[afro-nets] How AIDS in Africa was overstated

[A. Odutola <chpss_abo2@yahoo.com>]

How AIDS in Africa was overstated
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Reproduced as "fair use"

Source: Washington Post Foreign Service
http://www.washingtonpost.com/wp-dyn/content/article/2006/04/05/AR2006040502517.html

By Craig Timberg

Thursday, April 6, 2006; Page A01

KIGALI, Rwanda -- Researchers said nearly two decades ago that
this tiny country was part of an AIDS Belt stretching across the
midsection of Africa, a place so infected with a new, incurable
disease that, in the hardest-hit places, one in three working-
age adults were already doomed to die of it.

But AIDS deaths on the predicted scale never arrived here, gov-
ernment health officials say. A new national study illustrates
why: The rate of HIV infection among Rwandans ages 15 to 49 is 3
percent, according to the study, enough to qualify as a major
health problem but not nearly the national catastrophe once pre-
dicted.

The new data suggest the rate never reached the 30 percent esti-
mated by some early researchers, nor the nearly 13 percent given
by the United Nations in 1998.

The study and similar ones in 15 other countries have shed new
light on the disease across Africa. Relying on the latest meas-
urement tools, they portray an epidemic that is more female and
more urban than previously believed, one that has begun to ebb
in much of East Africa and has failed to take off as predicted
in most of West Africa.

Yet the disease is devastating southern Africa, according to the
data. It is in that region alone -- in countries including South
Africa, Botswana, Swaziland and Zimbabwe -- that an AIDS Belt
exists, the researchers say.

"What we know now more than ever is southern Africa is the abso-
lute epicenter," said David Wilson, a senior AIDS analyst for
the World Bank, speaking from Washington.

In the West African country of Ghana, for example, the overall
infection rate for people ages 15 to 49 is 2.2 percent. But in
Botswana, the national infection rate among the same age group
is 34.9 percent. And in the city of Francistown, 45 percent of
men and 69 percent of women ages 30 to 34 are infected with HIV,
the virus that causes AIDS. Most of the studies were conducted
by ORC Macro, a research corporation based in Calverton, Md.,
and were funded by the U.S. Agency for International Develop-
ment, other international donors and various national govern-
ments in the countries where the studies took place.

Taken together, they raise questions about monitoring by the
U.N. AIDS agency, which for years overestimated the extent of
HIV/AIDS in East and West Africa and, by a smaller margin, in
southern Africa, according to independent researchers and U.N.
officials.

"What we had before, we cannot trust it," said Agnes Binagwaho,
a senior Rwandan health official.

Years of HIV overestimates, researchers say, flowed from the
long-held assumption that the extent of infection among pregnant
women who attended prenatal clinics provided a rough proxy for
the rate among all working-age adults in a country. Working age
was usually defined as 15 to 49. These rates also were among the
only nationwide data available for many years, especially in Af-
rica, where health tracking was generally rudimentary.

The new studies show, however, that these earlier estimates were
skewed in favor of young, sexually active women in the urban ar-
eas that had prenatal clinics. Researchers now know that the HIV
rate among these women tends to be higher than among the general
population.

To view graphical representation of revised AIDS data, click on:
http://www.washingtonpost.com/wp-dyn/content/article/2006/04/05/AR2006040502517.html


A. Odutola
mailto:chpss_abo2@yahoo.com