SUB-SAHARAN Africa, one of the world's poorest and least-educated
regions, has more than half the world's estimated 6 million to 8
million cases of AIDS, according to the World Health Organization
(WHO). Most of the 2 million women WHO estimates will die of AIDS in
this decade live in sub-Saharan Africa.
Some of the hardest-hit countries are in Central and Eastern
Africa. But in Zaire, a coordinated prevention campaign appears to
be making progress.
The challenge is great. Besides the large number of deaths they
attribute to AIDS, officials say the disease has serious economic
consequences as well.
A study in Zaire estimated that annual loss of income because of
illness was about $400 for an AIDS patient. (Per capita income in
Zaire was about $170 in 1988, according to the World Bank and the
Population Reference Bureau in Washington, D.C.) And since most
income earners in Africa support large families, a patient's
incapacity has an economic effect on many others.
With African economies practically stagnant at present, and
per-person spending on health care ranging from only $1 to $10 a
year, most African countries can not afford the extra burden of
medical care for AIDS cases.
At the same time, many African countries have been slow to
recognize the AIDS challenge and even slower to do something about
it. But a few, including Uganda and Zaire, were quick to acknowledge
the problem and are in the forefront in efforts to prevent the
spread of AIDS.
Prevention specialists in Zaire are claiming progress on two
fronts: greater awareness among the public about AIDS and changes in
sexual behavior that doctors say can reduce the risks of
"I feel progress is being made - a lot of progress," says Bill
Martin of the United States Agency for International Development
(USAID), an important funder of AIDS-prevention programs in Zaire.
"The average person who lives in Kinshasa, Zaire, knows more about
AIDS, how it is transmitted, how it is prevented, than the typical
American," Mr. Martin claims.
In one of the most extensive educational campaigns in Africa,
Zairians since 1987 have been blanketed with radio, television,
poster, drama, and brochure messages about AIDS and how to prevent
"We look for creative ways to reach people,' says Julie
Convisser, who heads a small AIDS-education team here for Population
Services International (PSI), a private organization based in
Washington. The program is funded by USAID.
DOCTORS say AIDS in Africa is most commonly spread through
heterosexual sexual relations, often outside marriage. (In the US
and Europe, on the other hand, experts say the disease has affected
primarily homosexuals and intravenous drug users.)
The message of many church-sponsored and other AIDS-awareness
campaigns is clear: The best prevention is premarital chastity and
marital fidelity. …