Ethics and HIV in Africa

I want to thank the Society for Women and AIDS in Africa (SWAA) for inviting me to speak at this 11th international conference taking place here in Ouagadougou , in Burkina Faso . The theme of this conference HIV/AIDS, Gender and Human Rights: Time for Action is very appropriate. It addresses the cogent issues at the heart of the HIV/AIDS pandemic in Africa .
First of all let me convey the solidarity greetings from all African Humanists and from the International Humanist and Ethical Union (IHEU) to SWAA and to all of you, fellow participants who came from all over the world to attend this event.
Your presence is a clear indication of the enormous threat HIV/AIDS poses not only to Africa but to humanity at large. And we, at the Humanist Movement, share in your sense of urgency and commitment to tackling HIV/AIDS on the continent. We stand with you in your quest for a solution and a resolution of the AIDS crisis.
But we are also aware of the complex and complicated challenges HIV/AIDS presents to Africa and to the world at large.
And we hope this conference would come up with real ideas and ways of marshalling Africa 's gender and human rights resources against the spread of HIV infection.

Distinguished participants, we, humanists, believe as the theme of this conference says that it is time for action. It is time for us to take action against this deadly virus and save humanity from going into extinction.
It is time for us to move against every institution, position or policy that harbors or facilitates the spread of HIV infection in Africa and the world.
It is time for us to mobilize against any form of bias, prejudice, habit, doctrine or dogma that fuels or feeds this killer virus. It is time for us to starve HIV to death. It is time for us to stop, contain, confront, combat, terminate and eliminate HIV from the face of the planet.

But my dear friends, there is one question that stares us all on the face. And that is: How do we act? What kind of action do we take?
This is an ethical question. This is a question that urges us to examine critically what we do or can do as a people, as a race, as a continent and as a generation to tackle this global scourge.
How do we conduct ourselves? How do we behave in the face of this deadly virus and the catastrophic consequences of its continued spread in Africa and throughout the world?
This is because, today, HIV presents the African continent with the greatest ethical challenge and dilemma especially in the areas of prevention, treatment and care.

PREVENTION: HIV has no cure yet. So, preventive mechanisms are critical to combating the spread of the infection. Some of the ways that have proven effective in combating the HIV infection include abstaining from sex, being faithful to one's partner, the use of condom, avoiding any contact with contaminated blood etc. Over the years, a holistic promotion of the preventive measures has yielded very positive results, leading to a significant reduction in HIV infection in countries across the region.
But today the preventive programs are under threat from governments and religious bodies.
For instance, the American government is funding and promoting the abstinence only campaign worldwide. This campaign maintains that abstinence is the only moral- and politically correct- route to eradicating HIV/AIDS. The Roman Catholic Church and other religious bodies oppose the use of condom. They misinform the world about the effectiveness of condom use. They equate its promotion to encouraging immorality, sexual promiscuity and impiety. While the US government withholds funds from organizations that promote safe-sex strategies including the use of condoms.

Obviously, this policy of the US government has put many governments and non-governmental organizations (NGOs) in Africa in a very difficult situation.
The governments and NGOs in Africa know that condom is an effective weapon in the fight against HIV/AIDS. But unfortunately, they depend on the American government and donor agencies for funding. And now the US government has made the promotion of abstinence-only a condition for receiving aid and assistance. Hence many governments and NGOs in Africa have abandoned the promotion of safe sex strategies for abstinence-only schemes, in order to receive funding from the US government. What a shame?
Meanwhile, a review of the abstinence-only programs conducted in 2006 in the developing world found little evidence that they were effective in HIV prevention. So the question is -why waste money funding useless schemes that offer little hope and help to world when there are more effective programs in need of support? Why promote an unrealistic scheme when there is a realistic one out there?

HIV TREATMENT With no cure yet in sight for HIV/AIDS, what we have as treatment are the anti retroviral drugs which inhibit the development of the virus into AIDS. Unfortunately, most people infected with HIV in Africa still do not have access to these drugs. They cannot afford the cost (of the treatment). This situation is further complicated by the greed and the commercial interests of drug companies, and corruption and lack of political will on the part of the governments in Africa . The pharmaceutical companies that manufacture the anti-retroviral drugs put more emphasis on their profit than on saving human lives. While corruption on the part of African politicians has undermined the efforts of governments to deliver, fund and subsidize the HIV treatment.

