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As the AIDS pandemic moves into its third decade, the African continent is bearing the brunt of the HIV virus, leaving scores dead and many children orphaned. But light and hope has also emerged from the continent, which has from time immemorial been kicked to its knees only to get up again.
The XV International AIDS conference - the global gathering of HIV/AIDS doctors, scientists, and activists - took place last July in Bangkok, Thailand. The news from the conference was grim: treatment remains costly; there is no vaccine yet, nor is one coming soon. Ferocious debates roared over two distinct methods to deal with HIV/AIDS: ABC or Abstinence, Being Faithful and Condoms; or CNN, Condoms, Needles and Negotiating Skills. Many also debated whether the United Nations goal of getting 3 million people in the developing world on anti-retroviral therapy by 2005 is a reality. This therapy knocks out the virus permitting infected people to live longer healthy lives. Time will tell if the laudable 3 x 5 goal is achieved.
Among the world leaders and those with access to capital were a throng of African activists who, despite a paucity of resources, found their way to Asia to state their case.
The Nigerian fighter
Rolake Odetoyinbo-Nwagwu is an AIDS treatment activist who came to Thailand to push for more access for the poor worldwide. Her condition, diagnosed six years ago, has empowered her in a nation where people living with HIV are still on the fringe. With upwards of four million Nigerians living with HIV (reliable estimates are unavailable) Odetoyinbo-Nwagwu, 34, is determined to ensure that access to treatment is available for all, not just the lucky few. She now speaks out publicly about HIV.
"After seven years of marriage I found myself single again," a luminous Odetoyinbo-Nwagwu, recalled as she prepared to step into Bangkoks ImPact Convention Center. "He knew for over a year I'd been wanting to talk openly about HIV," she said of the man she married four years after university. "Other events led to my having to leave which had nothing to do with HIV: we just could not get the marriage together," she said of the husband whose sensitive career made it impossible for her to go public.
A 1992 graduate of Nigeria's elite University of Ife, upon graduation Odetoyinbo-Nwagwu finished her first film production which focused on love and people living with disabilities. Soon after, she became a clinic volunteer, a commitment which continued after her marriage.
In 1998, a positive HIV test came as a rude shock: it took years before she saw a counselor. A cousin in the United States connected her with a counseling training program. "I still believe that [volunteering is] why I'm able to take HIV this way. I still think it was building me up for what was to come later even though I never imagined that I would be on the other end of table being the care receiver."
"It helped me believe in me because one thing something like this does is that it strips you of your sense of self worth. I was just totally messed up on the inside."
Then came Barcelona where the last international AIDS confab was held in the summer of 2002. Friends contributed anything they could to get her there because knowledge is power. She returned to Lagos a changed woman. "For the first time in my life I came away with positive and not ashamed thinking, Positive and proud! Then she returned home and left another long love."
"I'd always baked," she laughed. I did not have a paid job. I was working mainly as a volunteer, so I was baking. If it's anybody's birthday, Id get an order. I started baking full time. When I came out with HIV, a few people said am I sure I can eat this cake? so I lost a lot of that business." So out went dreams of being a bakery magnate and in came activism.
"There was too much happening in my life. I was immensely enjoying what I was doing. It just gives me so much joy that I'm helping people," she said.
Her next project is getting together a Buyers club so Nigerians can buy their medication in bulk directly from manufacturers without having to wait for the limited or non-existent government programs.
The Zambian Virus Warrior
Like Nwagwu, Winston Zulu had to defer a dream. In September 1990, Zulu was an ambitious 26-year-old who was poised to take his place as part of the next generation of African leaders. The ruling Socialist party had awarded him a political science scholarship to the Soviet Union. "But then they asked me to go and do medical exams, which included HIV and unfortunately the HIV test came out positive. I could not travel," the soft-spoken 40-year-old said. "I lost the scholarship and I thought I was going to die." After HIV entered his life, he became a leader, but not an elected one.
