How AIDS in Africa was overstated (2)
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Hallo all,
I wish to thank Odutola for sharing with us the article on 'How
AIDS in Africa was overstated'. In as much as we must acknowl-
edge the impact of AIDS in Africa, it is important that we ob-
tain fairly accurate statistics on the same. We must appreciate
the fact that there is a lot of information now on control and
prevention not just for AIDS, but for many other diseases. The
consequence/impact of all these control & prevention efforts is
manifested on some of the disease indicators. For instance, to
evaluate the impact of control & prevention efforts, I believe
it would be more accurate to rely on the Incidence rates as op-
posed to Prevalence rates.
This article reminds me of a related aspect of self-reported ad-
herence with treatment in some research studies, especially on
overestimation of levels of adherence versus poor adherence.
What purpose/interests do these disease overestimates serve?
What are the consequences of such overestimates? When we over-
state/overestimate health problems and predict national catas-
trophes, we may achieve some tiny element of deterrence / behav-
iour change; but it may cause a lot of despair, fear and disil-
lusionment in a given population. People without hope can do
very little or nothing at all since they lose the sense of pur-
pose in life.
As for southern Africa being the 'absolute AIDS epicenter', this
calls for doubling of control efforts & information dissemina-
tion in the region. Success stories on the reversal of the AIDS
pandemic have been reported from some villages in Uganda.
Clearly, it is achievable with a multi-faceted approach involv-
ing all stakeholders, including the infected and those affected.
The current article also raises questions with regards to the
methods of data collection and representative sample popula-
tions. How can we justify that our health research is crucial as
a source of new knowledge; as a means of identification of
health problems and solutions; and as a means of implementing,
monitoring and evaluation of interventions if it is so biased?
Monitoring by the U.N. AIDS agency, which for years overesti-
mated the extent of HIV/AIDS in East and West Africa and, by a
smaller margin, in southern Africa, needs to be critically
evaluated.
It is true that there is need to strengthen and develop the
Medical records units in healthcare systems in African coun-
tries. This will enable accurate and easy health tracking which
will in turn provide concrete and reliable nationwide data.
Let us not lose hope and focus, let us all keep up the struggle
against AIDS and other diseases. The clear or accurate picture
is not necessarily the 'dark' picture, why always paint Africa
this way? Let us not run away from reality but at the same time,
let us not overstate/overestimate issues.
The time to retreat is not now, those overestimates should not
intimidate us!
Maurice R. Odiere
CDC-Entomology Section
P.0.Box 1578
Kisumu, 40100, Kenya
Tel (Office): +254-572022902
Cell: +254-721-845-777
mailto:modiere@ke.cdc.gov