HEALTH-MALAWI: No Celebrations Despite Apparent Drop In HIV Infection Rates

By IPS Correspondents Reprint | | Print |

Anderson Fumulani

LILONGWE, Apr 23 2003 (IPS) - -HIV/AIDS infection rates appear to be on the decline in Malawi and authorities have attributed the drop to the declining number of AIDS related deaths of already infected people.

The national prevalence rate in 1999 indicated that 16 percent of the country’s 11.2 million population were infected but these estimates have now leveled off to below 15 percent in 2000 and 2001 according to latest information by the National Aids Commission (NAC) released in March 2003.

These estimates fall below the trend and analysts say the reason is not definitive but is probably related to some yet to be explained random fluctuations.

"It could also be because prevalence is starting to decline due to a high death rate among older adults. Although some decline in prevalence is noted among 15-19 and 20-24 year-olds in Lilongwe, there is no similar decline in Blantyre or elsewhere," says a joint review report of NAC HIV/AIDS Strategy.

In Malawi HIV/AIDS reportedly kills 81,000 people each year adding an overload of 65,000 orphaned children to an already staggering 500,000 orphans countrywide. Over 845,000 Malawians are estimated to be living with the HIV virus countrywide 65,000 of them children, according to the report. It also says more women than men are infected accounting for between 12 percent and 18 percent of those infected as opposed to between 5 – 8 percent for men of the same age group.

"The primary mode of HIV transmission in Malawi remains through unprotected heterosexual sex [accounting for 90 percent of those infected] with more women [representing 56 percent] infected than men. This suggests that women are more at risk and are being infected by older men," says the report.

If the declining infection rates are gains at all, abject poverty on the other hand is significantly eating away those gains and contributes to a faster manifestation of full blown AIDS to those infected because of lack of adequate food and high malnutrition.

A recent United Nations (UN) report said the number of Tuberculosis (TB) cases in Malawi increased dramatically between January and June 2002 by about 26 percent "clearly indicating the devastating impact of hunger in accelerating fragile HIV conditions into symptoms associated with full blown AIDS."

In 2000, the United Nations Development Programme (UNDP) ranked Malawi at number 163 of the 173 poorest countries of the world, both in terms of quality of life and income poverty. Over six million people in the country live below one United States dollar per day with Gross Domestic Product (GDP) of about 170 dollars in 2000, according to the Poverty Reduction Strategy Paper (MPRSP).

The food crisis that has hit Southern Africa now threatens 3.6 million people in Malawi in need of food aid but the situation significantly poses a more serious danger to those living with the HIV virus.

"Despite the fact that the [humanitarian] crisis is due to a variety of factors (including erratic weather, seven-fold rise in the price of maize and weak governance), it is clear that HIV/AIDS is an underlying and exacerbating factor, and that its impact is harshest among individuals and households battling HIV/AIDS.

"To date, an estimated 5.8 percent of the Malawi farm labour force has died due to AIDS, and a substantially higher number are challenged and impeded in their everyday lives to work their farms on account of HIV/AIDS related complications," the report notes.

Linking food shortages to the AIDS crisis, special envoy for the UN Secretary General for Humanitarian Needs in Southern Africa, Stephen Lewis, said when he visited Malawi recently that the drought may end but the crisis would not.

"The distinguishing factor this time being that HIV/AIDS remains the underlying determinant to the perpetuation of the crisis in Southern Africa and that, combined with cyclical food shortages and chronic poverty, the epidemic becomes even more deadly," he noted.

The government of Malawi spends nearly 123,500 dollars outside operating budget to finance funeral expenses of dying civil servants every year, a government commissioned report said recently.

Justin Malewezi, Vice President of Malawi said at the launch of the report that the financial implications of HIV/AIDS through training and recruitment, funerals, death benefits and absenteeism was very high and was pushing the government outside its operating budget.

"Everyday we’re burying our workmates, our teachers, doctors and other professionals. HIV and Aids erodes human capital as professionals die making the public and private sector less efficient through lack of capacity," Malewezi said.

The report sampled out five of the 42 government ministries of Water Development, Agriculture and Irrigation, Education, Science and Technology, Health and Population and the Malawi Police Service (MPS).

Among the government ministries, hardest hit is the ministry of Education, Science and Technology that loses on average up to 58 percent of it’s employees singling out secondary school teachers standing at 77 percent of those who die from the pandemic out of the estimated 50,000 teaching workforce.

"High vacancy rates and increased absenteeism result in more workload pressures on available staff and this leads to added stress and burnout which negatively affect staff morale," part of the government commissioned report says.

The virus that causes Aids, according to UN Aids, has mostly hit Sub-Saharan Africa region with 67 percent of the world’s total population of people living with HIV/AIDS representing 21 million men, women and children.

Although over 845,000 live with the HIV virus in Malawi, only 25 000 people are expected to be able to access the Anti-Retroviral Viral (ARV) drugs through the Global Fund to fight HIV/AIDS, Tuberculosis (TB) and Malaria, according to Wesley Sangala, Chief Technical Advisor for the Health Ministry. The Fund has granted 208 million dollars to the Government of Malawi.

ARV drugs that prolong the lives of HIV/AIDS sufferers can only be accessed in Malawi at a subsidized price of 28 dollars per month, a cost far beyond the reach of the majority of those poor suffers. (ENDS/IPS/AF/SF/HE/SD/AF/SM/03)

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