October 2001


Editorial from the Times-Picayune

On a continent that is being ravaged by AIDS, the west African nation of Senegal has handled the epidemic admirably. Leaders there have managed to keep the infection rates low despite high rates of illiteracy and poverty, and they have successfully encouraged the use of condoms among a population that is predominantly religious.

While other African heads of state were debating whether HIV causes AIDS or whether the disease would infect anybody other than gay men, the government of Senegal was going about the much more important business of protecting its citizens from the virus.

The government began sponsoring an HIV prevention program in 1987, within a year of its first three known HIV cases.

Fourteen years later, fewer than 2 percent of the Senegalese are infected with HIV. Compare that rate to Botswana where more than 33 percent of the adult population has the virus. In South Africa, 20 percent have been infected.

In all, there are 36 million people infected with HIV worldwide. Africa has 70 percent of them.

Yet the Senegalese government has demonstrated that an aggressive education program can be effective, no matter the demographics of the country. Nearly two thirds of Senegal's 10 million people are illiterate, but the classes showing women how to use a condom have worked.

As early as the 1980s, the leaders of Senegal secured the nation's blood supply to make sure that the virus would not be transmitted through blood transfusions.

Unlike Thabo Mbeki, the president of South Africa who has described HIV medications as poison, the elected government in Senegal negotiated cheaper medicines for its citizens. Also, religious leaders talked about the disease in their mosques, teachers talked about it in their classrooms and the government required all its registered prostitutes to get annual tests for HIV.

It is obvious that health officials in Senegal have chosen to make the health of their citizens a priority even when they've run the risk of making controversial public policy decisions.

Health officials now worry that they will become a victim of their own success, that because the nation has done such a good job keeping the HIV rates low, the Senegalese will become complacent and not be as vigilant in preventing the disease.

American health officials have the same concerns about people here. The number of people contracting AIDS has been declining since the early 1990s, but now the decline is leveling off and epidemiologists worry that with the introduction of new drugs that manage the symptoms, Americans are no longer as afraid of HIV as they should be.

A healthy fear and vigilance are still necessary, as well as a worldwide educational campaign. Some African heads of state complain that they can't successfully combat AIDS because their citizens are too poor or too religious or too patriarchal or because their countries lack sufficient infrastructure to distribute medications. But Senegal has been successful despite those obstacles, so now the question is: Why can't others?