Joana Mangueira, Executive Secretary of Mozambique's National Council for the Fight against AIDS (CNCS), on Tuesday recognised that the anti-AIDS strategies followed to date have not succeeded in halting the spread of the lethal disease.
She was speaking at the start of a three day public debate in Maputo on prevention strategies.
"We want the debate we are starting today to extend to other parts of the country, with wide-ranging, democratic, frank and direct discussions that will allow us to identify the reasons why the strategies implemented so far are not having the desired effects", Mangueira said.
The increase in the prevalence of infection by the HIV virus that causes AIDS "is unequivocal proof that the efforts undertaken so far have not been effective". The latest figures from the Ministry of Health, announced in November, indicate that 13.6 per cent of the population aged between 15 and 49 is infected with HIV. In parts of central Mozambique the situation is much worse than the national average: thus HIV-prevalence in Sofala province is estimated at 26.5 per cent.
Mangueira express particular concern about the spread of the disease in rural Mozambique where "sporadic and superficial consciousness raising activities about HIV/AIDS are not reaching the objectives we are all trying to attain".
As elsewhere in the world, the Mozambican AIDS prevention campaign stresses abstinence from sexual activity (particular for the young), faithfulness to a single sexual partner, and the use of condoms.
But when AIDS activists raise these issues with the public, "we are dealing with a controversial and sensitive topic", Mangueira said, "because we don't all view sexuality in the same way. What is wrong for some people may be regarded as correct by others, since sexual conduct is not just biologically and psychologically determined. It is also influenced by values, beliefs and behaviour that varies in accordance with the cultural standards of individuals".
But the message would have to be transmitted despite cultural differences, "because we are surely all in agreement that the preservation of life is intrinsically linked to health, and in this case sexual health".
"HIV penetrates our bodies silently", Mangueira warned, "but when it expresses itself, it is violent. It destroys the fabric of families, it increases the number of orphaned and vulnerable children, and of prematurely aged and fragile widows, as well as the deaths of children and of young people".
"All this makes the problem of eradicating poverty still more difficult, and seriously compromises our economic development plans", she said. "But we have no choice but to attack this evil with the same force that it is attacking us".
In the ensuing debate, journalist Salomao Moyana, editor of the weekly paper "Zambeze", pointed out that AIDS is killing more Africans than all the armed conflicts plaguing the continent put together. Since Mozambique does not have the financial or material capacity to make anti-retroviral therapy available throughout the country, prevention must remain the main thrust of any anti-AIDS campaign, Moyana stressed.
He took the common sense view that people must be allowed to choose how to protect themselves. No single member of the trio of abstinence, faithfulness and condoms must be imposed. "Give people the information, and let them choose", urged Moyana.
He insisted on the need for cultural sensitivity, pointing out that in parts of rural Mozambique sending women to teach men, or men to teach women, about aspects of sexual health would simply not work.
Cultural producer David Abilio noted that many Mozambicans still explain diseases, and not merely AIDS, in supernatural terms. There was still a prevalent belief in supernatural forces that could be manipulated by particular individuals.
In such a belief system, AIDS was the work of malignant spirits, and could be cured by driving the spirit away. But about 57,000 people died of AIDS in Mozambique last year, and Abilio thought it crucial to persuade the public that these deaths "have nothing to do with supernatural forces".
He criticised those in the media who have given credibility to charlatans who claim to cure AIDS. The main culprit here is Moyana's paper - "Zambeze" has run a string of uncritical articles, interviewing people calling themselves "traditional doctors", and claiming to possess roots and herbs unknown to science that will cure AIDS.
As was to have been expected, a couple of religious voices from the floor denounced condoms, but the reaction from the audience made it clear that this was a minority opinion.
Fonte: AIM
