DREAMS in Namibia
At one point, Namibia had the highest HIV prevalence rates globally. In the country, HIV disproportionately impacts young women, with their incidence rates being several times higher than those for men. However, the Namibian government and the President’s Emergency Plan for AIDS Relief (PEPFAR) wanted to change the narrative for the country. To help, PEPFAR funded Namibia with $50 million for treatments and resources.

New HIV infections have decreased by 50% since 2004. Namibia now has an estimated 85.4% of viral suppression and 8.3% HIV prevalence, according to a Namibia Population-based HIV Impact Assessment (NAMPHIA) report. Through the partnership, the Namibian government and PEPFAR were able to give people DREAMS in Namibia.

DREAMS Project

DREAMS (the acronym for Determined, Resilient, Empowered, AIDS-free, Mentored and Safe) first launched on World AIDS Day 2014 with private sector partners such as the Bill & Melinda Gates Foundation, Girl Effect, Gilead Sciences, Johnson & Johnson and ViiV Healthcare. The DREAMS Project works to address leading factors for increased vulnerability in adolescent girls and young women (AGYW) with HIV. The project has created change in 15 countries including Botswana, Cote d’Ivoire, Eswatini, Haiti, Kenya, Lesotho, Malawi, Mozambique, Namibia, Rwanda, South Africa, Tanzania, Uganda, Zambia and Zimbabwe. By doing so, it has pushed partner governments to renew their commitments to gender equality and the impact on adolescent health and development.

The U.S. Department of State mentioned on World AIDS Day 2020, data showed new HIV diagnoses among AGYW declined in countries implementing DREAMS, with 96% of which had a decline of more than 25% and almost 62% of which decreased by more than 40%.

Of the 15 countries, DREAMS in Namibia officially launched in October 2017. The U.S. Embassy noted the project is focusing on three regions: Khomas, Oshikoto and Zambezi. While the primary target of DREAMS in Namibia are AGYW ages 9-24, orphans and vulnerable children, the male sexual partners aged 20-49 are a part of the targeted population.

DREAMS and Project Hope

The DREAMS project is also partnering with Project HOPE Namibia. Project HOPE similarly works to mitigate the impact of HIV by safeguarding access to quality health care for vulnerable populations. Through the partnership, more than 100,000 orphans and vulnerable children with household services, loans and startup kits for their caregivers.

In partnership with DREAMS in Namibia, Project HOPE empowered more than 20,000 AGYW across Namibia with education on HIV, job skills and financial literacy. Project HOPE also offers clinical support for survivors.

On February 23, First Lady Jill Biden visited Hope Initiative Southern Africa to listen in on the testimonials of those that DREAMS in Namibia increasingly impacted. Among the testimonials, the common theme was that these young women’s voices grew and obtained more opportunities to kick-start their businesses.

Looking Ahead

Namibia is still fighting against the HIV epidemic. However, DREAMS in Namibia continues to reach the masses of those who are HIV infected by changing one life at a time. The project allows those infected to pursue their dreams.

Brianna Green
Photo: Flickr

HIV/AIDS in Uganda
Uganda is among the largest countries in Africa and is home to around 46 million people. Many have recognized Uganda for its significant efforts to mitigate HIV/AIDS among its population in the last couple of years. Nonetheless, HIV/AIDS in Uganda continues to present disproportionate ramifications among women. This is why government partnerships with several foreign agencies are key to facilitating effective treatments for HIV-infected women of all ages and addressing the gender gap in treatment.

History of HIV/AIDS in Uganda

The HIV virus ranks among the most dangerous health diseases in many Sub-Saharan African countries. In Uganda specifically, the disease has been following an exponential upward trend since the start of the 1980s. Among female adults (>15 years), HIV-recorded cases ranged from 1.7% for those between the ages of 15 and 19 to 13.6% for those 50-54 years of age. HIV also underpins gender inequality, as 12.4% of females between the ages of 30 and 34 had HIV while only 4.8% of males in that same age group had HIV. In Kampala in 1985, estimates indicated that 11% of pregnant women had HIV, which likely only increased up to the early 90s since by 1992, 18% of Uganda’s overall population had HIV.

Progression of HIV/AIDS in Uganda and Women

Over the past few decades, Uganda has significantly progressed in the fight against HIV/AIDS. Through the introduction of behavioral and educational policies, Uganda’s government reduced the prevalence of the HIV burden to 7%. Uganda’s government launched various campaigns devoted to advocacy efforts encouraging citizens to undergo testing, as well as donated condoms among different rural regions of the country. From 2011 to 2016, the country witnessed an overall 18% decline in the prevalence of HIV-recorded cases for ages 15-49. This indicates effective development in the health sector, which is especially necessary to alleviate the number of cases.

