Poverty in Lesotho
Lesotho is a small, mountainous nation surrounded entirely by South Africa. Since gaining independence from the United Kingdom in 1966, Lesotho has been plagued by political instability and slow economic development. A high prevalence of HIV further complicates efforts to end poverty in Lesotho. Despite an attempted military coup in 2014, conditions have been improving in the country in recent years. Here are 7 factors that affect poverty in Lesotho.

7 Factors Affecting Poverty in Lesotho

  1. Agriculture: Sixty-six percent of Lesotho’s population lives in rural areas where the economy is largely based on small scale agriculture. Many of these people engage in subsistence farming, meaning they rely on a good harvest to be able to feed their families. The success of each harvest makes a huge impact on the lives of millions in Lesotho. A drought from 2015 to 2016 crippled poverty reduction efforts for the next few years, proving the delicacy of this system.
  2. Gender: Households run by women have a poverty rate of 55.2%, compared to 46.3% for households run by men. This is because women are typically denied the same opportunities as men in Lesotho’s highly patriarchal society.
  3. Urbanization: Poverty in Lesotho is more prevalent in rural areas than in urban areas. Urban areas have a 28.5% poverty rate while rural areas face a 60.7% poverty rate. Despite Lesotho’s economic development in recent years, most improvements have been made in urban areas while rural areas have been left behind.
  4. Education: Achieving a college education is extremely rare in Lesotho – only 4.4% of people live in households with someone who has gone to a college or university. Those that do receive higher education have a low poverty rate of 8.7%.
  5. Government programs: Over the past 20 years, the government in Lesotho has been working with international organizations to expand protections for the poor and increase economic opportunity. As a result, the national poverty rate decreased from 56.6% to 49.7% from 2002 to 2017.
  6. HIV: Poverty and HIV are clearly connected in Lesotho. Almost 24% of adults are living with HIV and treatment is essential to stopping the spread and helping these people live normal lives. Lack of resources and awareness means that on average only 57% of people with HIV are currently getting help. This directly impacts their quality of life and makes it harder to land above the poverty line.
  7. NGOs: Though poverty in Lesotho is an important issue for the country’s government, NGOs are stepping in to fill gaps. Many international nonprofit groups such as Caritas Lesotho operate in the country. Caritas Lesotho is a group which seeks to help individuals escape poverty by teaching them technical skills. They focus on vulnerable children and teach them a trade such as farming or woodworking. Groups like Caritas Lesotho are slowly helping to improve the economic situation in the country.

Examining the causes of poverty in a country is essential in deciding how best to address the issue. It is clear that poverty in Lesotho will continue to be an issue for many years. However, the country is on the right track and will improve as education and economic opportunity increase.

– Jack McMahon
Photo: Flickr

Tuberculosis in BotswanaBotswana is a southern African country with just over 2 million residents living inside its borders. Every Batswana lives with the threat of tuberculosis, an infectious disease that remains one of the top 10 causes of death on the African continent. Tuberculosis has a 50% global death rate for all confirmed cases. Investing in tuberculosis treatments and prevention programs is essential. Botswana has one of the highest tuberculosis infection rates in the world with an estimated 300 confirmed cases per 100,000 people, according to the CDC. Preventative and community-based treatment shows promise in combating tuberculosis in Botswana.

Treating Tuberculosis in Botswana

Tuberculosis treatment cures patients by eliminating the presence of infectious bacteria in the lungs. The first phase of treatment lasts two months. It requires at least four separate drugs to eliminate the majority of the bacteria. Health workers administer a second, shorter phase of treatment to minimize the possibility of remaining bacteria in the lungs.

Early identification of tuberculosis is a crucial step in the treatment process and significantly reduces the risk of patient death, according to the Ministry of Health. Preventative treatment methods are vital because they inhibit the development of tuberculosis infection. They also reduce the risk of patient death significantly.

Health workers detect tuberculosis with a bacteriological examination in a medical laboratory. The U.S. National Institutes of Health estimate that a single treatment costs $258 in countries like Botswana.

Involving the Community

Botswana’s Ministry of Health established the National Tuberculosis Programme (BNTP) in 1975 to fight tuberculosis transmission. The BNTP is currently carrying out this mission through a community-based care approach that goes beyond the hospital setting. Although 85% of Batswana live within three miles of a health facility, it is increasingly difficult for patients to travel for daily tuberculosis treatment. This is due to the lack of transportation options in much of the country.

Involving the community requires the training and ongoing coordination of volunteers in communities throughout the country to provide tuberculosis treatment support. Community-based care also improves treatment adherence and outcome through affordable and feasible treatment.

