UKWETHEMBA

NIKOSI JOHNSON
Nkosi's courageous stance and will to survive will be the focus of further coverage in Numedx. Ten-year old Nkosi Johnson, born HIV positive, and orphaned, is South Africa's oldest child living with AIDS. As one of the Conference's opening speakers, he addressed over 10,000 audience members as well as millions watching on TV and the Internet in a moving speech about living with AIDS in Africa. "The first day at school I didn't tell anybody that I have AIDS, but I think they knew. If I go near a boy he moves away. If I go to touch other boys they say, don't go near him, don't touch him!"

KELVIN GLEN

Numedx.com is proud to announce the opening of our satellite office in Durban, South Africa. Numedx.com will now be covering AIDS in Africa in every issue. We are proud and honored to welcome Kelvin Glen, a native South African, as our correspondent and editor for this important department.

Kelvin Glen has committed his life to those who are less fortunate, and is driven to ensure that his fellow man helps those in need. Following his education, Kelvin worked in many orphanages and street children shelters. Realizing that starving children were not only on the streets of South Africa, he then dedicated two years of his life to relief Aid to Ethiopia. Kelvin was called upon by The South African Red Cross Society (Kwa Zulu Natal region) to source much needed funding and went on to become the youngest operations manager (Disaster management /Community Based Primary Health Care) within the organization. Once the South African Red Cross Society were back on their feet, Kelvin took up the challenge to an educational marketing company which focused on Health, Hygiene, and Life Skills to youths throughout South Africa. Kelvin translated diverse talents and a passion for the development of philanthropic giving into a successful consultancy, Inkulumo Consulting.

Inkulumo Consulting is a dedicated results-driven company that specializes in community development, communications, and fundraising. Through uplifting programs and community empowerment, Inkulumo Consulting worked with The XIII International AIDS Conference and Marine Conservation. Kelvin's dedication to fundraising in Africa has resulted in him filling the post of Vice President of The South African Institute of Fundraising. Kelvin's philosophy on life is: "We all have a role to play within the world. If we all try to make the world a better placewe will succeed. You too can make a difference. Make your mark."

BY: Kelvin Glen and Gabrielle Harris

South Africathe rainbow nationemerged unshackled from the depths of oppression and Apartheid into a new and hopeful position in the world. With freedom, liberation, and a new beginning, most of us could feel a sense of national pride and triumph for the first time. But the glory has not lasted. South Africa now faces an even greater challenge than ApartheidHIV/AIDS. Although this is an international crises, statistics show that South Africa is one of the most problematic regions. The latest UN figures say that 4.2 million South African are HIV-positivethat is more than 10% of the population. Last year 250,000 deaths were AIDS-related. But why here? In a nation that has risen against such terrible adversity in the past? From a social perspective, HIV/AIDS seems to be the perfect metaphor. It grows by feeding on weaknesses in governments and societyit is almost a manifestation of all man's ills. We no longer care about our fellow man. There is segregation, racism, sexism, an endless list of Who's Who in the hate book. We have put names to our prejudices and made them acceptable. And too many believe that AIDS only happens to bad peoplepeople who deserve it. It's their problem. If we care so little about people and are so ill informed about HIV/AIDS, how can we ever hope to overcome and deal with the threat?

Moreover, in the last forty years there have been dramatic changes in what was once considered traditional values. Media and advertising have exploded, and everything can be sold using sex. Sexual behavior is more liberated and more acceptable. Sex before marriage is acceptable. And marriage no longer lasts.

Modern humankind is not what it used to be. Many of the social changes are exacerbating the AIDS pandemic. And in our wonderful South Africa, social problems have even greater diversity and complexity. Many problems are holdovers from the Apartheid era. Others result from the fact that we are a multicultural society, hankering after westernization but clinging to our ancestral beliefs.

In the Apartheid era, cultures were segregated and forced into migrant-labor situations. Groups are still settled in these formerly segregated areas, and migrant labor exists even today. This means that families are disrupted when breadwinners go to work. Breadwinners spend long periods away from home, and it has become acceptable for men in particular to have multiple sexual partners. Distances are covered between work and home, and thus HIV has traveling opportunities. There are still people in this culturally diverse and evolving country who practice polygamy. Some men will only marry a woman if she has already proven her fertility. And South Africa is a male-dominated society, which presents many difficulties for woman trying to protect themselves from HIV/AIDS. It is not surprising that this society, where woman are submissive and good old-fashioned family values are often disrupted, has the highest rape statistics in the world. Rape legislation, in fact, is in dire need of revision. Not a good prognosis for the control of AIDS.

Thanks to our previous government, distribution of wealth on our society is far from ideal. Some are very rich; many are still very poor. Unemployment is high, around 34%. Over a quarter of those that do work earn less than $90 a month; only 11% earn more then $500 a month. The poor are not well informed about AIDS. They are also less able to protect themselves against contracting the virus. Offering sex is sometimes a means to earnings or social acceptance. Poverty presents unique challenges to the control of AIDS.