According to UNAIDS statistics, HIV continues to affect almost 570 Ugandan girls and women aged 15-24 per week. One can attribute the increased vulnerability of young girls to HIV to their reproductive systems which have not yet matured, which increases their susceptibility to contracting the virus during sexual intercourse. Data shows that in Uganda, two-thirds of all new infections of HIV occur in young girls, but only about 30% of them receive any HIV testing services.

Working Towards Equality

The U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) program and the CDC partnered to eliminate mother-to-child transmission of HIV in Uganda. Since March 2022, the CDC supplied HIV treatment for more than 700,00 people residing in Uganda, including around 19,875 pregnant and breastfeeding women. Based on Uganda’s Ministry of Health records, there has been a considerable decline in mother-to-child transmission of HIV in 2000 from 20% to 2.8% in 2021. Considering this, it seems that Uganda is making progress in addressing the gender gap in treatment.

The AIDS Support Organization (TASO) is a non-governmental institution, which has significantly reduced the number of HIV cases in the country since its inception in 2006 by Uganda’s government. The NGO works to support infected patients through its community drug distribution point (CDDP) by providing physical and psychological aid. The CCDP reduced travel time for Antiretroviral therapy (ART) and the wait times from typical pharmacies from two to three hours to 30-45 minutes. An estimated 65% of the patients enrolled in the CDDP program are women, with the program targeting 200 female sex workers.

The battle against HIV/AIDS in Uganda has been persistent for several years. With the various external and internal forces working to reduce existing inequalities in HIV treatments in Uganda, Women may be better able to access adequate treatment. Collaborations such as those between the government of Uganda and governmental agencies from the U.S. demonstrate the importance of U.S. aid and a mutual goal in addressing the gender gap in treatment and helping the most vulnerable populations across the world.

– Andres Valencia
Photo: Unsplash

HIV/AIDs in Cameroon
One of the most prominent challenges citizens in Cameroon are facing today is the prevalence of HIV/AIDs throughout the country. With the national infection rate being 3.7% in 2021, achieving epidemic control continues to be a constant battle. However, with the help of foreign aid, NGOs and the proactive efforts of the Cameroonian government, the country is making progress toward this goal. Here are the most important things to know about the history of HIV/AIDs in Cameroon and the state of the prevention effort.

History and Demographics

Like many countries in sub-Saharan Africa, there is a higher rate of individuals infected with HIV/AIDs in Cameroon than in most other parts of the world. The earliest reported case in Cameroon was in 1985 and by 1990 the country had an estimated 49,000 infected individuals. This number increased every year until it peaked at an estimated 520,000 cases in 2012. Since then, the annual rate has slowly but steadily declined to an estimated 500,000 cases in 2021.

Though many children have HIV/AIDs in Cameroon, people 15 years or older are by far the most common and represent an estimated 460,000 of the 500,000 currently infected, according to UNAIDS. Within the adult over 15 cohort, women are more than twice as likely to have HIV/AIDs than men.

Prevention and US Support

The first measure the government of Cameroon took to prevent the spread of HIV/AIDs was the establishment of the National AIDS Control Committee (NACC) in 1986. Its function was to facilitate cooperation between prevention efforts nationally. It expanded its efforts further in 2000 when it launched the first of three five-year plans to prevent the transmission of HIV/AIDs in the country.

There has also been a myriad of U.S.-backed efforts to help assist in the prevention effort. For example, in 2008 the U.S. Center for Disease Control and Prevention (CDC) partnered with Cameroon’s Ministry of Health as well as a host of NGOs to assist in the fight against HIV/AIDs. Through this collaboration the CDC aimed at “providing technical leadership on HIV epidemic control efforts within the country” but eventually expanded its operations to also include “direct clinical support” and help “scale-up access to HIV prevention and treatment services.”

Additionally, USAID has backed and helped execute a variety of HIV/AIDs prevention plans in Cameroon through the President’s Emergency Plan for AIDS Relief (PEPFAR). A few of these initiatives are The Continuum of Prevention, Care and Treatment (CoPCT) of HIV/AIDS with Most-at-Risk Populations in Cameroon (CHAMP), Reaching Impact, Saturation, and Epidemic Control (RISE) and Community-Led Monitoring (CLM).

In general, PEPFAR programs aim to mitigate the spread of HIV/AIDs in Cameroon through education, community outreach, reliable data collection and strengthening existing government and non-governmental healthcare agencies.