The implementation of strategies such as community care combats tuberculosis. For example, it mobilizes members of the community to provide treatment for tuberculosis patients. The participation of community members also provides an unintended but helpful consequence. For example, community participation helps to reduce the stigmas surrounding the disease and reveals the alarming prevalence of tuberculosis in Botswana.

A Second Threat

In addition to the tuberculosis disease, the HIV epidemic in Africa has had a major impact on the Botswana population, with 20.3% of adults currently living with the virus. Patients with HIV are at high risk to develop tuberculosis due to a significant decrease in body cell immunity.

The prevalence of HIV contributes to the high rates of the disease. The level of HIV co-infection with tuberculosis in Botswana is approximately 61%. African Comprehensive HIV/AIDS Partnerships (ACHAP), a nonprofit health development organization, provides TB/HIV care and prevention programs in 16 of the 17 districts across the country in its effort to eradicate the disease.

Fighting Tuberculosis on a Global Scale

The World Health Organization (WHO) hopes to significantly reduce the global percentage of tuberculosis death and incident rates through The End TB Strategy adopted in 2014. The effort focuses on preventative treatment, poverty alleviation and research to tackle tuberculosis in Botswana, aiming to reduce the infection rate by 90% in 2035. The WHO plans to reduce the economic burden of tuberculosis and increase access to health care services. In addition, it plans to combat other health risks associated with poverty. Low-income populations are at greater risk for tuberculosis transmission for several reasons including:

  • Poor ventilation
  • Undernutrition
  • Inadequate working conditions
  • Indoor air pollution
  • Lack of sanitation

The WHO emphasizes the significance of global support in its report on The End TB Strategy stating that, “Global coordination is…essential for mobilizing resources for tuberculosis care and prevention from diverse multilateral, bilateral and domestic sources.”

– Madeline Zuzevich
Photo: Flickr

HIV prevention in AfricaHuman Immunodeficiency Virus (HIV) is known to have impacted the world for approximately 40 years. Considering the fact that the virus was equally as aggressive as it was untreatable, first world countries like the United States and France were more able to provide for their citizens. Doctors could properly and continually perform research in order to educate citizens on the virus. Additionally, they could hastily link HIV prevention and methods of protection and treatment. Unfortunately, in sub-Saharan African countries, accomplishing the same feats proves more difficult. Therefore, 66% of newly diagnosed HIV cases worldwide come from sub-Saharan African countries.

HIV/AIDS’s Effect on Africa

Eswatini, Lesotho, Mozambique, parts of South Africa, regions in Zambia, Namibia, Southern Malawi and Kenya are the countries in Africa whose populations have the highest rates of being infected or affected by HIV. In Kenya, only about 30% of sexually active individuals practice safe sex methods. Additionally, only 47.5% of adolescent women could properly identify methods that would prevent them from contracting HIV sexually. With that said, women are at an extremely high risk of contracting HIV in sub-Saharan Africa.

An Increased HIV/AIDS Risk Factor for Women

One of the main factors contributing to women being at a higher risk of contracting HIV in sub-Saharan Africa is that the rate of school attendance is extremely low for girls in sub-Saharan Africa. Girls are more likely to be exposed to social and economic scenarios that could potentially threaten their survival and put them at an increased risk of contracting HIV. Therefore, it is important to increase both the school attendance rate for girls and the amount of sex education offered at school. This would include information on HIV and STI prevention.

Sex Education’s Impact on Adolescent Health and Choices

UNAIDS analyzed a series of studies in order to determine whether or not sex education makes a significant impact on school-aged children’s sexually based decisions. Out of a total of 53 studies, 22 studies showed that, after sex education was implemented, three things changed– individuals waited a longer amount of time to initially have sex, the number of sexual partners per person decreased and the number of unplanned pregnancies and STI diagnoses decreased. Additionally, 27 studies showed that HIV/AIDS rates, alongside overall sexual health, did not improve or worsen the amount of sexual activity, pregnancies or STI rates.

Overall, the results of these studies support the claim that implementing sex education in schools’ curricula is an efficient way to reduce practices that could result in the spread and contraction of HIV/AIDS and other STIs in school-aged children.

Africa’s Implementation of Sexual Education

South Africa has taken the initiative to create and implement a plan for discussing HIV prevention in the school setting. The priorities of this plan include generating attention toward HIV/AIDS for both students and teachers, including information on HIV/AIDS in the school’s curriculum and creating models that display the effects of HIV/AIDS on the school district. This initiative also ensures the protection of students’ and teachers’ constitutional rights and confidentiality about HIV/AIDS status.

