " outdated " HIV/AIDS messages which have been

circulating for years but have failed to achieve behaviour change.

Handing out pamphlets with catchy slogans has little effect, experts say.

People require more than awareness and basic education - they need advice

on how to apply their knowledge of AIDS to their daily lives.

Yet, large numbers of grassroots organisations keep handing out pamphlets

with simplified phrases like " Use condoms " or " Break the silence " , which

were developed more than 10 years ago. As a result, experts have found

that many South Africans have lost interest in understanding the virus,

while the HIV infection rate has remained stubbornly high at more than 21

percent of the population.

Sally Ward, a manager at Soul City, an HIV/AIDS learning material

producer, told PlusNews that people were tired of hearing the " same old "

AIDS messages over and over again. " The pandemic has changed [over the

years], and so has people's need for information, " she said. People do not

want to hear anymore that they need to use condoms, but rather how to

negotiate safer sex with their partners.

Nonhlanhla Xaba, operations manager of the Durban-based AIDS Foundation

South Africa, gave a further example of a widely used awareness campaign

that she said failed to make the grade. " The slogan ABC [Abstain, Be

faithful, use a Condom] is regrettably still prevalent, although we know

that women, due to gender imbalances, cannot implement these rules, " she

noted.

Xaba also highlighted the fact that AIDS messages needed to be updated

regularly. " Right now, messages crafted years ago tend to stay on although

they clearly have loopholes. "

For maximum impact, HIV/AIDS messages need to be well researched and

tested by a target audience before being publicised. The Soul City

education team, for example, goes through an in-depth evaluation process

before launching new training material.

Most recently, Soul City has been developing brochures on the subject of

antiretroviral therapy. The team first interviewed a range of health

workers, doctors, nurses and patients for background information, then

discussed the brochure content in a workshop, wrote a number of drafts

and, lastly, tested the new education material with a target audience. The

process took almost a year, Ward said.

" It is very difficult to develop material on complex, medical topics that

is easy to understand, " she pointed out.

Soul City was founded in 1994 when little user-friendly educational

material was on the market. It has developed a range of training

materials, including posters, comic books and videos, as well as working

on " edutainment " television and radio programmes.

" We don't have a reading culture in South Africa, " noted Xaba. " Especially

young people need to be entertained while educated, for example through

drama, games and activity-based learning. "

She added that a large number of education programmes have failed to make

an impact because they were designed by people who had a great deal of

medical knowledge, but knew little about the cultural realities which

would determine whether people would be able to relate to the messages.

Training organisations agree that there is a huge gap between hearing a

slogan and behaviour change.

Washington, facilitator of the Durban-based training organisation

Project Empower, told PlusNews that her group realised that tackling

high-risk behaviour was " not about the condom " but about people's " social

fabric " , such as communication within relationships, gender imbalances and

societal perceptions of sexuality.

Project Empower decided to move beyond AIDS as a topic and began

organising workshops to talk more broadly about cultural restrictions, and

issues of taking control, tolerance and social power. The subject of

HIV/AIDS is discussed only indirectly.

" People need to engage in the learning process and explore what the newly

gained knowledge means for them on a personal level, " Washington

explained.

[ENDS]

3 - SWAZILAND: Prominent traditional leader condemns AIDS drugs

MBABANE, 30 December (PLUSNEWS) - Swaziland's AIDS control programme

received a set back this month in the shape of a prominent traditional

healer who has condemned the use of antiretroviral (ARV) drugs.

" Why do we spend money on something which does not cure the disease but

makes the situation worse? " Nhlavana Maseko, president of the Traditional

Healer Organisation (THO), asked at an AIDS rally in the eastern

provincial capital, Siteki.

Maseko criticised the rollout of ARVs, which were introduced in earnest

this year, because of the unpleasant side effects of some of the drugs.

Swaziland has the world's highest HIV prevalence rate at close to 40

percent of the adult population.

" The money should be used in finding the cure for the disease involving

both traditional healers and medical doctors, " Maseko said at the rally,

hosted by the Alliance of Mayors Initiative for Community Action Against

AIDS at the Local Level.

ARVs are not a cure for AIDS, but they suppress the virus and can extend

people's lives.

" Many different people need to be educated. ARVs are new to the country,

but we are very sure that they work, " Sibusiso Dlamini, coordinator for

care and support for the National Emergency Response Committee on

HIV/AIDS, told PlusNews.

The committee distributes money from government, private groups, and the

Geneva-based Global Fund to local NGOs involved in AIDS-related

programmes.

" Many workshops have been conducted by the ministry of health for

traditional healers. But in terms of ARVs, there haven't been many. We see

using Global Fund money next year to train them – traditional healers and

everyone else, " said Dlamini.

Other health officials have accused Maseko of campaigning for a cabinet

post after he called for the creation of a ministry solely devoted to

traditional healers.

" This is the same person who condemned condoms to prevent the spread of

HIV when the virus was just setting foot in the country in the late '80s.

Having contributed to the spread of HIV, he is now disparaging the ARV

rollout that can prolong the lives of people living with HIV, " a health

ministry source said.

Many Swazis respect and rely on traditional medicine and healers in what

has remained a highly conservative society.

[ENDS]

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