Looking Forward

Though it may seem like a sign of inefficacy that total infection numbers have only gone down by a small margin since 2012, it is important to remember that epidemics tend to grow exponentially and that the population of Cameroon has been increasing steadily at a high rate for the past several decades. With this in mind, a stagnated or only marginally decreased total infection figure is actually quite an accomplishment, as the government has to account for an enormous increase in population and the spread of infectious diseases is notoriously difficult to subdue.

Further, aid from countries like the U.S. was undoubtedly instrumental in achieving this feat and continued international support will be necessary as the national government continues to battle HIV/AIDs in Cameroon.

– Xander Heiple
Photo: Unsplash

African Governments Combating HIV/AIDS
The threat of the COVID-19 pandemic is still a major problem today. A variety of problems continue to affect the globe, such as poverty and HIV/AIDS, the latter of which has severely affected Africa for years. Globally, estimates indicated that HIV infected 33.9 to 43.8 million people by the end of 2021 and nearly two-thirds of those infected were Africans. However, the situation is far from hopeless as African governments are combating HIV/AIDS and some progress is occurring on that front.

The Current Situation in Africa

According to reports by the Joint United Nations Programme on HIV/AIDS (UNAIDS), new HIV infections have declined by 14% between 2010 and 2015 in Eastern and Southern Africa. Similarly, there was an 8% decline in West and Central Africa. Despite the small percentages, progress is obvious. In 2000, only 11,000 people were getting antiretroviral treatment (ARV) for HIV. Now, more than 12 million people today are receiving the treatment. African governments that are combating HIV/AIDS have also expanded prevention methods to stop the spread of HIV/AIDS. Some of the prevention methods are voluntary medical male circumcision and tests for pregnant women to see if they are HIV positive. Those who are positive receive medicine in order to prevent the transmission of HIV/AIDS to their unborn babies. Hence, there has been a decrease in infections throughout the region.

Despite the progress, the epidemic still severely affects African countries. Poverty and the COVID-19 pandemic only further exacerbate this issue. HIV/AIDS affects the region socially and economically. There are still a large number of people who are not receiving the treatment they need and the cure has yet to emerge. Sub-Saharan Africa suffers the most as it is the world’s epicenter of HIV/AIDS, accounting for two-thirds of the global total of new HIV infections. Progress continues to be slow and multiple challenges remain.

Response and Progress to End HIV/AIDS

Currently, African governments are aiming to put an end to the HIV/AIDS epidemic worldwide by 2030. They have partnered with multiple organizations such as UNAIDS, PEPFAR and other global health organizations to realize this goal. Together, they are working tirelessly to respond and accelerate progress in the continent. Access to condoms and lubricants for men is increasing, programs encouraging changes to sexual behavior are undergoing implementation and affordable methods to prevent infections are spreading.

The United States Global AIDS Coordinator and Special Representative for Health Diplomacy, Ambassador Dr. John Nkengasong launched “Reimagining PEPFAR’s Strategic Direction, Fulfilling America’s Promise to End the HIV/AIDS Pandemic by 2030.” According to UNAIDS, it focuses on key priority areas that include addressing health equity for children, adolescent girls, young women and other key populations. It also focuses on maintaining long-term sustainability, enhancing global health security, nurturing transformative partnerships and leading with science. UNAIDS has reported considerable success in many sub-Saharan African countries. The number of deaths that HIV/AIDS has caused in Sub-Saharan Africa has declined by 35% in recent years.

The Global Mission to End HIV/AIDS

Global efforts addressing the epidemic have shown promising signs. People in resource-poor countries like Africa that are receiving HIV treatment have increased dramatically over the past decade. PEPFAR has provided HIV testing services for more than 50 million people as of 2021. Additionally, 2.8 million babies were born HIV-free from parents living with it. The battle continues as African governments combating HIV/AIDS continue to work around the clock. They are strengthening public health systems and local capacity for preparedness and response to other diseases. Progress may be slow but efforts put forth by various organizations continue to provide promising results. Research is also progressing as many around the globe work to prevent further HIV infection and find a cure someday. So long as Africa and its people continue to fight the good fight, the goal to end the pandemic by 2030 may just be achievable.

– Aaron Luangkham
Photo: Flickr

HIV-positive UkrainiansThe war in Ukraine disrupted its supply chain of HIV medication and necessary health services. More than 40 health facilities that provided services for HIV treatment and prevention are now closed. What is more, it may not be safe for HIV-positive Ukrainians to leave their shelters to pick up their medications, and even if it is, pharmacies are not guaranteed to have the drugs. People fleeing also do not have adequate amounts of medication. They may have a one-month or two weeks supply, but not enough to sustain them before they have access to more medication. The people in Russian-occupied territories along with those who are unable to relocate to a safe place are currently the most vulnerable.