Due to these precautions, HIV-positive individuals will not be discriminated against. In order to ensure that the students are learning the best methods of HIV-AIDS prevention, the curriculum will remain up-to-date and teachers will be trained accordingly.

Comprehensive Sexuality Education

Eleven sub-Saharan countries have introduced various courses into their schools’ curricula to educate them on sex education in varying degrees. Rwanda and Zambia adhere to what the United Nations has deemed necessary for students to learn through sex education. These classes fall under the category of “Comprehensive Sexuality Education” (CSE). These classes discuss healthy relationships between genders and how to decrease sexual violence; in addition to sex education in a way that is appropriate for younger children and adolescents. The main objectives of CSE are to teach children:

  • to acknowledge their “health, well-being and dignity”
  • to create considerate relationships, both sexually and socially
  • to analyze their choices and consider how the potential consequences will affect themselves and others
  • how to comprehend and protect their rights throughout their lives
There has recently been evidence of CSE being used at an increased rate in certain areas of Africa. Burundi, Senegal, Nigeria, Mozambique and Zambia have all ensured that their teachers and educators receive the proper education and training on CSE. Zambia’s program has been especially praiseworthy because the costs of instruction for sexual and reproductive health are included in the budget for education.

Various projects and initiatives throughout the world have provided crucial information pinpointing which countries need HIV prevention through sexual education implementation. The collaboration between many organizations has allowed third world countries to access resources that would be more difficult to achieve independently. Fortunately, the difficult challenges that impoverished countries have faced to prevent the spread of HIV in sub-Saharan Africa are becoming more attainable.

– Amanda Kuras
Photo: Wikimedia Commons

mass incarcerations in Colombia
Colombia is a country in South America with a population of nearly 50 million as of 2018. It is the second largest country located in South America, with the 38th largest economy in the world. The Colombian Justice System is structured similarly to that of the United States, where defendants have the right to a fair and speedy trial and are sentenced by judges.

Colombian prisons have a problem with mass incarceration. They have an overall capacity of 80,928 people; however, their actual capacity is at 112,864 people as of May 2020. The majority of people are incarcerated for non-violent crimes, such as drug-related offenses. Mass incarcerations in Colombia are also an issue because they lead to other health issues, such as the transmission of HIV and tuberculosis. Here are four more important things to know about mass incarcerations in Colombia.

Mass Incarcerations in Colombia: 4 Things to Know

  1. Capacity Rates: There are 132 prisons in Colombia with a total maximum capacity of just over 80,000 people. Despite this capacity, Colombian prisons have an occupancy level of 139.5%, or just over 112,000 people. Women make up approximately 6.9% of this number, or about 7,700 women. There are no children actively incarcerated in Colombian prisons. The country’s congress has regularly fought against the release of prisoners, instead choosing to keep the prisons full.
  2. Effects of COVID-19: Prison riots are becoming increasingly common in Latin America with the spread of the coronavirus. Mass incarcerations in Colombia have created panic amongst the prisoners, who have demanded more attention to their conditions. The Colombian Minister of Justice, Margarita Cabello, has not outwardly acknowledged the prison riots as demands for better care against COVID-19. Instead, she has stated that the riots were an attempt to thwart security and escape from prison. Furthermore, because of the scarcity in the number of doctors, many prisoners have contracted and/or died from COVID-19. In one particular prison in central Colombia, over 30% of staffers and prisoners have become infected with the virus.
  3. Infectious Diseases: Beside COVID-19, mass incarcerations in Colombia have allowed for the spread of other infectious diseases, such as HIV and tuberculosis. Colombian prisons have designated cell blocks for those who contract HIV, as it is common for prisoners to engage in sexual relationships with guards. Healthcare facilities are not readily available in prisons, and condoms are in scarce supply. Active cases of tuberculosis (TB) also correlate with mass incarcerations in Colombia. Approximately 1,000 prisoners per 100,000 were found to have active cases of TB with little to no access to affordable care.
  4. Possible Solutions: Local citizens Mario Salazar and Tatiana Arango created the Salazar Arango Foundation for Colombian prisoners. Salazar conceived the idea after being imprisoned in 2012 on fraud charges and seeking ways to make serving his sentence more tolerable. The Salazar and Arango Foundation provides workshops for prisoners in the city of La Picota and puts on plays for fellow inmates. Prisoners have found the organization to be impactful to their self-esteem and their push for lower sentences.

