GABORONE (Reuters) - The truly devastating threat that AIDS
poses to Africa comes into painful focus when the President of
Botswana, Festus Mogae, says his country faces extinction from
the disease. Mogae, who leads this diamond-rich southern Africa
country of 1.6 million people, is not being alarmist or playing
with rhetoric when he speaks out on AIDS.
The United Nations estimates that one in three of the country's
adults are living with HIV/AIDS, giving Botswana -- which is
roughly the size of France -- the highest percentage infection
rate in the world.
AIDS has put the people of Botswana, probably more than any
other, on a knife-edge between prosperity and poverty.
"We really are in a national crisis. We are threatened with
extinction...People are dying in chillingly high numbers,"
Mogae told Reuters.
"We are losing the best of young people...It's a crisis of the
first magnitude, it's a tragedy."
At Gaborone's main hospital, up to 80 percent of the medical
beds in the male ward are filled with sufferers in the last
stages of the disease.
More than a third of those in the children's ward also carry
the disease. Some patients fight for breath with the help of
oxygen masks while most just lie listlessly on mattresses, too
weakened by the disease to sit up. Like virtually every public
hospital in sub-Saharan Africa, no antiretroviral drugs to
combat the disease are available because they are too
expensive. All that overworked staff can do is battle to treat
opportunistic diseases such as meningitis.
Hospital head Howard Moffat fears that the hospital, built less
than 20 years ago, could soon buckle under the strain as the
number of people needing care from the later stages of AIDS is
only expected to peak over the coming five to 10 years.
"We're under very great stress. Already patients are being
discharged before they are well enough. For the staff it's very
demoralizing," Moffat said.
Sexual Practices Slow To Change
The alarming statistics and overflowing graveyards still have
little impact on the spread of AIDS across Botswana and the
rest of the African continent.
Some 90 percent of the sex workers who ply their trade with the
long-distance truck drivers at the town of Tlokweng on the
border with South Africa are HIV-positive.
Commercial sex is driving the disease throughout the continent.
In neighboring Zambia, Patricia works the bars at the top
hotels in the Zambian capital Lusaka where her clients are
mainly government officials, foreign businessmen and
Her tale is one of parental abuse and poverty that took her
into prostitution in one of the poorest countries in the world.
She says HIV/AIDS won't infect her.
"When a man doesn't want a condom, I ask for more money. They
usually pay extra," Patricia said.
Patricia, which is not her real name, is hardly unique. A U.N.
study in Ndola, Zambia, found that only one in four sex workers
used condoms with their last client and only one out of seven
used condoms with all clients.
In South Africa, studies have shown that sex workers are
cutting their fees and increasing their number of clients in
order to feed their addiction for crack cocaine, which has only
recently caught on in the country.
Young Slow On Safe Sex Message In Botswana
Doctor Arzumand Banu Khan, who heads Botswana's AIDS
coordinating agency, holds out little hope for the young.
"I don't think the message to our young people has really got
through about the use of condoms," Khan says, looking down onto
the city's main square.
"Just look down there -- pick out one in three of those people
and they will be living with HIV/AIDS," she says.
This alarming view is repeated across Africa where 24.5 million
of the 34.3 million people with HIV/AIDS live. The vast
majority are without hope of effective drugs, proper
supervision, basic health provision or counseling.
The number of deaths are going to rise and people are going to
get poorer as key family earners are lost to the disease. Life
expectancy in Botswana could fall to as low as 29, according to
a study by the U.S. Census department.
David Schneider, an actuary at the Botswana Insurance Company
who has done sophisticated modeling on the future course of the
country's epidemic, says AIDS is already claiming three times
as many people as any other disease.
"By 2004 this will rise to four times," he said.
Harvard Head See Vaccine In 5-7 Years
AIDS has blazed through Africa through unprotected heterosexual
sex, high rates of untreated sexually transmitted diseases
(STDs) and multi-partner relationships especially by older men
with younger women, which is condoned in many African
A culture of silence around the disease, the stigma attached to
AIDS and the high cost of anti-AIDS drugs and basic care
provisions have all allowed it to go unchecked.
A large migrant workforce dating back to colonial times,
particularly in the mines dotted throughout the continent, has
also proved a breeding ground for the epidemic.
There is no sign of a quick cure.
"Hopefully an effective vaccine will be ready in the next five
to seven years...It is extremely important that the governments
of the U.S., the major countries of Europe, Japan and Australia
work together," said Max Essex, chairman of the Harvard AIDS
Institute, which has a research station at the Gaborone
In seven years, millions more Africans will have died from