HIV Medication Explained

Antiretroviral therapy (ART) involves taking a combination of HIV medications daily. Though ARTs are not a cure for HIV, they help prevent transmission and let HIV-positive people live longer healthier lives. ART reduces a person’s viral load, the amount of HIV in a blood sample, to an undetectable level. If a person’s viral load level is undetectable, meaning that a viral load test cannot detect it, then that person cannot transmit HIV to others.

Before the war, approximately 260,000 people were living with AIDS. Of this population, only 58% had access to daily antiretroviral medications. Now, with the war resulting in reduced access to ARTs, UNAIDS reported the possibility of the “resurgence of Ukraine’s AIDS pandemic.”

How PEPFAR Has Been Providing ARTs

HIV-positive Ukrainians are now depending on international support for treatment. The United States President Emergency Plan for AIDS Relief (PEPFAR) invested $13 million in antiretroviral medications for Ukrainarinas in need. PEPFAR began in 2003 and is the largest commitment by any nation to address one disease. Its funding, which totals more than $100 billion, includes funding for the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund). The Global Fund also provided emergency aid for ART medication in Ukraine.

The first wave of medication from PEPFAR delivered 18 million doses of ARTs to the Public Health Center of the Ministry of Health in Ukraine and 100% Life, the “largest organization of people living with HIV in Ukraine” to distribute. This portion of life-saving treatment will cover six months of treatment for HIV-positive Ukrainians, less than that of PEPFAR’s commitment to cover one year, or 51 million doses of ART medication in Ukraine. PEPFAR flew the antiretroviral medications to Poland. From there, trucks transported the medication to medical facilities in Ukraine.

UNAIDS’ Efforts

Civil society organizations are making great efforts to distribute drugs and medical supplies to vulnerable people in locations that are difficult to reach. UNAIDS put forth an initial $200,000 in emergency funds for medical supplies to be distributed in seven cities with large HIV populations: Chernihiv, Dnipro, Kharkiv, Kryvy Rih, Kyiv, Odesa and Poltava. UNAIDS has requested an additional $2.24 million to fund civil service organizations in Ukraine that are providing HIV treatment and refugees in other countries that are experiencing HIV. Civil society organizations that receive support from UNAIDS are helping to get HIV-infected individuals ARTs in the Republic of Moldova and the European Union. In addition, the World Health Organization (WHO) helped push Viiv Healthcare, a pharmaceutical company, to provide HIV medication donations to the Czech Republic, Poland and other countries in the European Union that are hosting Ukrainian refugees.

The war in Ukraine has deepened the threat of HIV deaths for positive Ukrainians. Although foreign aid has played a pivotal role in obtaining and dispersing antiretroviral medications throughout the nation and to Ukrainians abroad, there is still a high demand for ARTs in difficult locations and to continue after the one-year investment from PEPFAR concludes. Ukraine’s Public Health Center created a website with more support for HIV-positive people. The website includes information about where individuals can continue ART therapy and provides information about how to find HIV help. It also provides contacts for Ukrainian refugees with HIV. The need to get medication to HIV-positive Ukrainians is urgent, and the threat of another AIDS pandemic is not over.

– Jordan Oh

Photo: Flickr

HIV/AIDS in Haiti
Haiti is not only one of the poorest countries in the world, but it is the most HIV-sickened nation outside of Africa. Having 2.2% of adults with the HIV virus makes Haiti the Caribbean nation with the highest rate of HIV, about twice that of the second-highest, the Dominican Republic 1.1%. Some are making progress in addressing this issue. However, it needs more work in order to significantly hamper HIV/AIDS in Haiti.

The Epidemic

In 2018, there were 160,000 cases of HIV in Haiti. Only two-thirds of those knew that they have the disease. In 2018, 2,700 Haitians died from AIDS-related health problems. The height of the epidemic occurred in the 1990s when more than 3% of the population of Haiti had contracted the HIV virus.

Effect on the United States

The disease arrived in Haiti in 1966. After the subsequent AIDS epidemic that occurred 15 years later in the 1980s, the United States has committed itself to addressing the AIDS problem, especially internationally. With regard to Haiti’s proximity to the United States, it is clear why it would be in the United States’ best interest to provide HIV and AIDS relief aid to prevent the further spread of the disease, not only for the betterment of Haiti but also from a national security standpoint to prevent the spread of the disease throughout the United States.

Progress in Fighting HIV/AIDS in Haiti

Since the peak of the epidemic in the 1990s, the percentage of the population of Haiti with HIV or AIDS is down from nearly 3.2% to 1.9% of the population, according to UNAIDS. One can attribute much of the success to the United States President’s Emergency Plan for AIDS Relief (PEPFAR) which has aimed to increase access to HIV health services across Haiti.

