U.N. Hails Senegal as African ‘Success Story’ in Fight Against AIDS

The West African nation of Senegal, which boasts an HIV infection rate of only 1% among adults, has been "hailed" by the United Nations as a "success story in the fight against the spread of HIV," the Los Angeles Times reports. Senegal has "tackled the HIV/AIDS problem head on," according to U.N. officials, unlike other African nations such as Kenya, which "only" in November 1999 declared AIDS a "national disaster." Although Senegal's record on HIV is not "perfect," the country's success in fighting the virus gives officials "reason for hope." Zephirin Diabre, associate administrator of the U.N. Development Program, said, "The main responsibility is (with) the Senegalese people themselves. What they have done proves that where there is a will to achieve, it can work." That willingness has come from all sectors of society -- the government, religious institutions and nongovernmental organizations -- that have been unafraid to "break taboos and become vocal about the threat," U.N. officials said. After the nation's first six HIV cases were identified in 1986, the government "swiftly" adopted a program to "protect the population" and established a system for screening donated blood by the following year. Condom promotion has resulted in an 11-fold increase in usage from 700,000 in 1988 to eight million in 1997. "Conservative" Islamic leaders have also joined the fight, making AIDS a "regular topic" at Friday sermons throughout the country, which is more than 90% Muslim. Religious leaders say they encourage abstinence but "acknowledge the importance of dispelling myths" about HIV/AIDS. "We go around informing and educating Muslims that it is a disease, just like any other, so a person who has AIDS must be accepted and cared for," Imam El Haji Ousmane Gueye said. Sex education has also become part of the national curriculum, "[c]ontrary to the practice of many conservative African nations." At the port in Dakar, the nation's capital, authorities and NGOs have worked together since 1995 on an information campaign aimed at dock workers. They created condom distribution points and distributed "bundles of literature," helping to decrease the STD prevalence from 3,926 reported cases in 1995 to 652 in 2000.

Taking Advantage of the Discounts
Senegal was also the first nation to "successfully negotiate" with major drug companies for the 90% discount in antiretroviral medications that was proposed last May. In order to qualify for the reduced prices, Senegalese officials had to "prove [the country] had personnel trained to make use of [the drugs], set in place a mechanism for managing the purchase and ensure proper monitoring of patients," according to the country's leading AIDS specialist Souleymane M'Boup. But so far the drugs' impact has been "small," reaching only 130 of the "most critical" cases. The drugs are also not free. Depending on income, patients may pay up to $100 a month for the medications.

Room for Progress
Despite the apparent successes, officials say work remains to be done. Prostitution and cultural practices such as polygamy and wife inheritance complicate prevention efforts. Prostitution is "officially tolerated and primarily driven by poverty." Senegal registers and tests sex workers and condoms are supplied "on demand," but prostitutes continue to account for the "highest number" of HIV/AIDS cases. Programs to help women find new careers exist but have made "scant progress" because the lure of money from sex work is strong in a nation where per capita income is less than $600 a year. Polygamy and wife inheritance, in which a widow marries her deceased husband's brother or close relative, have also "obstructed" Senegal's progress, particularly because the "stigma of living with HIV/AIDS is so great that few are willing to publicly admit that they are infected or that a relative might have died from the disease." AIDS is an issue which is "taboo despite all the information campaign[s]. It's very difficult to share that kind of information. That's why it's important to encourage different types of behavior and encourage people to speak out," Ali Ba, who is HIV-positive and runs an AIDS support group, said (Simmons, Los Angeles Times, 3/9).