HIV/AIDS in Sub-Saharan Africa

It`s evident that, nowhere on the globe are the public health challenges more prevalent than sub-Saharan Africa. Though, this region adds up to just about 13 percent of the total world population, it still carries a greater percentage of the disease (24 percent). Notably, the Continent`s deep rooted disease burden alongside the frail health systems are attributed to underdevelopment, conflicts, poverty, and poor governance. Thus, the complex interrelated challenges have eventually demanded sustained patience as well as integrated responses. This paper examines in detail the HIV trends and risk factors in the sub-Saharan Africa focusing on contributions of public health, prevalence, risks alongside the strategies and programs needed to put the matter to rest.
To begin with, sub-Saharan Africa is and in the foreseeable future still remains an enduring preoccupation and the target of world`s public health policies and interventions. In the recent past, the global HIV/AIDS pandemic had spurred a historical and unprecedented mobilization of great attention and resources trickling down to Africa. Indeed, HIV/AIDS has led to the emergence of global institutions such as, UNAIDS alongside the Global fund intended to fight AIDS, tuberculosis, and malaria (Anupah, 2009). The response of the United States to the scourging HIV in Africa, notably the pandemic epicenter, gained momentum in the late 1990s. This accelerated quickly during the George Bush Administration. The president`s emergency plan for AIDS Relief was formally announced in 2003 (Jennifer, 2009). It majorly focused on Africa, henceforth benefiting from the direct, personalized engagement and the leadership of the president, this eventually broke through the earlier on perceived skepticism. Currently, global attention to HIVAIDS alongside other infections disease in Africa has unquestionably realized concrete benefits in health.
Furthermore, massive international mobilization on HIV/AIDS has led to improved results in Africa. Notably, UNAIDS, points it out that, the national epidemics in the sub-Saharan Africa is stabilizing although still at unacceptably high levels. This region still remains among the places greatly affected by the scourge. Indeed research has shown that 67 percent of the people infected by HIV worldwide live in Africa, with 75 percent of the annual global deaths occurring in Africa. These studies further indicated that, there were about 70 percent of new infections in 2007, where about 90 percent of children living with AIDS were African, it was further indicated that about 90 percent of the new infections occurred among the African children while women accounted for about 60 percent of the new infections (Jennifer, 2009). Research findings have also indicated that, the epidemic varied significantly across the continent. For instance, West Africa had low prevalence`s as compared to other regions and subsequently has seen declining or continued slow rates. In East Africa, the epidemic appeared to be reaching a plateau. However, there has been disturbing indications of increased risk taking among the youth populations. While the epidemic in southern Africa appeared to be stabilizing, East Africa region still remained to be acutely affected, and home to the highest HIV-prevalence rates in the world. (Figueroa, Kincaid, Rani, & Lewis, 2002)
Today, antiretroviral treatment is offered to the majority of the infected in Africa, this has been in greater numbers than it was thought probable at the beginning of the decade. However, these treatments still remain out of reach to the some of those infected. The world health organization (WHO) points it out that, just about 30 percent of those in dire need of the treatment eventually get it, and still, low cost treatments of opportunistic infections remained unavailable to the majority of the Africans infected with the scourge. In 2008, a number of studies suggested that, ART was to be optimally initiated before a patient`s CD4 had fallen to 350. Thus, if this was to be adopted as international guidelines, an additional 1 million Africans will be in need of treatment (Johns, 2007). Considering that ART has to be sustained throughout a patient`s life, the African medical systems were more likely to be overburdened. Of concern too, were the added costs and complexity arising from the treatment of HIV patients who had developed resistance to antiretroviral drugs. As widely cited, South Africa exhibits a wide gap between new HIV/AIDS infections and prevailing efforts for prevention. In this country, new infections overstretch the access to treatment, and further estimated that for every individual in accesses of treatment, there were three to four persons reported to be newly infected. Furthermore, it has been pointed out that financial resource projections required to sustain the scale up in treatment couldn`t meet the increased growth in new infections. And that this was only probable if the incidences of HIV were greatly reduced. To add on that, World Health Organization projected that, only 9.5 women and 7.9 percent of expectant women living with HIV were on ART, to prevent mother to child infection.