Mass incarcerations have had major impacts on the Colombian prison system. Issues such as food shortages and violence have given way to poverty-like conditions with little action. Despite these conditions, organizations such as the Salazar Arango Foundation look to make mass incarcerations in Colombia more tolerable for those behind bars. Hopefully, with time, mass incarcerations in Colombia can eventually be eliminated.

– Alondra Belford
Photo: Unsplash

HIV in Eswatini
Swaziland or Eswatini, as it was officially renamed in 2018 by King Mswati III, is a tiny landlocked country in Southern Africa. It has the highest prevalence of HIV in the world, with the disease infecting about 31% of its sexually-active population. In 2018, HIV infected about 8,000 new adults and caused approximately 3,000 new fatalities. However, recent data suggests that the country has found ways to slash the new rate of infections by almost 45%. Here are eight facts about the fight against HIV in Eswatini.

8 Facts About Eswatini’s Fight Against HIV

  1. Mode of transmission: Heterosexual sex is the primary way HIV is transmitted, with about 94% of all new cases coming from it. The disease affects sex workers, adolescent girls and young men and women significantly more than other demographics.
  2. Poverty and education: Almost 59% of people in Eswatini live below the poverty line. Some regions have still not been able to recover from the regional droughts of 2015 and 2016. Due to poor economic conditions, young girls are often unable to continue their education. As a result, they are less empowered to negotiate for safer sex and sometimes also have to resort to prostitution. Rampant poverty also means that many suffering from the disease cannot afford proper healthcare.
  3. Most affected age group: Adults between the ages of 15 and 49 are most affected by HIV. Over the long term, this has induced major cultural changes surrounding death and illness. It has also led to an expansion of services such as life insurance and mortuary.
  4. Impact on women: HIV has affected women disproportionately. 35.1% of women in Eswatini are living with HIV, compared to 19.3% of men. This stems from widespread gender inequality in the country. Gender-based violence and men indulging in more than one partnership at the same time increase the risk of women contracting HIV. King Mswati withheld royal assent on The 2015 Sexual Offences and Domestic Violence Bill, which could offer more protection to women. The bill finally passed in 2018, however. This is an essential first step for improving gender equality in Eswatini.
  5. Condition of children: About 11,000 children (0-14 years) were living with HIV in Eswatini as of 2018. Only 76% of these children were on ARV treatment. Approximately 45,000 children have also been orphaned due to AIDS-related illnesses. Fortunately, the number of new infections and AIDS-related deaths have reduced to fewer than 1,000 each year.
  6. Increase in circumcision: The proportion of men opting to be circumcised increased significantly in recent years. Circumcision is a scientifically-proven way of reducing the transmission of the virus. The rate of male circumcision in the productive age group (15-49 years) more than doubled from 7% in 2007 to 19% in 2010.
  7. The 90-90-90 model: UNAIDS has developed the 90–90–90 testing and treatment targets to help Eswatini and other countries across the world address HIV and AIDS. Local and national efforts are working towards the following three goals by 2020: 90% of people living with HIV will be aware of their HIV-positive status, 90% of those who have been diagnosed with HIV will continuously and consistently receive antiretroviral therapy (ART) and 90% of all people who are receiving ART will have viral suppression. The 90-90-90 model is a world-renowned global benchmark to curb the spread of HIV in geographies with high prevalence.
  8. Availability of condoms: Targeted mass media campaigns promote condom use and sexual health services distribute condoms across the county. These efforts have resulted in about 51 condoms per year per male available in Eswatini. However, in spite of increased availability, condom use has actually declined. This suggests that a change in mentality is more important than increasing the distribution of condoms.

It is clear that Eswatini has made great strides in the fight against HIV in recent years. However, the high HIV prevalence indicates the government needs to address significant problems such as poverty, gender inequality and risky cultural practices, which contribute to a high risk of HIV infection. Moving forward, a greater focus must be placed on combatting HIV in Eswatini.

Akshay Anand
Photo: Flickr

Poverty in LesothoIn the country of Lesotho, a mountainous region landlocked by South Africa, there are two playing fields, although neither one of them results in a fair chance of winning a life away from poverty’s grasp. Instead, the two fields paint similar pictures of poverty with contrasting colors. The first field, the lowlands, is statistically less impoverished than its towering companion, the highlands. Agricultural impacts are not the only factor impacting poverty. Here is some information about the impacts on poverty in Lesotho.