Despite some success, issues like poverty and discrimination have made it difficult for individuals to stay on their HIV health programs and continue getting treatment from health services. Due to this, the U.S. and U.N. have encouraged a greater degree of community-led monitoring dedicated to implementing more effective strategies for providing HIV health services, according to UNAIDS. Community-led monitoring will give accurate assessments of the services being provided at the patient level.

Haiti’s Civil Society Forum Observatory is spearheading this system of community-led monitoring with the idea of holding HIV health services accountable for improved access and quality of these services.

Knowledge is Power

In order to continue the fight against HIV/AIDS in Haiti, the public must become more aware of what this disease entails. The most significant issues surrounding the HIV/AIDS epidemic in Haiti are discrimination and poverty.

The Haitian Red Cross Society, with help from U.S. foreign aid, is advocating to increase education on HIV transmission and prevention. The hope of this education and awareness initiative is to end the stigmatization and discrimination against those with the disease.

The Haitian Red Cross Society has been working towards providing better education to Haitians regarding HIV and AIDS treatment and prevention since 2004. Since then the rate of HIV and AIDS decreased across the country.

The Future of HIV/AIDS in Haiti

The U.S. has made incredible efforts in providing Haiti with health services to combat HIV and AIDS. However, with 2,700 HIV-related deaths in 2018, combatting the epidemic needs more work. Education initiatives and U.S. aid services help reduce the rate of HIV and AIDS, which in turn can help reduce poverty in Haiti. With the help of U.S. health service aid and education, the future of Haiti looks to be a brighter one with less HIV and AIDS.

– Declan Harkness
Photo: Flickr

School Enrollment Rates for Girls in Malawi
Malawi’s average literacy rate for adults 15 and older stood at 62% in 2015, according to the latest available World Bank data, which is lower than its neighboring countries. According to the latest estimates, Tanzania’s literacy rate stands at 78% and Mozambique’s literacy rate equates to 61%. In addition, the average literacy rate across sub-Saharan Africa stands at 66%. In 2014, Malawi noted a male adult literacy rate of 75% in comparison to 55% for females of the same group. Due to these gender disparities in literacy rates, several initiatives are working to improve school enrollment rates for girls in Malawi.

Reasons for Female School Dropout Rates in Malawi

In sub-Saharan Africa in general, roughly 33% of school-aged children do not attend school. Furthermore, for every 100 male sub-Saharan African students out of primary school, there are 123 female sub-Saharan African students not attending primary school. In Malawi particularly, research shows that female students are more likely to drop out of school than male Malawian students. Data indicates that “Malawi has one of the highest school dropout rates in Southern Africa.” Among females particularly, “three in every [20]” Malawian girls leave primary school “between Standard 5 and 8.”

According to a 2018 Malawi Government’s Education Management and Information Systems (EMIS) survey, girls in Malawi drop out of school for several reasons. Among these reasons are circumstances of poverty, child marriage, early pregnancy, “parents’ negative attitudes toward the education of girls” and household responsibilities. According to the survey, about 7% of female students abandoned their education due to marriage and 5% due to pregnancy.

Another factor is poor academic performance, which links to low quality of education. Living far away from schools also plays a role — 82% of Malawians live in rural areas, which often have few schools in close proximity. A lack of female teachers in schools means female students do not have female role models within the education sector. A 2015 study noted that “female teachers who also act as role models” to female students help keep girls in school. Poverty plays a significant role too as many impoverished families cannot afford school expenses and tend to prioritize the education of male children over female children due to societal perceptions.

Programs to Improve School Enrollment Rates for Girls in Malawi

In 1994, the Malawian government made primary education free to increase enrollment rates, especially among girls. The issue arises with secondary education, which is dominated by boys because many girls drop out before fully completing high school. Girls’ completion of secondary education is one of the most effective ways to combat other problems in Malawi, such as child marriages and early pregnancies.

The Improving Secondary Education in Malawi (ISEM) program is a four-year initiative running from 2017 to 2021, “which is supported by the European Union and implemented by GENET in partnership with OXFAM.” ISEM aims to improve secondary school enrollment rates for girls in Malawi, among other goals.

The program has funded school attire and learning supplies as well as bursaries. For rural students who walk long distances to reach school, sometimes more than two hours, ISEM donates bicycles as a transportation method. By eliminating these long travel times to school, ISEM aimed to improve the energy levels of students, increase punctuality and improve school performance while maintaining students’ interest in attending school. Fifty-one girls at Chibanzi Community Day Secondary School received these benefits through ISEM’s provision of bicycles. In the Golong’ozi Community Day Secondary School, the program has helped 177 girls who, thanks to this project, are able to continue their secondary education.

