- Against all odds, HIV prevalence rates in Malawi have dropped significantly during the last few years, indicating the country can avoid the pandemic spread of AIDS experienced by other Southern African countries. Openness and public education are seen as the main reasons for success.
When Pastor Gilbert Momola told the audience at Civo Stadium in Malawi's capital, Lilongwe, that he was HIV positive, he touched the hearts of many, including that of retired Zambian president Kenneth Kaunda. "Such openness is one of the tools with which to reduce the prevalence rate among our people," said Mr Kaunda, who has been an icon in the fight against the pandemic since the death of his 30-year-old son from an AIDS-related illness.
"When my son died of AIDS in 1986, we made it a point as a family to tell the world that AIDS is real, and that there was a need to speak openly about it if we were to save lives," ex-President Kaunda told the audience at the Annual International AIDS Candlelight Memorial Day on 18 May.
Mary Shawa, Malawi's secretary for HIV/AIDS and nutrition in the Office of the President and Cabinet (OPC), announced recently that Malawi's HIV prevalence rate had dropped to 12 percent in 2007, from 14.4 percent in 2004.
"We have moved from a society where there was a lot of stigma and discrimination to one that is accepting those that are living with HIV and AIDS, and for a reverend to talk about his sero-status so openly means that we have made a breakthrough," Ms Shawa told the UN media 'PlusNews'.
Apart from greater openness, she attributed Malawi's success in reducing its HIV prevalence to higher levels of testing and successful education campaigns. Civil society groups have also played a significant role by speaking openly about AIDS, and the importance of faithfulness and being tested, and talking about treatment to groups at schools, churches and public places.
Despite a dire shortage of health care workers, Malawi has also managed to increase the number of people on life-prolonging antiretroviral (ARV) drugs from around 70,000 in 2006 to 150,000 in 2008. The National AIDS Commission (NAC) aims to have all 240,000 Malawians in need of ARVs on treatment by 2010.
Ms Shawa pointed out that another important area to which Malawi has managed to channel scarce resources was improved nutrition for people living with HIV. "In Malawi, the pandemic is basically intertwined with nutrition and we tell people that taking ARVs without nutritious food does not help much." A government programme distributes food parcels containing cooking oil, beans, groundnuts and flour to malnourished people living with HIV.
However, many challenges remain. Justice Anastazia Msosa, chairperson of the Malawi Network of People Living with HIV and AIDS (MANET+), said one of the biggest challenges to Malawi's anti-AIDS efforts was inadequate human resources in the health care sector.
International donors and government have poured millions of dollars into the AIDS programme, but efforts to increase access to HIV testing, care and treatment have been hindered by the movement of health workers to Europe and other parts of the world. Although the country trains close to 80 nurses a year, analysts estimate that around 100 others leave annually.
Malawi has appealed to Britain not to employ its nurses and doctors, but efforts to completely halt the exodus are yet to start paying dividends. Dorothy Ngoma, president of the Nurses and Midwives Association of Malawi, said nurses were leaving in search of higher pay. "There is also a need to improve working conditions for nurses if they are to remain in Malawi."
It is estimated that 64 percent of nursing posts, and 33 percent of all health care posts, are vacant. The number of doctors working in the public health sector is one-sixth of that recommended by the World Health Organisation.
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