Agricultural Impact

According to UNICEF, 82% of children living in the highlands are multidimensionally poor compared to 53% of children living in the lowlands. This is due to the fact that the natural landscape of the lowlands is more suitable for agricultural endeavors as opposed to the rocky, mountainous terrain of the highlands. Since the majority of Basotho, the proper term for the country’s natives, grow their own food, a season of drought could greatly impact not only the current year’s harvest but future harvests as well because seeds would not reproduce for the Basotho to use the following year. Children lacking food and proper nutrition also increase student growth. In 2014, stunting impacted approximately 88,900 of 275,000 Basotho children. Stunting can result in a compromised immune system and poor cognitive performance which adds an unnecessary barrier to childhood education and future employability.

Educational Impact

One of the impacts on poverty in Lesotho including both the highlands and the lowlands is the absence of proper and consistent education. School is free for elementary-aged children. However, after these years, children have to purchase school uniforms to continue their education. This pulls many children out of the cinder-block classrooms and back into their homes. At home, they must often care for younger siblings or other abandoned children even though they have yet to reach puberty.

Allison Barnhill of Reclaimed Project, a nonprofit that partners alongside local churches to educate, equip and care for orphaned children, spoke with The Borgen Project saying, “Education is a huge part of it [poverty]. If you want to grow up and change the country, you have to be educated.” Reclaimed Project acknowledges this need by providing uniforms and school supplies to children in its program. These children also receive educational training outside of the classroom after each school day at one of Reclaimed Project’s orphan care centers. The care centers are located in two different highland villages and allow students to grow forward. Later in 2020, Reclaimed Project plans to open a skills training center to teach high schoolers and local Basotho basic computer, mechanic and sewing skills.

HIV/AIDS Impact

Another of the impacts on poverty in Lesotho is HIV/AIDS. It is easy to tell if a family does not have the means to purchase school uniforms. However, there is a type of poverty the Basotho people face that others cannot see. It is invisible and inescapable. HIV and AIDS fell upon the country of Lesotho in the 1990s, creating a wave of economic and social destruction. Currently, it affects 74% of children under the age of 2 with 23.2% of adults affected. Many victims of the disease are Basotho who once held steady jobs and now must succumb to treatment interventions.

Unfortunately, Basotho culture still highly stigmatizes this disease. Medical clinics, which predominantly serve people infected by HIV and AIDS, have specific days when people come to receive treatment. Therefore, if others witness a Basotho walking towards the clinic on this given day, they might assume that he or she has HIV or AIDS. This makes the unknown known and creates a social scar. To prevent this from happening, some Basotho willingly choose to avoid treatment and risk death to maintain their social standing. Overtime, refusing treatment can result in the inability to work, further lengthening the downward economic spiral of poverty.

Fortunately, with the passage of time comes the gradual reformation of these ideals. Within a five-year time span, the average percentage of full acceptance of Basotho living with HIV increased by 3.5%. This indicates that community acceptance is improving. However, HIV/AIDS treatment funding is limited and a burden on the government of Lesotho. In fact, the government funds less than half of Lesotho’s HIV/AIDS response. The majority of funding for HIV/AIDS reform comes from international resources. Therefore, the country relies heavily on the generosity of middle-income countries and nonprofits.

Future Impact

Speaking on the many dimensions of poverty, Barnhill stated that, “The issues are always compounding. If you’re living on the brink, it doesn’t take much to push you over the edge.” Fortunately, by 2030, the number of people living near the edge should reduce as the World Bank works with the Government of Lesotho to reduce extreme poverty. Even though poverty plagues the country of Lesotho, the country has come a long way from its roots. Lesotho continues to grow forward, creating branches of prosperity and leaves a budding of hope.

– Chatham Kennedy
Photo: Chatham Kennedy

The US is Making Strides to Help Reduce HIV in Tanzania Tanzania is the largest and most populous country in East Africa, with nearly 59 million inhabitants. It is a youthful and rapidly growing population with a fertility rate of nearly 4.8 children per woman. Almost two-thirds of the population is under 25, and 42% is under 15. While malaria is the leading cause of death for children under 5, HIV/AIDS is the main killer among adults. In 2018, 1.6 million people were living with HIV in Tanzania, with a prevalence rate of 4.6% among adults. Approximately 24,000 adults died of AIDS-related illnesses, the seventh-most in the world. As more of the country’s population reaches adulthood, containing the spread of HIV in Tanzania will become even more important, and international assistance can continue playing an important role in the effort to do so. 

The 90-90-90 Target to reduce HIV in Tanzania

In 2017, the Joint United Nations Programme on HIV/AIDS, a joint venture of six UN agencies that coordinates the international fight against HIV, set a “90-90-90” global target for 2020. The goals were by 2020, 90% of all people living with HIV would know the status of their disease, 90% of all people diagnosed with HIV would be receiving antiretroviral therapy and 90% of all people receiving treatment for HIV would have viral suppression. 