ASPIRE Project

Save the Children created the Girls’ Empowerment through Education and Health Activity (ASPIRE) project in 2015 with support from the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) and the U.S. Agency for International Development (USAID). In Malawi, the ASPIRE project seeks to improve literacy levels and reduce school dropout rates while improving school enrollment rates for girls in Malawi. ASPIRE achieves this by teaching mothers the importance of girls’ education. By doing this, mothers prioritize girls’ education more and are less likely to force their daughters into early marriages. Mothers are also then more likely to encourage girls to go back to school after pregnancy. Data shows that, in 2015 and 2016, 786 students re-enrolled in schools in three particular districts that the ASPIRE project covered, “suggesting an impact from the ASPIRE project.” Female students accounted for 504 of these students.

Education is not only a fundamental right but is also a proven pathway out of poverty. For this reason, several organizations are committing to improving school enrollment rates for girls in Malawi, recognizing that education is the basis of global development and gender equality.

– Ander Moreno
Photo: Flickr

HIV/AIDS in Africa
The HIV/AIDS epidemic remains a significant public health problem in southern Africa. In the last decade, infections have drastically dropped while awareness of HIV status and availability of treatment has increased. This progress aligns with the UNAIDS 90-90-90 goal. Meeting this goal means that at least 90% of people with HIV are aware of their status, 90% are receiving antiretroviral drug treatments and 90% are virally suppressed. Viral suppression means that the virus will not negatively affect a person and that that person will not be able to transmit it to another person. Some of the most HIV-afflicted countries in Africa have met and even exceeded the 90-90-90 goals. Eswatini has the highest HIV prevalence in the world today at 26.8%. It has reached 95% in all categories and is on its way to reducing new infections.

HIV/AIDS and Conflicts

Despite recent progress, international aid has been focusing on HIV/AIDS less and less, especially as the COVID-19 pandemic has become a more imminent global threat. Sub-Saharan Africa still has the highest rates of HIV/AIDS in the world. It is also one of the most conflict-ridden regions in the world.

HIV/AIDS has a history of destabilizing political and social institutions in countries and leaving them vulnerable to violent conflict. The International Crisis Group estimated that one in seven civil servants, including government employees, teachers and the armed forces in South Africa were HIV-positive in 1998.

How Does HIV/AIDS Affect Civil Servants in Africa?

  1. The disease affects the productivity of the military and its ability to respond to armed conflicts. In 2003, the Zimbabwe Human Development Report estimated that the Zimbabwe Defense Forces had an HIV prevalence rate of 55%. With such a high rate of illness, the military has high training and recruitment costs, as soldiers get sick and are unable to work. In addition to this, HIV can transmit through sexual contact. It disproportionately affects younger populations which typically make up the bulk of the armed forces.
  2. The HIV/AIDS epidemic breaks down political institutions by limiting their capacity to govern. According to former president Robert Mugabe in 2001, AIDS had a significant presence in his cabinet, killing three of his cabinet ministers in the span of a few years and infecting many more. The disease wipes out workers essential to the function of a state, like policymakers, police officers and judicial employees.
  3. HIV/AIDS threatens the quality and accessibility of education. A UNICEF report found that more than 30% of educators in Malawi were HIV positive. If children cannot receive a quality primary education, they are less likely to receive secondary education and start professional careers. Instead, crime may open up opportunities for security that education could not provide. With increased antiretroviral use and awareness of the disease, HIV rates and deaths among educators have likely dropped along with overall rates in the last decade.

Civil Servants

The impact of HIV/AIDS on civil servants in Africa has been immense. The disease affects vulnerable populations such as gay men, sex workers and young women disproportionately. However, it has also affected those who work as civil servants. Civil servants are integral to the functioning of governments. Without them, countries are vulnerable to conflict and violence. Furthermore, HIV/AIDS prolongs conflict in countries already experiencing it.

While there are many other causes of violent conflict, the breakdown of political and social institutions fueled by HIV/AIDS only exacerbates conflict. War can also be a vector for the further spread of the disease. According to UNHCR, both consensual and non-consensual sexual encounters happen more often during the conflict. Rape has been a weapon of war in conflicts in Rwanda, the Democratic Republic of Congo (DRC) and Liberia in recent years and has likely contributed to the spread of HIV.


Combating HIV and AIDS is a very important step in stabilizing economic, political and social structures across Africa. USAID programs like PEPFAR have had a significant role in combating HIV and AIDS. PEPFAR has invested nearly $100 billion in the global AIDS response in various ways. Most notably, it has provided 18.96 million people with much-needed antiretroviral treatment.