Furthermore, the HIV treatment program is complicated by the proliferation of HIV/AIDS cure-claims on the continent. Today in Africa there are several doctors, alternative health practitioners and faith healers-including a sitting president of an African country- who claim to have discovered the cure for HIV/AIDS. Incidentally, none of these cure claims has proven to be medically valid, safe and effective. Still HIV patients troop to these `doctors' who cash on their desperation, vulnerability and helplessness to enrich themselves. They charge HIV patients huge sums of money to administer questionable therapies that make little or no difference in their health condition, and sometimes worsen it.

CARE: HIV infected persons need care, love and respect. But in Africa they suffer a lot discrimination and stigmatization, in families, communities, schools, clinics and offices.

Throughout the continent, there is a high prevalence of PLWHA-phobia- that is the irrational hatred and fear of People Living With HIV/AIDS(PLWHA). HIV positive persons are often disowned or abandoned by the families. They are treated with utter contempt, indignity and disrespect. HIV positive persons are perceived as a curse. They treated as a plague, as outcasts and as bearers of demonic affliction. HIV positive persons are discriminated against in all areas of public life- medical care, treatment, job and educational opportunities.
Recently a move by a private university in Nigeria to exclude HIV positive persons from its graduation program generated a lot of controversy in the country. Some years ago a school in Lagos was closed down after it was discovered that the school authorities were carrying out forced virginity test on the pupils. And there are reports that in some clinics in Nigeria, pregnant women who are HIV positive are abandoned during delivery. While a recent study conducted in Nigeria says that the rate of discrimination against HIV/AIDS patients remains high. And as a result of this, many HIV positive persons do not want to disclose their status to their families, friends, or partners. These ethical challenges are there for us to confront and overcome if we are to win the battle against HIV/AIDS in Africa

TIME FOR ACTION.
So, the time has come for all governments and NGOs to take concerted and decisive steps against the HIV/AIDS pandemic. We need to adopt a bold, comprehensive, holistic and realistic approach to prevent the spread of the infection by emphasizing and promoting all effective measures including the use of condoms. African governments and NGOs should not allow the American governments or the religious bodies to dictate and determine the actions they take against HIV infection. And let me use this opportunity to send this message to the American government. "Your abstinence only campaign is overtly disingenuous and imperialistic. Please, stop sacrificing the lives, health, safety and survival of Africans on the altar of your bigoted faith-based politics"

And to the Roman Catholic Church and other religious bodies that oppose, discredit, demonize and immoralize the use of condoms I want to say. "Back off from this hypocritical medieval position. Come into the 21st century and stop misleading your folks. Stop endangering the lives of your faithful in this world. Stop undermining family values, health and survival."
African governments and non governmental organizations should be ready to promote any effective mechanism to prevent the spread of HIV infection whether the US government supports it or not; whether the religious groups endorse it or not. If the US government cannot fund any program, they should be ready to source the money elsewhere.
African governments and drug manufacturing companies need to partner and ensure a universal access to anti-retroviral treatment by all HIV positive persons in line with the Millennium Development Goals.
We must get our governments and drug companies to put the people above their petty politics and profit.

African governments and health ministries should check the proliferations of HIV/AIDS cure-claims. They should ensure that such therapies are tested and certified safe and effective before they are sold or administered by anybody. We need to act to check the exploitation of HIV patients by unscrupulous fake healers.

African governments and non-governmental organizations should take actions against the stigmatization and discrimination against PLWHA in all aspects of public life. We need to come out with more programs and trainings to combat PLWHA-phobia. For instance Nigeria is working on a bill that would outlaw any form of discrimination against PLWHA. Such a bill should be replicated and adopted by all countries in Africa .

In conclusion, the HIV/AIDS pandemic has caused and created a humanitarian emergency in Africa. And we all need to come out totally and forcefully against it. I want to say in line with the Humanist Manifesto 11 that "No Deity will save Africans (and humanity) from HIV/AIDS, we must save ourselves."
Hence we should not allow the policies of theocratic governments to stop us; derail us or vitiate our cause. We should not allow the other worldly dogmas of religious bodies to come between us and our victory over HIV/AIDS in this world. Instead, we should wage the battle against HIV infection guided by the highest principles and standards of ethics, human rights, gender equity and justice.
Already, SWAA is leading the way in this important struggle through its conferences and other numerous initiatives in the region. And we all need to join efforts with SWAA in this great struggle against a deadly virus and a devastating disease. And I want to use this opportunity to register the readiness of my organization -the IHEU- to cooperate with SWAA and other non-governmental organization in the fight against HIV infection in Africa.

Together we shall win.

presented by Leo Igwe at the 11th International Conference of SWAA in Ouagadougou Burkina Faso February 03-07 2008

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