Friday, February 7, 2025

AIDS at the UN General Assembly makes us Relevant

The 73rd session of the UN General Assembly (UNGA 73) opens on 18th September 2018 in New York City, and His Excellency the President Mokgweetsi Eric Keabetswe Masisi will feature on the 27th. An eloquent man he is, there is no doubt he will articulate the nation’s priorities and aspirations in the most persuasive approach as to grip the attention of the world body. After all, President Masisi has warmed up to such sophisticated audiences after the previous administration delegated him on several occasions. Arguably, the President always has an ace up his sleeves, and we cannot expect anything less in the upcoming weeks when he speaks on behalf of this Republic that entrusted its care in his hand since April 01.

Against a backdrop of a well thought-out theme; ‘Making the United Nations Relevant to All People: Global Leadership and Shared Responsibilities for Peaceful, Equitable and Sustainable Societies’ as announced by the Assembly’s President-elect Mar├¡a Fernanda Espinosa Garc├®s, our President would articulate with ease, the most pressing health challenge since 52 years ago, when we became independent. AIDS is by far that number one challenge and associated with its debilitating aftermaths, other non-communicable diseases such as cervical cancer among women and kaposi sarcoma among men are all too common. About 60 percent of HIV positive females end up with cervical cancer, while about 40 percent of males who are HIV positive end up with the cancer of the skin (Kaposi sarcoma). These health realities make us unique from the rest of the sub-Saharan nations. There is no denying that we have a myriad of challenges, but President Masisi should highlight those that pose a security risk to the nation of Botswana if left unchecked, or if the international community ignored to collaborate with Botswana to combat in a collective effort. The HIV situation to date, despite the trailblazing prevention interventions that have been emulated elsewhere in sub-Saharan Africa, continues to bear its burden on the taxpayers. 

Citizens in their prime and in whom the government has invested generously over the decades, continue to die of AIDS. As a nation, we have come far since the late 1990s confronting the scourge of AIDS through rigorous prevention messages from the ‘ABC’ to ‘SMC’ campaigns, yet we continue to register high incidences especially among the adolescent population, who either do not get the risk element in the prevention strategies that are echoing in the mass media, or their ‘invincible’ spirit pushes them to ignore the life-saving themes. Unless the scenario is reversed, as a nation, we are sitting on a ticking time-bomb that is waiting to explode in our faces, when our young people cannot transit into adults of tomorrow to lead Botswana to posterity.

The President must ring the bell loud and clear. In doing so, His Excellency needs to articulate how as a nation, we have come of age confronting the scourge by using the universally accepted and medically-sanctioned prevention strategies that view AIDS purely from the Western point-of-view, while consciously dismissing anything that is indigenous as ‘superstitious’ without subjecting such perspectives to any confirmation. Prevention methods that do not blend with cultural practices or that ignore the significance of customs and the impact they have on the attitudes and behaviours of individuals as well as their belief systems, all risk to leave no desired impact in as far as reducing the rate of new infections as we are seeing currently with campaigns such as the popularized male circumcision, condom use, and adherence to treatment.

All too often, our people are misinterpreting these prevention interventions as bulletproof against new HIV infections and surely, the ill-equipped media practitioners who misreport on these strategies inadvertently paint the picture that the wider population may misconstrue to be safe strategies. It is too common these days to hear the refrain; “AIDS is just like other chronic diseases”, implying that there is a treatment if one is infected, as opposed to the dark period when it was viewed as a ‘death sentence’. This complacency is too dangerous and reckless for our young nation and small population. While it is true that treatment provides some prevention if there is adherence to the anti-retroviral therapy (ART), we know also that it is impartially true that treatment only prevents insofar as to suppress the virus but not to cure the sick, making the risk of passing the virus to an uninfected partner high enough if there is unprotected sex between partners.

Similarly, the glamorization of safe male circumcision in which the vibrant “Mchiwawa” is celebrated by his peers after a six-week healing period wherein he displays his freshness is another risk factor in an already packaged concept of prevention that we the developing nations embrace without customizing to our own contexts to determine its practicability. For starters, Botswana, unlike other sub-Saharan Africa where circumcision is widely practised, the majority of tribes would find such a practice to be alien. But even more worrisome from this jingle playing out in the radio is how it ignores the 40 percent that is the risk element that circumcised males have to contract the virus that causes AIDS, whether they feel fresh or otherwise. Circumcision cannot guarantee safety against HIV, this is a highly communicable and incurable infection.

But when there is wide misreporting on such important global issues such as HIV, these messages which intersect with society and culture, influence risky behaviors that mirror the level of understanding and unwittingly, fuel the spread of the epidemic. Especially for a country that has waged a vigorous war against HIV since the early 2000s, our prevention messages must be embedded in the cultural nuances so as to strike a chord with the target populations, rather than to embrace that which is imposed on a distinct people with unique practices that influence behaviours and attitudes around sexuality. Botswana’s status as the number three world’s highest HIV prevalence (18.5%) is a disturbing trend for a country that boasts the best prevention strategies and unrivaled treatment program across sub-Saharan Africa.

From the above premise, the rising levels of HIV among the sexually active populations (15-49) might owe to the pre-packaged universally accepted themes without adapting them to our own environment to reduce ambiguity or lessen risks associated with misinterpretation that influences undesirable behaviours and resulting in new HIV infections. According to the National AIDS Coordinating Agency, the adolescents registered 1.35 percent of new infections in 2017. Botswana is position nine among the world’s top-ten hardest-hit nations by AIDS mortality, according to UNAIDS; and all worst-hit nations are in sub-Saharan Africa, a trend that reveals that the universally accepted ‘they-fit-all-contexts’ prevention interventions have not provided the much-needed solution.

President Masisi must make an appeal for prevention strategies to fit peculiar contexts, rather than to place an exclusive premium on the current interventions to communicate effectively to a society that views life as “communal” as opposed to “individualistic”. For sub-Saharan Africa, instead of messages that promote “I”, HIV-prevention interventions should promote “we” and remain culturally sensitive to relate to the society in which every member is, but a “part of the body” that needs to function collectively to marshal resources that can stamp out the scourge.

In conclusion, the interventions thus far, reveal the long distance we’ve covered, yet the required innovation to push forth and win the war against AIDS. Speaking AIDS will most definitely fit perfectly into the theme of the UN General Assembly to make the international body relevant to every member state.

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