PEPFAR also aids in prevention care. For example, it has supported more than 27 million voluntary medical male circumcisions as well as testing services for 63.4 million people. In 2012, there was a government campaign in Zimbabwe to promote circumcision, in which at least 10 members of parliament participated.

These campaigns and USAID programs have had tangible results. In 2013, a study by the South African National Defense Forces showed an 8.5% HIV prevalence rate among its soldiers, much lower than the 19% prevalence in the general population. Given the successes in decreasing HIV/AIDS infections across Africa, perhaps economic, political and social stability is to follow.

– Emma Tkacz
Photo: Flickr

HIV/AIDS in UkraineUkraine has one of the highest rates of HIV/AIDS in the world, with an estimated 260,000 people living with the disease. Odessa, the third-most populous city in Ukraine, has “the highest concentration of HIV/AIDS of anywhere in Europe.” Poverty exacerbates HIV/AIDS in Ukraine and links to injected drug use, threats to government funding, lack of access to antiretroviral treatment and social discrimination.

Poverty and HIV/AIDS in Ukraine

In 2019, Ukraine and Moldova stood as the two most impoverished countries in Europe. The poverty rate in Ukraine increased during the COVID-19 pandemic, from 42.4% in 2020 to 50% as of February 2021. There is a strong connection between poverty and the spread of diseases; disease could be both a cause and a result of poverty.

HIV/AIDS causes conditions of poverty when working adults become ill and can no longer support their families. The disease becomes a result of poverty when the conditions of poverty put people at greater risk of contracting it. As an example, women and girls who live in poverty are more vulnerable to sexual exploitation. They are more likely to resort to working in the sex trade, which could put them at high risk of contracting HIV.

HIV/AIDS in Ukraine’s Women and Girls

UNAIDS estimates that out of all people with HIV/AIDS in Ukraine, 120,000 are women older than 15 and 2,900 are children aged 14 or younger. Gender inequality, poverty and violence against women and girls are significant factors in the spread of HIV. Women and girls who live in fear of violence may be reluctant to advocate for safe sex, receive testing or seek treatment for HIV and other diseases.

Gender inequality inhibits women’s access to resources for sexual and reproductive health. In rural Ukraine, where the poverty rate is highest, 36% of women do not participate in community or family decision-making. Only 46% of these women are competent with a computer or the internet. Furthermore, almost 48% do not have access to medical services.

The Lack of Access to Antiretrovirals

As Sky News reported, access to antiretrovirals is a major problem for many people living with HIV/AIDS in Ukraine. Although a law stipulates that antiretroviral therapy should be free to all citizens, limited national resources have resulted in restricted access.

Antiretrovirals are crucial for preventing the spread of HIV to children. The use of antiretrovirals during pregnancy and administered to an infant for four to six weeks after birth can result in a transmission rate of 1% or less. According to U.N. Women, the majority of women living with HIV/AIDS in Ukraine fell between 18 and 45 years old. Out of these women, 39% discovered that they were HIV-positive during pregnancy.

Social Discrimination Against People Living With HIV/AIDS

According to the World Health Organization (WHO), discrimination against people who use drugs and people living with HIV presents a serious challenge to identifying those who need treatment. Harsh drug laws, fear of HIV/AIDS and systematic police abuse undermine efforts to provide HIV information and services such as testing and safe needle exchanges. In addition, the law requires drug treatment centers in Ukraine to register drug users and share the information with law enforcement. This protocol keeps people who use drugs from seeking medical help, which subsequently prevents them from testing and receiving treatment for HIV/AIDS.

The War in Donbas

The war in Donbas has made it difficult for people to receive treatment in a region that previously had one of the highest rates of HIV/AIDS in the country and was home to nearly one-quarter of all antiretroviral recipients. When the war began in March 2014, it displaced 1.7 million people. To compound this, unsafe sex has resulted in an increase of HIV/AIDS within the military. Combined with ongoing military conflict and a shortage of antiretrovirals, Ukraine is experiencing a crisis: the government has failed to keep up with infection rates.


In July 2021, Ukraine received a grant of $35.8 million from the Global Fund to Fight AIDS, Tuberculosis and Malaria. According to the Ukrainian government, the nation would use the funds to purchase personal protective equipment (PPE), reduce risks associated with COVID-19 and strengthen the health care system.

Ukraine is collaborating with the Centers for Disease Control and Prevention (CDC), USAID and the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR). The country wants to implement prevention campaigns, increase access to antiretroviral treatment and target key risk groups, such as people who inject drugs, sex workers and men who have sex with men.