The setbacks observed recently in the vaccine alongside the obstacles encountered in the cultural and health system involving the expansion of the male circumcision, clearly reflects the need for the creation of more effective outreach and up scaling of the tested HIV prevention interventions, such as, provision of free testing, availing condoms, championing for behavioral change, as well as, airing programs that reach out to empower women to be better negotiators in matters of sexual contact. Notably, South Africa has the highest incidences, prevalence, and the death rate per capita globally. Mozambique and Zimbabwe were ranked second and third. In addition, the rising cases of multi- resistant tuberculosis and drug resistant tuberculosis could have gone unreported. With most of the cases believed to arise due to the non adherence to the Tuberculosis therapy, deeper investigation have revealed that the fatal outbreak of the multidrug- resistance cases were attributed to the re-infection with the resistant strain of tuberculosis. These findings clearly indicated that the primal treatment provided wasn`t adequate. Since most of the patients were already co infected with Tuberculosis and HIV/AIDS. Indeed, the combination HIV infected population with poor tuberculosis treatment rates, limited drug-resistance testing, and absence of air bone infection control, alongside the overburdened Tuberclosis treatment programs provided ideal conditions for the increased prevalence of the different strains.
HIV/AIDS and TB required a more integrated approach towards their treatment, better airborne infection as well as, incorporation of proper testing and surveillance systems of drug resistance. Despite the increased resource allocation made in the past decade to curb HIV together with other infectious diseases, these resources will eventually reach a level of diminishing marginal returns, when proper public health capacity is not put in place. Currently, there is a widespread awareness of the need for stronger health systems, however, it is has been difficult to gain support for such programs as opposed to the rapid disease interventions techniques employed. Notably, these interventions presented quick tangible results. Precisely, having stronger health systems, and devising effective measures of results as well as minimization of wastes were presumably had to achieve. Thus, in solving this issue, leaders in power within Africa, the United States and in a broader perspective the international community, have been obliged to ensure proper investments in the health systems. This wills eventually lead to solving of African challenges.
Implementation of skewed disease programs, limits people to the wide range of basic health services available. In the event, a rise in disturbing effects over time, and this further reinforces the health inequalities henceforth undermining the broader efforts. For instance, in Nigeria rural imams obstructed the donor funded polio eradication campaign, eventually causing a fresh outbreak of diseases which spread to other regions such Sudan and Kenya. With proper coordination, and better procurement networks as well as extensive outreach, better opportunities can be realized. However, it is important that sustained patience in investments which are the pillars of the health system be fostered. These pillars include, proper public information and surveillance, adequate human and proper physical health infrastructure, proper health financing alongside good leadership and health policies.
Looking at the health policies presented, Africa forms part of the wider array of challenges experienced. It`s important to note that, these challenges are intertwined with the well being and health of an individual. Thus, failure to address these issues eventually puts earlier investments in a health risk. Considering that we live in a world comprising of unlimited resources, it warrants a major mobilization of adequate funding and attention (Susan & Rupali, n.d). According to the current global financial constraints, United States, donor countries as well as, Africa partner states should manage and coordinate their efforts precisely in order to ensure that no one within these r is regions is hurt. Further on, for opportunities related to health issues to be felt, a proper balance needs to be in place. Occasionally, a number of challenges are experienced by African countries namely, gender inequities and norms, poor water and sanitation, poor nutrition, impoverished infrastructure alongside the emergency of the complex post conflict issues. It`s arguably that, Africa was greatly hit by the global economic recession. This put to risk the segments of the already impoverished continent. Indeed, their health budgets were prone to the deep cuts of the recession. As a result of this, HIV/AIDS pandemic created wide domestic constituencies. These units were majorly sensitized to the health challenges and have deemed it as a moral obligation of the United States.
In conclusion, research carried out has revealed that, HIV/AIDS in the sub-Saharan Africa still remains to be a major problem. This has been attributed to the poverty levels, high illiteracy levels, poor health facilities as well as, poor governance among other factors. Thus in order to arrest this issue, it is important for the African leadership to encourage proper health governance, also encouraging coordinated collaboration and burden sharing among nations. Moreover, developed world Nations should develop a proper response mechanism to the African health issues. Also there should be proper integration of the health and other developmental challenges, and lastly the United States among other developed nations, should offer proper attention in the emergence of complex health issues among the fragile states.
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