"I went to this new HIV support organization called Kara because I just wanted to have poems published. The idea was if I'm not going to have any children, I should leave something written."
Then he got a surprise. "When I went there I was told you do not die immediately you can still live another six years, but I've been living with HIV for 14 years." Three months after that initial counseling he spoke to a small group of priests about his virus. It was the first public acknowledgment of HIV by a Zambian.
"Something happened. I felt freer. This whole thing of hiding made me feel like a guilty person, like a criminal. When I talked I felt much more free, that I was now living."
I married someone who is HIV positive and that was controversial. People felt if you are HIV you are not supposed to marry even if the person is also HIV, even if you are going to use condoms. I've been married since 1993." Now he fights for orphans and to have the world recognize that tuberculosis and malaria are equally deadly.
Crippled by polio as a child, the man who thought he was going to die now has three children and is looking at politics again. "That has been my passion and I think one day Im going to run for office, maybe in 2006 for member of parliament."
The Continental Trailblazer
Zulu and Nwagwu may be providing encouragement and counseling but Ernest Darkoh is administering treatment successfully. "You can give someone ARV [potent drug cocktails] under a tree or out of the back of your car. The total time they actually spend (receiving ARV) in a physical building is negligible," Darkoh declared to The AFRican.
The Harvard trained physician runs the much-lauded Masa treatment program in Botswana. He and his delegation were there to say to the world: "Africa does not have to have highest state-of-the-art technology to treat its AIDS patients - Africa just needs the medications."
"You see a lot of emphasis on building brick and mortar infrastructure. It does not make a lot of sense to me. This is a chronic condition that once managed, the person becomes well. So why are you building fixed infrastructure to address a population that will never ultimately need it," Darkoh said.
Botswana has an adult prevalence rate of above 35%, and in January 2002, the nation introduced ARV medication free of charge to its citizens. Masa - Setswana for dawn - signifies the hope ARV offers to people living with HIV/AIDS.
Its remarkable success owes much to the unprecedented level of commitment from the countrys leadership. [Last year The AFRican reported on President Festus Mogaes trailblazing efforts.]
"We have about 24,000 people on ARV therapy. The incidence of side effects is less than seven percent," Darkoh said. "The program pushed for and obtained routine HIV testing in the country as part of regular doctor visits. We feel that by treating HIV differently we may be contributing to the stigma. We want it to be as normal as any other condition."
"Patients are offered the test as a matter of routine and it is for the patient to say no doctor, I do not want the test. Then you offer the patient counseling and find out why. That said, we found very few cases since we started this policy in January where patients actually say no." Botswana has negotiated its own drug prices and has a partnership with the Bill & Melinda Gates Foundation and pharmaceutical giant, Merck.
Darkoh, 34, born in Ghana, raised in Kenya, educated in America and at Oxford is one of those African intellectuals who have taken their knowledge back home. His company BroadReach HealthCare, though based in Washington DC, focuses on Africa and developing nations.
"I knew I wanted to come back to Africa but I also did not want to come back and be frustrated and not be able to be effective. For me it was just a question of when the right opportunity would exist for me to come back and do the right kinds of things I wanted to do in an environment of relative safety."
"Although my parents are Ghanaian I do not really have a country per se, so for me it was any African country where I felt you could come and do work and contribute, but also feel human. Africa is the place where I feel the most like myself: the place I feel like Im the best I can be and it's the place I want to be able to contribute anything meaningful," he added.
"I see the effects and it feels good to be a part of that but frustrating because you know that so much more could be done and isnt being done. Across the continent, you see the potential but yet you dont see that potential being actualized."
The unmarried Darkoh, who is working in Asia as well, plans to spend the next three to five years crisscrossing the continents and hopes to eventually settle down and have a family. "No one would put up with me doing this," he laughed.
PHOTOCREDITS: MASA (Darkoh); GREG MCNEAL (Odetoyinbo-Nwagwu, Zulu)
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