Gabon
Gabon awakes on failing AIDS prevention programme

Misanet.com / IPS, 12 February - Health officials here are only now waking up to the fact that the government's National Programme Against AIDS and Sexually Transmitted Diseases is not working. A recent report outlining that the disease is spreading quickly has them scrambling for solutions to the public health threat.

According to figures published by the Gabonese Ministry of Public Health and Population, one Gabonese citizen is infected with HIV every three hours, translating into eight new cases per day for a population of 1.2 million. 

More than half the Gabonese population lives in its capital, Libreville. The rate of infected people here has risen from 4.3 percent to 6.8 percent. There are almost 31,000 cases of infection in the 15 to 49 age group. "We can no longer close our eyes to the fact that the rate of infection is rising in Gabon and that each and every day, people are mourning more and more of their loved ones," said Dr. Julien Mezui of the National Programme Against AIDS and Sexually Transmitted Diseases (PNLS/MST). 

The PNLS/MST report, which came out last December, shows that 7.6 percent of Gabon's sexually active population (those 18 to 45 years old) is affected by AIDS. In 1998 the rate was only 1.8 percent. There are now three times as many carriers of the virus as there were two years ago. 

A true statistical picture indicating the scope of Gabon's AIDS epidemic was only belatedly made available. Officials at the Health Ministry seemed unaware of the danger it posed to the country's sexually active population. "Gabon is dying," stated Sidonie Siaka, the president of the Gabonese Association to Assist People Living With HIV and AIDS (AGAASS). 

Public opinion pins the blame squarely on the government. People here think the problem was intentionally ignored and that the government refused to take appropriate steps to counteract it. Although Gabon is one of the few sub-Saharan African countries to have had an AIDS policy in place since the 1980s for poor and at-risk people, the monies allocated to help those with the disease have been mismanaged. 

According to a report by the United Nations Development Programme (UNDP), health standards in the country remain only mediocre, and the report points to various inefficiencies in Gabon's health system. Health spending accounted for 54.4 percent of the country's budget in 1990, 60.5 percent in 1995, 57.7 percent in 1997, and almost 61 percent in 2000. But there has been no improvement in the Gabonese health system's delivery of services. 

The government belatedly enacted three emergency measures after the discouraging PNLS/MST report was published. In collaboration with the World Health Organisation (WHO) and the United Nations Joint Programme on HIV-AIDS (UNAIDS), the PNLS/MST has developed a multi-pronged plan to stop the disease's unbridled spread.

The government has also set up a walk-in treatment centre (CTA) which will open later this month. The centre will treat people who are HIV positive. The third emergency measure is the soon-to-be creation of a 1.4 million dollar therapeutic solidarity fund, provided in its entirety by President Omar Bongo.

If used efficiently, it could provide great hope for infected people who would otherwise be resigned to a sorry fate. There is much discrimination in access to anti-retroviral medications which slow the progress of the disease in humans. 

- Some sick people are able to get the expensive, appropriate treatment, while poorer patients must let the disease take its normal course, bemoaned Fernande Ossouami, a nurse at Libreville General Hospital. 

As people and public officials become more aware of the dangers of the AIDS pandemic, its impact is being felt within the family unit. "The family is the fundamental element of economic decision-making in Gabonese society," notes Lydie Martins of PNUD's Libreville office. 

- HIV-AIDS is going to reduce household income as it threatens the productivity of family members, added Martins. "To deal with such an impact, households are going to have to change how they bring in income, and could be forced, in some instances, to sell property to pay for medical care." 

Even though preventive measures have had some effect in Gabon, the present high rates of HIV infection and the long incubation period of the virus mean that the disease's economic impact will constitute a major obstacle to development in the years to come. "It's urgent that we take bold, unified action. We must use every means at our disposal to enact significant change in the sexual behaviour of young people," the Gabonese Minister of Public Health and Population, Faustin Boukoubi, said.

By Antoine Lawson, IPS

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