Kaiser Daily: HIV/AIDS Report Monday, 21 May 2001
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Politics and Policy
*Powell Embarks on Eight-Day Tour of Africa to Address Strategies
to Tackle HIV/AIDS
* OPINION HIV Prevention Programs that Focus on Sexual Behavior
Will Fail, The Nation Contributor Says
* Focus Prevention on Poverty
POLITICS & POLICY
Powell Embarks on Eight-Day Tour of Africa to Address Strategies
to Tackle HIV/AIDS
Secretary of State Colin Powell tomorrow embarks on an
eight-day trip to Africa, where he will speak to political leaders
about strategies to combat the AIDS epidemic, the Washington Times
reports. The trip is scheduled to begin in Mali, where Powell will
meet with West African leaders, including President Alpha Oumar
Conare, head of the Economic Organization of West African States,
which runs a peacekeeping operation in Sierra Leone. In Mali, Pow-
ell will "observe" the country's efforts to prevent the spread of
HIV, such as a joint project with NIH. Powell then heads to South
Africa, Kenya and Uganda, where he will review trials of new AIDS
vaccines (Barber, Washington Times, 5/21). Powell's trip marks
the earliest visit made to the continent during a secretary of
state's tenure (Strobel, Philadelphia Inquirer, 5/21). Powell
said, "I have a personal interest because I am an African-
American. But beyond that, perhaps the greatest disaster on earth
is unfolding in Africa: AIDS. So it seemed to me that I should go
to Africa early on" (Washington Times, 5/21). Susan Rice, assis-
tant secretary of state for Africa in the former Clinton admini-
stration, said Powell's trip is a "welcome sign" that the Bush ad-
ministration is "at least investing in symbolism and trying to
give the impression that Africa is of significance to them," add-
ing, "The real question will be whether they go beyond symbolism
to substance" (Philadelphia Inquirer, 5/21).
OPINION HIV Prevention Programs that Focus on Sexual Behavior
Will Fail, The Nation Contributor Says
AIDS prevention programs, particularly those in Africa,
that focus on HIV transmission as an issue of sexual behavior in-
stead of considering "biological factors that result from poverty"
have failed and led to the "perpetuation of racial stereotypes,"
Gettysburg College economics professor Ellen Stillwaggon writes in
The Nation. Instead, what is needed is an "interdisciplinary ap-
proach that incorporates biological and social data into an analy-
sis of the social context of HIV disease in Africa," according to
Stillwaggon, author of Stunted Lives, Stagnant Economies: Pov-
erty, Disease, and Underdevelopment. She asserts that "sexual be-
havior alone cannot explain HIV prevalence as high as 25% of the
adult population in some African countries and less than 1% in the
United States." Further, there are "significant levels of unpro-
tected, multipartnered sex in the United States and Europe," but
no corresponding "heterosexual epidemic of AIDS" like that in Af-
rican nations, Stillwaggon says. "Treating African AIDS as a spe-
cial case caused by a hyper sexualized culture obviously rein-
forces racist stereotypes and pessimism over Africa's future," she
adds. Such a focus also "pushes AIDS policy to an almost exclusive
reliance on behavior modification and condom use and away from
general health and nutrition, and it gives us little preparation
for similar epidemics that are now incubating in South Asia and
Latin America."
Focus Prevention on Poverty
Instead, Stillwaggon proposes that prevention programs ex-
amine the culture of impoverished nations and praises South Afri-
can President Thabo Mbeki for questioning how poverty in Africa
affects the development of HIV/AIDS there. She says that "pre-
existing health conditions play a key role in susceptibility to
disease," adding, "We should expect HIV/AIDS to develop differ-
ently in rich and poor countries, just as do tuberculosis, pneumo-
nia, measles and nearly all other infectious diseases." Popula-
tions in poverty are "characterized by malnutrition, parasite in-
fection and lack of access to medical care and antibiotics for
bacterial STDS" -- the "biological conditions for greater suscep-
tibility to infectious diseases," Stillwaggon says. HIV prevalence
is "strongly correlated with falling protein consumption, falling
calorie consumption, unequal distribution of national income and
... labor migration," she adds. Stillwaggon notes that prevention
programs that focus on the "synergistic relationship among malnu-
trition, parasite infestation and infectious disease" do not deny
that HIV is an STD or that it causes AIDS. She concludes,
"Strengthening immune systems will help to protect people from
some of the consequences of unsafe sex and from other infectious
diseases as well" (Stillwaggon, The Nation, 5/21).
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