Apartheid may be dead, but there is still mistrust between the races. Rumors are generated because of this. For instance, it has been held that the white man invented the disease, and it was not a threat, simply an attempt to get the black man to stop breeding. Other rumors about AIDS are rife, and do great harm to education initiatives. Beliefs exist such as: 'If you sleep with a virgin, you will be cured from AIDS,' and 'Virgins cannot get AIDS the first time they have sex.' To oppress the majority in South Africa, the old regime legislated to keep the black population uneducated. Many adults today do not know how to read or write. Education in this country is still in disarray. And the only way to make people aware of AIDS is to educate them.

The new and democratic government is also not without its faults when it comes to the fight against AIDS. Enormous challenges faced the new government when they were voted into power in 1994. And although recently has there has been a commitment from the new legislators to tackle the problem, advances in strategic policy development have been slow. These are just a few of the issues that complicate the South African situation. South Africa needs to overcome the AIDS threat. We are a developing nation. And our workforce, which we rely on, is already costing the country an enormous amount of money because of AIDS-related absenteeism. The cost of medication and the loss of breadwinners is also an enormous economic pressure that we suffer. This is going to get worse. Many people are HIV-positive, and the number of AIDS sufferers will increase.

Sadly, many children are being orphaned, resulting in added economic burdens. The number of orphans will increase. In 2005, it is estimated there will be 800,000 orphans under the age of 15. Caring for them will be an enormous challenge for South Africa. There is a risk that these children will develop antisocial behavior and become unproductive members of society. There is also an increase in the number of infant and child deaths. These deaths, and the diagnoses of HIV status, create major stress and depression in people, which compromises overall social functioning. And it is not only the HIV-infected individuals who suffer this psychological trauma; family and close friends are also deeply affected.

But it is possible for South Africans to overcome this challenge. In Uganda, President Museveni made a commitment to his people in 1987. He took a strong stand and led his country in an organized battle against HIV/AIDS. Since then, the prevalence of the virus has decreased from 26.8% to 9.8% in Uganda. How did he do it? He appealed to all sectors of society, including churches and other nongovernmental organizations, to play a part and get involved in the battle. A policy of nondiscrimination towards people living with the virus was enforced, encouraging people to care about their fellow man, and to get involved together in the fight. People carrying the virus were given courage to be open and to speak out about their sufferings. A 'behavior change' policy was promoted. In any society, it is usually easier to walk the known path and not consider change, but the Uganda initiative has proved that people and societies are capable of changes in behavior and attitude. South Africa seems to be taking a lesson out of President Museveni's book.

A strong initiative along the Ugandan lines has been launched to try and begin to solve the AIDS problem in the South African region. Called Love Life and funded largely by the Henry J. Kaiser foundation, it is organized under Mrs Zanele Mbeki as a national program of nongovernmental organizations in partnership. The organizations include the Department of Health, the National Youth Commission, UNICEF, other government agencies, and private-sector organizations. Among all the HIV/AIDS-affected age groups, the most affected are 15- to 20-year-olds, Love Life's target group. The primary goal is to positively influence adolescent sexual behavior to reduce teenage pregnancies, sexually transmitted diseases, and HIV/AIDS.

Let us hope that South Africans continue the long walk to freedom that Nelson Mandela began, and that we do not let AIDS re-shackle our enthusiasm and prevent us from moving forward. We have grown so much as a nation; now we need to rise as one and use this time as an opportunity to resolve our conflicts, understand our differences, learn to love and care for each other, integrate our welfare, and solve our social problems in a manner befitting our Rainbow nation, so that we can stop the spread of HIV/AIDS.

Corporate and Private Philanthropy Respond to AIDS in Africa
One of the most important results of the recent XIIIth International Conference on AIDS in Durban was the development of a more unified response to the AIDS problems facing Africa today.

The Bill and Melinda Gates Foundation, Merck & Co, Inc. and the Republic of Botswana have established the Botswana Comprehensive HIV/AIDS Partnership, an initiative to advance HIV/AIDS prevention, healthcare access, patient management and treatment of HIV in Botswana, a country where an estimated 29 percent of the adult population is HIV-positive. The Gates Foundation will dedicate $50 million over five years to help Botswana fundamentally strengthen its primary healthcare system. Merck and The Merck Company Foundation will match the Gates Foundation funding by developing and managing the program and by contributing antiretroviral medicines. This collaborative program is designed to demonstrate the benefits of a comprehensive approach to improving the care of people living with HIV in a resource-constrained countryan approach intended to provide a model for similar programs in other developing countries.

Also joining the partnership are Boehringer-Ingelheim and Unilever. Boehringer-Ingelheim will donate medication to prevent mother-to-child transmission of HIV infection, and Unilever PLC will contribute expertise in setting up distribution systems and public communications and awareness programs. The Gates Foundation and Merck will seek additional participants in the project. In a related announcement, the United Nations Cooperative Endeavor has brought together Merck & Co, UNAIDS, the World Health Organization (WHO), The World Bank, the United Nations Children's Fund (UNICEF), the United Nations Population Fund (UNFPA), Boehringer-Ingelheim, Bristol-Myers Squibb, GlaxoWellcome, and F. Hoffmann-La Roche to improve access to HIV/AIDS care and treatment in developing countries. This project is designed to reflect a common vision of how the HIV/AIDS epidemic can be more effectively tackled in such settings.