Senegal's good practice: How music is key to turning tide in war on Aids

Leonard Doyle
Friday 01 December 2006 01:00

Senegal is the poster boy of the struggle against Aids in Africa and is also the home of some of the continent's best music. The two facts are not unrelated.

Musicians such as Baaba Maal would argue for a very direct connection. Maal, a goodwill ambassador and youth emissary for the UN, uses his music to talk about the problems of young people, poverty and society - and Aids in particular.

Overwhelmingly Muslim and politically stable, Senegal has an HIV infection rate of 1 per cent - the lowest in sub-Saharan Africa. It is such a rare success story that the UN calls the country "a beacon of hope". Only Uganda, which has cut its infection rate from 11 to 6 per cent, has a comparable record in fighting Aids.

But it is music, more than press releases, that is helping to turn the tide in Senegal. The UN has turned Baaba Maal's concert schedule into a stage to deliver the message about HIV/Aids. Maal has travelled extensively throughout Senegal, Guinea and other neighbouring West African nations to talk about HIV/Aids during his concerts. He also goes to remote villages to gain an understanding of Aids-related projects.

"The challenge is to make people understand," Maal recently told All Africa.Com. "The important thing for me to do is to make these people understand and know what's going on. Sometimes people don't believe that HIV exists."

DJ Awadi, a rapper with a Senegalese group, Positive Black Soul, based in Dakar, says: "It is really important for our generation to understand that Aids is a real disease. A lot of people are dying because they do not have enough communication about this disease."

He laments that while urban youth in Dakar may be aware, "in most of the country they know nothing about it [Aids]. Maybe they hear about it today [World Aids Day], they talk a bit about it and that's it. Afterwards they forget and they continue doing what they used to do."

Most other African governments went into deep denial when the first Aids infections started appearing in the 1980s. Senegal, by contrast, set up a blood-screening programme after the first cases appeared in 1986, ensuring a safe supply of blood to hospitals. That, along with conservative attitudes towards sexual promiscuity, public education and the availability of condoms, appear to have saved the country.

When the first - expensive - antiretroviral drugs came on the market it was immediately apparent that their inaccessibility to most people in Africa was a disaster in the making. Senegal became the first country on the continent to negotiate a 90 per cent cut in the price of Aids drugs from multinational pharmaceutical companies. Hundreds of Aids sufferers were prescribed ARVs under a scheme gradually rolled out across the country.

Having a deeply traditional Muslim society also helped keep HIV/Aids at a manageable level, even though talk of Aids remains taboo among more conservative Senegalese. Even at Friday prayers, however, some imams have been getting out the message about abstinence and protection.

Some of the credit must also go to the country's President, Abdoulaye Wade, who has been warning his compatriots that they must help break the silence and dispel any myth surrounding Aids. President Wade's message is: "Beware of the dangers, find solutions, change our behaviour and encourage everyone to go for HIV tests."

This is groundbreaking stuff on a continent where the leadership can as often be in denial about the threat of Aids. "If we succeed in inculcating the notion in the mind of every single Senegalese, that they must not transmit the disease, or be the cause of the loss of other people's lives in any way, then we would have taken a significant step forward." The President told a group of visiting journalists recently that it was "all about education, about information ... through the medium of meetings. And the most important element is the youth and women."

African leaders have, belatedly, come to describe Aids as a "state of emergency in the continent", and resolved to "place the fight against HIV/Aids at the forefront and as the highest priority issue in our national development plans".

Many of those leaders, who are seeing the most productive generations dying off, now regret not following the lead of Senegal in tackling the threat to their countries from Aids.

Beating the epidemic

* Senegal has responded quickly to the threat of an Aids epidemic. National HIV infection rates kept below 1 per cent.

* It has campaigned to change high-risk behaviour. Most Senegalese women in their early twenties do not have sex before 19 or older, three years later than their mothers' generation.

* Dakar has backed a rise in the use of condoms. The number of condoms distributed is up from 800,000 in 1988 to more than 12 million by 2006. A recent study of condom use by sex workers showed that a total of 99 per cent reported using a condom with their most recent new client.

* Muslim and minority Christian churches involved in campaign. Aids became a regular feature of Friday prayers in mosques. Christian religious leaders, including Catholics, provided counselling and psychosocial support and advocating tolerance and care.

* Focus on sex workers. Senegalese prostitutes must be registered and undergo regular health checks. Weekly markets were visited as well as venues frequented by transport workers or migrant labourers - both high-risk groups for HIV infection.

* Uganda has showed high-level political commitment to HIV prevention and care. Same-day results for HIV tests and social marketing of condoms and self-treatment kits for sexually transmitted infections, backed up by sex education programmes, have helped reduce HIV infection rates.

* Focus on pregnant women. Since 1993, HIV infection rates among pregnant women, a key indicator of the progress of the epidemic, have more than halved in some areas. Infection rates among men seeking treatment for sexually transmitted infections have dropped by one-third.

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