About 5,500 people died in sub-Saharan Africa yesterday—about one and a half times the number of American troops killed since the invasion of Iraq—and few people in the United States noticed.
The killer wasn’t a war or famine or natural disaster but rather a virus the shape of a spiky basketball which hijacked its victims’ DNA, replicated itself and then destroyed the host’s immune system.
The killer was AIDS, and it will kill 5,500 more Africans today. And tomorrow. And every day for the foreseeable future. The scourge of the disease and its precursor virus, HIV, is destroying lives, families, communities and countries. The disease’s effect on everyday people is the subject of Stephanie Nolen’s book, 28 Stories of AIDS in Africa, a group of profiles written by the reporter for Toronto’s Globe and Mail newspaper.
The pandemic has all but disappeared from today’s media. One reason seems to be the so-called “AIDS fatigue”—simply put, Americans are tired of reading about the disease. Dying with AIDS is a gruesome way to die, and it doesn’t make good reading or fun watching.
Also, living with HIV/AIDS in the West has become not much different than living with a chronic disease. The development of antiretroviral drugs—which can arrest the spread of HIV or AIDS but don’t cure it—is one of the most underappreciated and remarkable breakthroughs in medicine in decades.
Many countries are offering free or subsidized ARVs—but the drugs are hard to come by in the area with the highest rates of infection: sub-Saharan Africa.
The decreasing interest abroad and a sense of horror after witnessing a group of Tanzanian men wasting away with the virus is why Nolen chose to focus her efforts on reporting HIV/AIDS.
And why 28 stories? According to the United Nations’ AIDS organization, 28 million of the estimated 39.5 million people in the world living with the disease live in Africa.
The book’s profiles can be heartbreaking or inspiring—or sometimes both at the same time. One such case is Lefa Khoele, a 12-year-old Basotho boy born with HIV who has been too sick to take his year-end school exams, so he’s stuck in a class with 7-year-olds. Still, he makes the best of things—he’s learning gardening, and his ambition isn’t dimmed by the disease.
There’s Mohammed Ali, a Kenyan trucker who frequently purchased the services of prostitutes on his routes. After testing positive, he changed his behavior: no sex with his wife (who is HIV-negative) or prostitutes. No more cigarettes or drinking. He believes the disease will kill him, “but everybody dies one day,” he said.
And there’s Cynthia Leshomo, who won the Miss HIV Stigma-Free beauty contest in Gabarone, Botswana, and is trying to break social taboos.
The most famous person profiled in this book is Nelson Mandela. South Africa’s first post-apartheid president announced two years ago that his final surviving son, Makgatho Mandela, had died of AIDS-related diseases.
The power of the announcement can’t be overstated. Mandela was the glue that kept the “Rainbow Nation” from fracturing into race-based warfare after the first all-race elections in 1994. He’s the only politician respected among almost all races, classes and political affiliations. And then he announced AIDS had affected the Mandela family, too.
“The admission that AIDS had touched them, too, made it all a bit more normal, a bit less shameful,” Nolen writes.
It’s difficult to figure out if the war on HIV/AIDS is being won. Various groups give mixed signals. One example: Siphiwe Hlophe founded a successful grass-roots AIDS awareness and treatment group in Swaziland, but the country’s King Mswati III, Africa’s last ruling monarch, is a polygamist who chooses a new wife each year. He’s up to 13 wives.
South Africa transmits the most conflicting messages. Mandela, now a vocal advocate for increased HIV/AIDS funding and treatment, was largely silent about the disease while in office.
Mandela’s successor, Thabo Mbeki, has called AIDS a disease of the poor and defended a group of scientists who allege HIV does not cause AIDS. He’s criticized the West for its portrayal of the pandemic in Africa, saying reporters buy into the stereotype that Africans are savage and unable to control their bodies.
His health minister, Manto Tshabalala-Msimang, has promoted a diet rich in vegetables as a traditional cure for the virus. After much domestic and international fury over her statements, she’s modified it—now she says the best cure is a diet and antiretroviral drugs.
Yet despite this sharp rise in boneheadedness at the top of Africa’s richest and most industrialized nation, there are positive signs. Mbeki’s Cabinet forced the president to accept South Africa’s use of antiretroviral drugs, and it commanded Tshabalala-Msimang to develop a way to distribute them free to those who can’t afford them. The president has backed off his previous comments, and his health minister is fading away from the political scene because of health concerns.
The drug rollout program is under way, but only reaches 250,000 of the 5 million infected in South Africa. Within five years, Pretoria hopes ARVs will reach 80 percent. But the stigma remains: Most people do not want to be tested or acknowledge the disease.
These are the obstacles in Africa’s richest nation. Cross the borders into some of its neighbors—Lesotho, Swaziland, Mozambique, Zimbabwe, Namibia—and suddenly the poverty rate skyrockets and the infection rate increases.
These countries often can’t afford to give away ARVs.
Every day, Nolen reminds us at the end of her book, 5,500 people in Africa die of AIDS-related diseases. More are infected every day. Therefore, she writes, “we have twenty-eight million reasons to act.”