On September 1, 2021, President Biden announced that the United States would provide more than $45 million in additional assistance for Ukraine. The aid would help people facing the impacts of the COVID-19 pandemic and the war in Donbas. The U.S. is working with USAID-supported programs to provide supplies for Ukrainian health care centers, training for health care workers and psychosocial support for the most vulnerable populations.

– Jenny Rice
Photo: Flickr

Diseases in Nigeria
Nigeria ranked 142 out of 195 countries in a 2018 global health access study. However, although Nigeria has a challenging health care system, the country has improved the infrastructure that has helped it fight diseases such as polio, measles and Ebola. Nigeria now has centralized offices called Emergency Operation Centers (EOCs) that serve as a base for government health workers and aid agencies to coordinate immunization programs and collect data. While there is progress, many diseases still plague Nigeria.


Cholera is a water-borne disease that results in a quick onset of diarrhea and other symptoms such as nausea, vomiting and weakness. It is one of the many diseases impacting Nigeria in 2021. If people with cholera do not receive treatment, the disease may kill them due to dehydration. A simple oral rehydration solution (ORS) can help most infected people replace electrolytes and fluids. The ORS is available as a powder to mix into hot or cold water. However, without rehydration treatment, about half of those infected with cholera will die, but if treated, the number of deaths decreases to less than 1%.

In August 2021, Nigeria began to see a rise in cholera cases, especially in the north, where the country’s health care systems are the least prepared. The state epidemiologist and deputy director of public health for Kano State, Dr. Bashir Lawan Muhammad, said the rise in cases is due to the rainy season. It is also because authorities have been dealing with Islamist militants in the north. In Nigeria, 22 of the 36 states have suspected cholera cases, which can kill in hours if untreated. According to the Nigeria Center for Disease Control, 186 people from Kano have died of cholera since March 2021, making up most of the country’s 653 deaths.


Malaria is another one of the diseases affecting Nigeria. Through the bites of female Anopheles mosquitos, parasites cause malaria and transmit it to humans. Globally, there were 229 million malaria cases in 2019, with 409,000 deaths. Children under the age of 5 years old are the most susceptible group, and in 2019, they accounted for 274,000 or 67% of worldwide malaria deaths. That same year, 94% of malaria cases and deaths occurred in the WHO African Region. Although the disease is preventable and curable, the most prevalent malaria-carrying parasite in Africa, P. Falciparum, can lead to severe illness and death within 24 hours.

The President’s Malaria Initiative (PMI), which USAID and the CDC lead, works with other organizations to help more than 41 million Nigerians. Despite the difficulties that COVID-19 presented in 2020, the PMI was able to assist Nigeria to distribute 14.7 million treatment doses for malaria, 8.2 million of which went to pregnant women and children. Besides that, the “PMI also distributed 7.1 million insecticide-treated mosquito nets (ITNs), provided 7.2 million rapid test kits, and trained 9,300 health workers to diagnose and treat patients” of malaria. Before the PMI, only 23% of Nigerian households had bed nets, but since 2010, that number has risen to 43%. The PMI also aims to improve health systems and the skill of health workers to administer malaria-related services.


HIV (human immunodeficiency virus) attacks the immune system, leading to AIDS (acquired immunodeficiency syndrome). One can control the virus with proper medical care, but there is no cure. The disease is prevalent in Africa because it originated in chimpanzees in Central Africa. The virus likely spread to humans when the animals’ infected blood came into contact with hunters. Over the years, HIV spread across Africa and other parts of the world, becoming one of the diseases impacting Nigeria today.

The CDC works with the Federal Ministry of Health (FMOH) and other organizations to create and sustain HIV response programs in Nigeria. The CDC’s “data-driven approach” and prevention strategies and treatment strengthen the collaborative system in Nigeria. These include HIV treatment, HIV testing, counseling, services to help prevent mother-to-child transmissions and integrated tuberculosis (TB) and HIV services. TB is the leading cause of death among people living with HIV.

From October 2019 to September 2020, nearly 200,000 Nigerians tested positive for HIV and began treatment. During the same period, over 1 million HIV-positive people tested for TB. More than 5,000 of those individuals tested positive and began treatment for TB. By the end of September 2020, nearly 25,000 orphans and other vulnerable children received HIV/TB services through the CDC. Not only that, but all facilities in Nigeria that the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) supports now use TB BASICS, which is a program that “prevents healthcare-associated TB infection.”

In 2021, Nigeria will face many diseases. On the other hand, great strides are occurring to educate the Nigerian population on diseases like HIV, malaria and cholera. Despite efforts, there is still much more necessary work to reduce illness in Nigeria.

– Trystin Baker
Photo: Flickr