By Caroline Cooney
What is HIV/AIDS and how has it affected Africa?
HIV, which stands for human immunodeficiency virus, is a virus spread through certain body fluids and attacks the immune system. If left untreated, the disease weakens the immune system until the body can no longer fight off infections and disease, leading to acquired immunodeficiency syndrome or AIDS (“What are HIV”, 2017)1. Since the beginning of the HIV/AIDS epidemic, around 78 million people have become infected with the disease and over 35 million have died due to AIDS-related illnesses. According to UNAIDS data in 2016, there were over 36 million people living with HIV worldwide, with an estimated 25 million of those infected living in Sub-Saharan Africa. Two countries hit the hardest by the epidemic are South Africa and Nigeria.
HIV/AIDS funding in the United States
For those who live in the U.S., it may be hard to understand the way other countries suffer from diseases such as HIV/AIDS. Currently, there are around 1 million people living with HIV in the United States whereas countries like South Africa are home to over 7 million people infected with the virus. The United States is able to fight diseases due to the amount of funding and research that is performed every year. We often take for granted the health benefits we are able to receive because we don’t always educate ourselves about why other countries are struggling. According to the Henry J. Kaiser Family Foundation, federal funding for HIV/AIDS rose to more than $32 billion in 2017 (“U.S. Federal Funding”, 2017)2.
HIV epidemic in South Africa
With over 7 million people living with HIV, South Africa is home to the largest HIV epidemic in the world (UNAIDS, 2017)3. The man who runs CAPRISA, a major research lab in Durban working to fight HIV/AIDS, known as Salim Abdool Karim, states “one out of every five people living with HIV in the world lives right here in South Africa” (“How South Africa”, 2016)4. Regardless of these numbers, the country has made great efforts to ensure that those infected with the disease are aware of their status and receive antiretroviral treatment (ART). Since HIV is such a major issue, there are three targets countries aim for in an attempt to keep the epidemic under control, known as 90-90-90 targets (“HIV and AIDS”, 2017)5. The goal is for 90% of those infected to be aware that they have the disease, 90% to be receiving treatment, and 90% to be virally suppressed. As of 2016, South Africa has reached 86-65-81. This success is largely due to the amount of funding the country has put towards HIV programs, which has helped them to build the largest ART program in the world and nationwide campaigns which focused on providing education about HIV/AIDS and encouraging more people to get tested for HIV.
Progress made in South Africa
Due to their efforts, South Africa was able to almost reach the first 90-90-90 target, which is for those living with HIV to be aware that they are infected. This is an important step because if they do not get tested, they will not be able to receive treatment. With more people aware of their status, they have been able to get around 56% of adults and 55% of children to be on ART and have lessened the amount of AIDS-related deaths to around 110,000 in 2016.
AIDS epidemic in Nigeria
Unlike South Africa, Nigeria has a low prevalence of HIV; however, due to a small number of testing and counseling sites, and low access to antiretroviral treatment for those infected with HIV, a large number of AIDS-related deaths occur in this country. Nigeria has made efforts to increase government spending on HIV/AIDS programs, but has still fallen short as in 2016, there were still around 160,000 AIDS-related deaths (“HIV and AIDS”, 2017)5.
Nigeria’s 90-90-90 targets
A major problem in Nigeria is that many are unaware that they are infected with the disease since there aren’t many testing sites like in South Africa. The 90-90-90 targets in Nigeria are 34-88-81, which is a bit misleading as there really are only 31% of adults and 21% of children infected with HIV receiving treatment. Education is a major need in Nigeria in order to raise the amount of awareness of HIV/AIDS and the number of people getting tested for the disease throughout the country.
Legal barriers in Nigeria
There are some legal barriers which have affected the number of people who are able to access treatment as in this country. Those who take part in same-sex relations can be sentenced to around 14 years in prison. This has greatly limited access to HIV prevention programming and has caused a great amount of discrimination based on sexual orientation.
Lack of funding and education in Nigeria
Lack of funding and education may be the largest barrier in Nigeria. While South Africa is able to invest a large amount of money to create strong programs that provide information to educate those who visit about HIV/AIDS, most of the funding of Nigeria’s HIV response comes from international donors. Nigeria’s first 90-90-90 target number of only 34% knowing that they are infected with HIV shows a need for education (UNAIDS, 2017)3. Educating those who are unaware of how HIV is transmitted could have a significant impact on this number as it may persuade more people to get tested for the disease. Also providing ART to all people living with HIV would be beneficial not only to those already living with HIV, but to those at risk of getting the disease as well. Treatment greatly reduces the chances of transmission to others and since in Nigeria there are so many not receiving the treatment they need, it is hard to keep the epidemic under control.
Hope for progress
The HIV/AIDS epidemic has taken a huge toll over the years, infecting 78 million people and taking the lives of over 35 million. While many in the United States have experienced the epidemic, due to a great amount of funding and research, we are able to keep the disease under control. Other countries in Sub-Saharan Africa including South Africa and Nigeria haven’t been as lucky. Although they have been hit the hardest by the epidemic, efforts are being made to control the disease by building testing sites/campaigning to raise awareness and raising funding to allow more access to treatment. While countries like South Africa have made great progress in recent years, many countries like Nigeria have found it difficult to find ways to fund treatment programs; nevertheless, there are hopes to make progress in the near future.
1What are HIV and AIDS? (May 15, 2017). HIV.gov. Retrieved from https://www.hiv.gov/hiv-basics/overview/about-hiv-and-aids/what-are-hiv-and-aids.
2U.S. Federal Funding for HIV/AIDS: Trends Over Time. (November 09, 2017). KFF. Retrieved from https://www.kff.org/global-health-policy/fact-sheet/u-s-federal-funding-for-hivaids-trends-over-time/.
3South Africa. (2016). UNAIDS. Retrieved from http://www.unaids.org/en/regionscountries/countries/southafrica.
4Brangham, W. (Interviewer) & Karim, S. A. (Interviewee). (July 21, 2016). South Africa, the nation hardest-hit by HIV, plans to ‘end AIDS’ PBS News Hour. [Interview Transcript]. Retrieved from https://www.pbs.org/newshour/show/south-africa-nation-hardest-hit-hiv-plans-end-aids.
5HIV and AIDS in Nigeria. (March 26, 2018). AVERT. Retrieved from https://www.avert.org/professionals/hiv-around-world/sub-saharan-africa/nigeria.