Despite new drugs and campaigns for condom use, the battle against Aids in Africa is still raging

In Uganda and elsewhere, cases are once again on the rise

Share

It is becoming as hard to recall the terror of Aids as it is the Cold War. And yet, only 30 years ago it was laying the world to waste, taking an appalling toll on gay people, users of shared needles and other vulnerable groups. In one part of the world, it was having a comparable impact on the majority population as well – and that was where it all started, in sub-Saharan Africa. Aids remains a massive problem in this huge region today, but the good news is that now Africa is a laboratory for work that may not merely alleviate the misery of acquired immunodeficiency syndrome, but may also finally stop the disease in its tracks.

Tomorrow concludes The Independent’s week-long series of reports from the front line of the war against Aids, one that – despite its appalling human cost – risks becoming as forgotten as the continent’s military conflicts.

The good news is that inroads have been made, thanks to an increasing supply of anti-retroviral drugs. But new problems have arisen, too. Energetic, well-funded campaigns to encourage the use of condoms have reduced the spread of the disease among sex workers and their clients. And yet in Uganda, the first African country to be hit, the first to respond vigorously and the first to see cases fall, they are once again rising. One reason is that growing prosperity means that more men have more money in their pockets, and in the only part of the world where multiple, overlapping heterosexual partnerships are the norm, that encourages more sexual partners.

Another reason is that condom use has become so closely identified with prostitution that when a partner in a stable relationship suggests their use, it creates mistrust. Furthermore, because ARV drugs allow those with Aids to lead normal lives, the spectre of a horrible death is no longer ever present, galvanising the vulnerable into taking preventive measures.

Widespread dislike of condoms, combined with fears that existing efforts to stem Aids may unravel, have driven researchers to try new approaches. Male circumcision, which can reduce the risk by 60 per cent, is traditionally rejected by some tribes, but courageous leaders have broken the taboo. Similarly, the need to give women a practicable way of protecting themselves has driven tests of a vaginal ring, for which there are high hopes, in five countries across southern Africa.

The most remarkable development comes from the most discouraging setting, however. In the South African province of KwaZulu-Natal, one in four people have HIV – the highest regional rate in a country which is itself the world’s worst affected. But a medical breakthrough has prompted a trial programme with great promise. The aim is to enrol 10,000 patients – including those in their twenties, and therefore at their most sexually active – in mobile clinics, in the hope that the early studies suggesting that ARV  treatment can both halt the disease and cut its transmission can be replicated.

Thus, from the most benighted corner of the continent comes the most optimistic experiment, one which could tackle the disease at its source. That, indeed, is the fundamental challenge. As they say in Africa: “You can’t mop the floor with the tap still running.”

React Now

Latest stories from i100
iJobs Job Widget
iJobs General

Ashdown Group: Marketing Manager (B2B) - Romford - £40,000 + car

£35000 - £40000 per annum + car and benefits: Ashdown Group: Marketing Manager...

Ashdown Group: Helpdesk Analyst - Devon - £20,000

£18000 - £20000 per annum: Ashdown Group: Helpdesk Analyst - Devon - £20,000 ...

Ashdown Group: Data Scientist - London - £50,000 + bonus

£35000 - £50000 per annum + generous bonus: Ashdown Group: Business Analytics ...

Ashdown Group: IT Project Coordinator (Software Development) - Kingston

£45000 - £50000 per annum: Ashdown Group: IT Project Coordinator (Software Dev...

Day In a Page

Read Next
 

If I were Prime Minister: I'd end the war on drugs

Patrick Hennessey
David Blunkett joins the Labour candidate for Redcar Anna Turley on a campaigning visit last month  

General Election 2015: Politics is the messy art of compromise, unpopular as it may be

David Blunkett
General Election 2015: Ed Miliband's unlikely journey from hapless geek to heart-throb

Miliband's unlikely journey from hapless geek to heart-throb

He was meant to be Labour's biggest handicap - but has become almost an asset
General Election 2015: A guide to the smaller parties, from the the National Health Action Party to the Church of the Militant Elvis Party

On the margins

From Militant Elvis to Women's Equality: a guide to the underdogs standing in the election
Amr Darrag: Ex-Muslim Brotherhood minister in exile still believes Egypt's military regime can be replaced with 'moderate' Islamic rule

'This is the battle of young Egypt for the future of our country'

Ex-Muslim Brotherhood minister Amr Darrag still believes the opposition can rid Egypt of its military regime and replace it with 'moderate' Islamic rule, he tells Robert Fisk
Why patients must rely less on doctors: Improving our own health is the 'blockbuster drug of the century'

Why patients must rely less on doctors

Improving our own health is the 'blockbuster drug of the century'
Sarah Lucas is the perfect artist to represent Britain at the Venice Biennale

Flesh in Venice

Sarah Lucas has filled the British pavilion at the Venice Biennale with slinky cats and casts of her female friends' private parts. It makes you proud to be a woman, says Karen Wright
11 best anti-ageing day creams

11 best anti-ageing day creams

Slow down the ageing process with one of these high-performance, hardworking anti-agers
Juventus 2 Real Madrid 1: Five things we learnt, including Iker Casillas is past it and Carlos Tevez remains effective

Juventus vs Real Madrid

Five things we learnt from the Italian's Champions League first leg win over the Spanish giants
Ashes 2015: Test series looks a lost cause for England... whoever takes over as ECB director of cricket

Ashes series looks a lost cause for England...

Whoever takes over as ECB director of cricket, says Stephen Brenkley
Fishing for votes with Nigel Farage: The Ukip leader shows how he can work an audience as he casts his line to the disaffected of Grimsby

Fishing is on Nigel Farage's mind

Ukip leader casts a line to the disaffected
Who is bombing whom in the Middle East? It's amazing they don't all hit each other

Who is bombing whom in the Middle East?

Robert Fisk untangles the countries and factions
China's influence on fashion: At the top of the game both creatively and commercially

China's influence on fashion

At the top of the game both creatively and commercially
Lord O’Donnell: Former cabinet secretary on the election and life away from the levers of power

The man known as GOD has a reputation for getting the job done

Lord O'Donnell's three principles of rule
Rainbow shades: It's all bright on the night

Rainbow shades

It's all bright on the night
'It was first time I had ever tasted chocolate. I kept a piece, and when Amsterdam was liberated, I gave it to the first Allied soldier I saw'

Bread from heaven

Dutch survivors thank RAF for World War II drop that saved millions
Britain will be 'run for the wealthy and powerful' if Tories retain power - Labour

How 'the Axe' helped Labour

UK will be 'run for the wealthy and powerful' if Tories retain power