Behind the story: The lingering effects of South Africa’s war on AIDS

After years struggling with the AIDS epidemic, South Africa has turned the corner. Fewer people are contracting HIV and treatments are making it so those who do get it can not only live full lives, but not pass it along to their children or partners.

We caught up with the Christian Science Monitor’s Jina Moore to ask her more about a cover story she did examining the lingering effects, and hidden dimensions, of the impact of HIV and AIDS on South Africa.

Readers meet Olga Thimbela, a woman who cares for her her nieces and cousins orphaned by AIDS. South Africa is in many ways a story of success, in terms of foiling a pandemic that once threatened to overwhelm the nation.

It’s difficult to resist the evangelism of South Africa’s good news on AIDS, and not just because there’s finally relief in a country that was the worst-hit in the world for so long. It’s difficult because South Africa represents what can be achieved around the world.

But it’s not an unmitigated success, free from ongoing tragedy and struggle. Thimbela’s challenges show what families must continue to endure. I asked Jina how South Africa found success and what readers should expect next as she reports from Congo, South Sudan and Rwanda in the coming months.

An accompanying video by Melanie Stetson Freeman:

Humanosphere: How has the recognition of the problem of AIDS by South African leaders helped reduce stigma?

Jina Moore: Well, moving beyond Mbeki’s early denials is obviously a big help. Edwin Cameron, now a justice at the Constitutional Court, was the first South African official to disclose his HIV/AIDS status publicly, in 1999. His (much-recommended) memoir is great for insight into the effects of denialism and the beginnings of change. Roughly ten years after Cameron’s disclosure, the President of South Africa (Jacob Zuma, by now) publicly discussed his HIV test results. That’s a huge change. It doesn’t eliminate stigma, but it does help break some of the taboos that contribute to stigma.

H: AIDS orphans are at times held up as the children in need of international adopting, but your story features a South African women with foster children. What are some of your observations regarding how communities in South Africa stepping in to care for children who lose parents to AIDS?

JM: It felt constant to me. If I said, “I met a woman who took in six AIDS orphans,” I was bound to be answered by, “Oh, have you heard of so-and-so? She took in such-and-such many kids…” There are two South African women in my story, one who raises six kids as her own and another who become a surrogate mom, with a non-profit organization, that helps out 2,200 kids through a child-headed household focus. And those were just the two I had the chance to spend some time with. The choices they made happened in many cases years ago — but it’s a choice they live every day, and will continue to. This was a lifetime commitment they made, and I hope it comes with a lifetime of public appreciation.

H: You talk a bit about Treatment as Prevention (TaP) and briefly mention behavior change. What are ways that groups are employing behavior change techniques to address the issue of AIDS in South Africa?

JM: Some of this is familiar, goes back several years, and includes abstinence, monogamy, and safe sex practices. There’s been a lot of progress regarding so-called “vulnerable groups,” in particular sex workers, men who have sex with men and intravenous drug users. And just a few days ago, the US Supreme Court struck down a plank of PEPFAR that required agencies using its funding to sign a pledge that they won’t “support” prostitution — a rule that had the effect of excluding sex workers from PEPFAR-funded interventions. So I’d expect the number of sex workers reached by HIV testing and condom distribution should increase.

H: What, from your reporting, has you feeling optimistic that we may be approaching the clunky phrased ‘beginning of the end of AIDS?’

JM: I’m not a doctor or a health specialist, but the fact that ARVs, when taken consistently and when CD4 counts are monitored and all that, make it virtually impossible to transmit HIV to your partner seems like a pretty big step. That those drugs are cheaper than they’ve ever been helps a great deal. The reports I read and the people I talked to said what you’d probably expect, but which is nevertheless a miraculous story, based on the sheer size of the epidemic: that where there’s access to treatment and to prevention, including prevention of transmission of HIV from pregnant or new mother to child, infection rates go down.

H: I know you have some more stories in you from the region, thanks to the IRP fellowship. Without giving away too much, what can we expect to read in the next few months by you?

JM: I don’t mind spoilers! I’ll be up in northern Rwanda, reporting on some innovative health infrastructure. Next month, I’m slated to be in South Sudan, looking at how the world’s newest country tackles building a healthcare infrastructure, and then I’ll be in Brazzaville, tag-teaming a story on maternal health with a brilliant Congolese colleague. I’ll also have a series of dispatches from the Great Lakes region on health issues, and I’ll be using short multimedia elements from my field reporting to give visual context and individual voice to the stories I get to tell. I’m pretty excited about that part, if I can keep all those darn WordPress plugins working right.

Follow along on Instagram, my blog, my Soundcloud, or my Twitter.  And join me and the five other IRP fellows in August for our next Tweet chat, on the role of digital media in news production and consumption developing countries.  Follow @irpchirps to keep updated!

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About Author

Tom Murphy

Tom Murphy is a New Hampshire-based reporter for Humanosphere. Before joining Humanosphere, Tom founded and edited the aid blog A View From the Cave. His work has appeared in Foreign Policy, the Huffington Post, the Guardian, GlobalPost and Christian Science Monitor. He tweets at @viewfromthecave. Contact him at tmurphy[at]humanosphere.org.