Magazine 雜志：An HIV/AIDS success story

Number of people living with HIV/AIDS in 2004: 39.4 million

Deaths from Aids in 2004: 4.9 million

Children (under 15) with Aids by end of 2004: 2.2 million

The West African Republic of Senegal has a population of 10 million (95% Muslim) and there are about 80,000 cases of HIV/AIDS in the country. It seems like a large number but in fact, at about 2% of the population, it's very low in comparison to other countries. And this percentage rate has not increased for the last ten years. The United Nations recognises this success and has named Senegal, the Philippines, Thailand, and Uganda, as countries which have done the most to fight HIV/AIDS.

How has Senegal achieved this?

The political stability of the country over the past few decades has been an important factor. But what other things may have contributed to this success story?

Social and religious values

There is no doubt that social and religious values are an important factor. The Senegalese culture is traditional and religious belief is strong. This means that there is less sexual activity outside of marriage than in many societies. And many young people still believe in the traditional values of no sex before marriage and being faithful to your husband or wife.

Breaking the silence

Many nations in the world have strong religious and social values, but the Senegalese government decided early on that the subject of HIV/AIDS must be discussed openly. Political, religious and community leaders could not treat it as a taboo subject. This wasn't easy. Speaking openly about the use of condoms means accepting that people may have sex outside of marriage. Religious leaders spoke about HIV/AIDS and condoms in the mosques. They still talked about sexual abstinence and fidelity as the best way to avoid becoming infected, but they also recommended condoms for those people who were not going to abstain from sex.

The National Plan

The National Plan to Fight HIV/AIDS was already in operation in 1987, less than a year after the first cases were diagnosed in Senegal. Its aim was information, education and prevention and it was the first such campaign in Africa. A compulsory class was introduced into the national curriculum in schools. Private companies were encouraged to hold classes for their workers. The government gave the campaign strong support and a regular budget and the religious leaders became strong supporters too. Senegal has a long tradition of local community organisations and there were marches and workshops all over the country. High-risk groups such as sex workers, soldiers and lorry drivers were specially targeted. Women were particularly important in this process. Senegal recognised that women need more than education and condoms. They need to have the economic and social power to say 'No' to unprotected sex. Many young, popular musicians also became involved in the campaign reaching young people all over the country.

Sex workers

Prostitution was legalised in Senegal in the 1960s. Sex workers were registered and had to have regular medical check-ups. Anyone who was suffering from a sexually transmitted disease was treated free of charge. This system gave Senegal two big advantages in the war on HIV/AIDS. Firstly, it wasn't too difficult to extend the system of testing and treatment to HIV/AIDS. And secondly, the fact that sex workers were registered and known to the authorities meant that it was easy to reach them with education programmes. Many prostitutes themselves became involved in educating other women, and distributing free condoms. Twenty years ago fewer than 1 million condoms were used in Senegal. Now the figure is more than 10 million.

Safe blood

In 1970, Senegal began testing all the donated blood in its blood banks. So, unlike many Western countries, infected blood transfusions never caused the spread of the virus.

International scientists

Senegal has HIV/AIDS scientists who are known and respected all over the world. Professor Souleymane Mboup, is a world-renowned AIDS researcher. He is most famous for his work on documenting HIV2, a strain of the AIDS virus which is common in West Africa. Professor Mboup is in charge of his country's National AIDS Programme. He co-ordinates the Convention of Research between Senegal and Harvard University in the United States. He also works with the African AIDS Research Network.

The future

So far so good, but Senegal itself knows that it still has a long way to go. The biggest challenge is to hold on to what has already been achieved. Many experts are afraid that this initial success will spread a false sense of security and people will become less careful. One problem is that Senegal is a regional crossroads. Many men go to work in neighbouring countries and return infected with the virus. There is still a great deal of poverty in the country and many people cannot read or write. HIV/AIDS grows well in these conditions. Large numbers of prostitutes are working secretly without registration. Many sex workers cannot afford to refuse customers who don't wear condoms. And if women had more economic power they would not have to turn to prostitution to feed their families in the first place.

So Senegal must continue with the work. And maybe we can all learn a little from what the country has achieved so far.