Although it is too early to predict whether Tanzania will achieve these targets, the Joint United Nations Programme on HIV/AIDS reports the country has made strides in fighting the disease. In addition, the number of AIDS-related deaths per year declined to 49% between 2010 and 2018. Moreover, according to a 2019 report based on a 2016-2017 survey, Tanzania appeared close to reaching at least two of the three 90-90-90 benchmarks: 60.6% of people knew their status as living with HIV; around 93.6% of people diagnosed with HIV were receiving antiretroviral therapy; 87% had viral suppression of the people receiving treatment.

Action Taken by the United States

The President’s Emergency Plan for AIDS Relief (PEPFAR) is the United States’ response to the epidemic and is a leader in the fight against HIV/AIDS. The initiative provides antiretroviral treatment to more than 14.6 million people in more than 50 countries. As a result, this reflects remarkable progress since the program began in 2003 when only 50,000 people were on treatment in sub-Saharan Africa. Furthermore, the United States’ program uses granular data to map the HIV epidemic and maximize the impact of its efforts. For example, in 2014 the U.S. announced the Accelerating Children on HIV/AIDS Treatment (ACT) Initiative. Around 84,745 people in Tanzania who are 20 years or younger were receiving ART. The ACT initiative has given ART treatment to over a million children and adolescents in total.

PEPFAR and DREAMS

Girls are roughly 75% more likely to become HIV infected than boys. In addition, PEPFAR has created DREAMS (Determined, Resilient, Empowered, AIDS-free, Mentored, and Safe). In an overview between 2016 and 2019, PEPFAR DREAMS in Tanzania was given over 52 million dollars in funding. Private sector partners include the Bill and Melinda Gates Foundation and Johnson and Johnson. As with all PEPFAR countries, the U.S. collaborates with Tanzania’s government in the fight against HIV/AIDS. The United Republic of Tanzania’s Ministry of Health, Community Development, Gender, Elderly and Children started the National Aids Control Programme (NACP).

Tanzania took strides to reach the 90-90-90 target. One of these is the Treat All strategy, where they attempt to test and treat as many people as possible. Another effort includes distributing condoms to public and private places consistently to prevent the spread of infection. They also hope to educate males to raise awareness about their vital role in spreading the virus. Finally, they hope to address sub-groups at higher risk, such as those who inject drugs. These efforts, among many others, have helped reach the hopeful numbers listed above and have given Tanzania great potential for progress towards 2030.

Looking Ahead

The NACP is proud of its efforts to eradicate HIV in Tanzania. Looking forward, UNAIDS has created a new target: 95-95-95 by 2030. Tanzania is making progress and has a bright future.

Annie Raglow

Photo: Flickr

facts about child marriage in Africa
Child marriages have been occurring for thousands of years. While child marriage is more commonly seen between female children and much older men, child marriage is defined as marriages where either one or both partners are younger than the age of 18. According to UNICEF, Africa has the highest rate of child marriages in the world. Specifically, sub-Saharan Africa has the highest rates where every four in 10 girls are married before the age of 18. Within this region, the country of Niger has the highest child marriage rates, with 77% of girls married before the age of 18. Here are seven facts about child marriage in Africa.

7 Facts About Child Marriage in Africa

  1. Children marry as young as 7 and 8 years old. The U.N. estimates that every day around 37,000 girls under the age of 18 are married. Of the girls forced into marriage, one in three girls experience child marriage before the age of 18 and one in nine experience it before the age of 15. UNICEF estimates that if no change occurs, the rate of child marriages in Africa alone may double by 2050.
  2. Girls often experience suppressed education. Most girls who are in a child marriage do not get an education higher than the mandated primary education of grades one through nine. This is due to social stereotypes that categorize girls as domestic wives who stay in the home to cook, clean and bear children. Another reason is that most child marriages take place in poverty-stricken areas and they cannot afford to pay for an education or do not have access to education near them.
  3. Children involved in child marriages are at greater risk of domestic violence. A high percentage of girls in a child marriage experience domestic and sometimes sexual violence. According to the International Center for Research on Women (ICRW), girls who marry before the age of 18 are twice as likely to experience domestic violence when compared to girls who marry after the age of 18. Many girls cannot escape this violence because of poverty and the lack of education.
  4. Having a daughter is seen as a burden in Africa. Most child marriages take place in poverty-stricken areas where families consider daughters to be economic and financial burdens. Many families, wanting to make up for the money they put into raising a daughter, require a dowry for their daughter’s marriage. The high cost of a dowry means that most men will work for years to save up for a wife. As a result, most child marriages are between a young girl and a much older man.
  5. Child brides have a greater risk of contracting HIV and other STDs. Since men are typically much older when they marry a child bride, they tend to have had multiple partners before they are married. As a result, girls involved in child marriages are more susceptible to contracting HIV and other sexually transmitted diseases. Additionally, research found that many young people lack the proper knowledge of HIV and other STDs and safe sexual education. Sex education is a mandatory curriculum in Africa, but religious and cultural taboos prevent schools from properly teaching this curriculum. In 2015, the Department of Basic Education began developing lesson plans for grades seven through nine that properly educate children about safe sex and STDs.
  6. Many child brides face high-risk pregnancies. Since girls marry at such young ages, many girls have high-risk pregnancies due to their underdeveloped bodies. As a result, they often have a difficult childbirth. Additionally, pregnancy lessens the body’s immune system, leaving young girls easily susceptible to illnesses such as malaria. Malaria is harder to treat when one is HIV positive and can lead to death in young pregnant girls.
  7. Ultimately, child marriage violates human rights. Child marriages involving boys is significantly more rare than those involving girls. The primary difference in a marriage involving young boys is they do not pose the same health risks as girls. However, child marriages between both sexes take away a child’s basic human rights. In 1948, in an attempt to discourage child marriages, the U.N. declared child marriage an act against human rights, as stated in Article 16 of the Universal Declaration of Human Rights.

These seven facts about child marriage in Africa explain the difficulties young girls face every day. While child marriages around the world have been in a steady decline, Africa has been the slowest progressing area. According to the U.N., child marriages in Africa could actually continue to grow rather than decline. A continued growing awareness around the world helps to end child marriages. A group of girls in Africa started a petition to change the laws and raise the age of consent. So far, the petition has received over 245,000 signatures. Efforts like these continue to help bring an end to child marriages in Africa.

– Chelsea Wolfe 
Photo: Flickr

HIV in South AfricaFollowing apartheid, South Africa became the focal point of the AIDS epidemic. Despite the rapid rise of HIV in South Africa, the governmental response was slow. During the 1980s, people often assumed that the virus spread because of the behaviors of injection drug users and gay men. However, the spread of the disease in Africa looked incredibly different since more than half of the people living with HIV in sub-Saharan Africa were women.

HIV and AIDS in South Africa

When HIV and AIDS started having a widespread impact on South African society and communities, President Thabo Mbeki followed the arguments of Peter Duesberg. Duesberg believed that HIV could not be the cause of AIDS. This was opposed to Western medical approaches to solve the epidemic. Moreover, Tshabalala-Msimang, the Health Minister, advocated for nutritional solutions in 2003.

Other countries tried to help President Mbeki but were unsuccessful in persuading him. Civil society groups raised grave concerns over the need for urgent action. One of the most prominent groups to raise concerns and to have the greatest impact in the region was the Treatment Action Campaign.

The Treatment Action Campaign

Zackie Achmat, along with fellow 10 activists, founded the Treatment Action Campaign (TAC) in 1998. Achmat was a gay rights activist living with HIV. TAC was a tripartite alliance between the AIDS Law Project and COSATU. It was formed as a response to HIV in South Africa. The organization was needed because of the lack of urgency that the government and the medical industry had in responding to the virus. 

TAC is a rights-based organization focused on getting those in need access to treatment for HIV/AIDS. TAC is technical and political in its arguments as it utilizes justifications for actions through moral, scientific and economic reasoning. Also, TAC develops partnerships with activist groups such as the Gay Men’s Health Crisis (GMHC) and ACT UP. It aids in training on ‘treatment literacy’ and initiated a more extensive peer education network. In addition, TAC formed partnerships between elites, academics, professionals and press. However, it ultimately served to strengthen the effort for the poor to advocate for themselves. TAC uses its sources for social mobilization, advocacy, legal action and education.

TAC Fight Against HIV in South Africa

TAC’s first action was to argue for the right to access medical resources, namely antiretrovirals (ARVs). The organization found an inherent fault with the World Trade Organization’s 1995 TRIPS agreement, which legally protected intellectual property and patents.

In 1998, TAC demanded that the South African government introduced a program to prevent mother-to-child HIV transmission (PMTCT). The social movement around advocacy for PMTCT was primarily made up of predominantly poor black women living with HIV. The issue was framed as a moral issue. The pharmaceutical company GlaxoSmithKline (GSK) was profiteering off the sale of the drug. As a result, TAC demanded a price reduction and framed it as a moral issue regarding the South African constitution. The organization succeeded in its demand for legal action.

TAC’s Success

The essential tools for TAC’s success were its use of legal resources and advocacy. TAC made legal demands of the South African government. It also collaborated with progressive lawyers, scientists and researchers to develop plans and alternative policy proposals. TAC went beyond merely advocating for the poor and based policy on the entitlement of rights. The organization has taken successful litigation measures on many occasions. The past successful cases were supported by the efforts of lawyers and TAC’s actions, which involved marches, media campaigns, legal education and social mobilization.

This was possible due to advocacy and partnerships that TAC formed and developed. The structures in which it functioned also made it possible. Article 27 of the South African Constitution took effect in 1997. It includes the right to access medical services, reproductive healthcare and emergency medical treatment.

A key component that made TAC successful was the context in which it was based. The actions of TAC would not be possible without the tools it employed that were already in place within South African infrastructure and ideology. Additionally, TAC focused on the issues of the affected people. This included economic inequity, women’s rights, post-apartheid race relations and the necessity of medication access. The Treatment Action Campaign met immediate and long-term demands for people affected with HIV by addressing inherent human rights issues. TAC was mostly successful in its response to HIV in South Africa because it mobilized the personal into the political.

Danielle Barnes
Photo: Flickr

Why HIV and AIDS in Russia is Steadily IncreasingHIV and AIDS have increased in Russia throughout the years. In fact, Russia’s failure to implement government policy, education and resources has allowed HIV/AIDs rates to increase at an unknown rate. These rates allow poverty and infection to course throughout the country. According to estimates from the World Bank, more than 10 percent of the total population will have HIV/AIDs by 2020. Also, as many as 21,000 people per month could die from infection of HIV and AIDS  in Russia. Experts anticipate that these values will continue to increase by 10 to 15 percent each year.

Efforts

The Russian government has made minimal efforts toward eradicating this epidemic. Numbers show that HIV and AIDS in Russia primarily occur among certain groups of people. In 2016, individuals who inject drugs accounted for the largest number of confirmed cases at 48.8 percent.

Further, in 2015, government reports determined that more than 38 percent of newly diagnosed cases occurred in women. These numbers pushed experts to believe that heterosexual transmission would significantly impact the heterosexual population. In fact, in 2017, researchers found that heterosexual transmission occurred in 48.7 percent of the Russian population.

Additionally, sex work is one of the leading causes of HIV and AIDS in Russia. People’s stigmas with this specific group of people inevitably cause an increased risk for those who utilize this service. Sex workers are often unable to access health care resources to decrease the likelihood of spread, thus making it challenging to eradicate HIV and AIDS in Russia.

Barriers

The marginalization of certain groups of people has led to a reduction in the treatment and prevention of HIV and AIDS in Russia. One study showed those who are living with HIV/AIDS and are injecting drugs are unlikely to seek treatment. Only 10 percent of that specific group has sought treatment. Some experts assume that the inaccessibility of information and denial of treatment or prevention services are the primary reasons for this low percentage.

Also, women who are sex workers are particularly vulnerable. Studies have shown the unwillingness to seek treatment due to negative opinions regarding the occupation of these women.

Another obstacle is funding for HIV and AIDS education, which is very minimal if it exists at all. Financial support for HIV/AIDS programs in Russia remains a significant barrier to treatment and prevention. Dedicated support for HIV and AIDS in Russia has decreased and no programs to educate and prevent the disease have replaced it.

Solutions

In 2013, the Aids Healthcare Foundation in Russia registered with the Russian Federation to ensure the implementation of programs to contribute support financially, provide education about HIV and treat those living with HIV. Russia made further efforts in 2017; the Russian Federation committed to a 90-90-90 target by 2020. This goal aimed to diagnose, update treatment status and suppress the viral loads of 90 percent of people living with HIV.

In 2018, the Russian Federation released a progress update, showing substantial improvements from 2017. Overall, 81 percent of people living with HIV received confirmed diagnoses, 45 percent of people who knew of the diagnosis received treatment and 75 percent of people who obtained treatment experienced viral suppression.

At the 28th meeting of the Health Council of the Commonwealth of Independent States, Ms. Veronika Skvortsova, the Russian Minister of Health stated that “We have to provide every person living with HIV with quick access to the correct treatment. The Ministry of Health plans to increase the coverage of people living with HIV who know their status on antiretroviral therapy to 75 percent by 2019, and by 2020 the figure should reach 90 percent.”

Rates of HIV and AIDS in Russia continues to raise concerns across the country. Without Russian government implementation of policy toward a movement of eradication, estimates suggest that the numbers will continue to rise.

Tiffany Hill
Photo: Wikimedia