Professor Hoosen Coovadia, a leader in maternal, newborn and child health, said that understanding the underlying social and political problems was key to curbing the tide of the HIV/Aids epidemic.
He said this in a lecture entitled “HIV and Aids and children’s health: What mistakes have we made and how can we create a better future for all children in this country?” at Rhodes recently. It was part of series on HIV/Aids in the post-Mbeki era.
Professor Hoosen Coovadia, a leader in maternal, newborn and child health, said that understanding the underlying social and political problems was key to curbing the tide of the HIV/Aids epidemic.
He said this in a lecture entitled “HIV and Aids and children’s health: What mistakes have we made and how can we create a better future for all children in this country?” at Rhodes recently. It was part of series on HIV/Aids in the post-Mbeki era.
In South Africa the gap between the haves and the have-nots was huge and becoming wider, according to Coovadia, a result of the social conditions in which mothers and children found themselves.
The social problems could be solved by addressing poverty and unemployment and increasing access to education and basic sanitation services.
According to Coovadia, South Africa did not need fancy hospitals, but rather community health workers, nurses, doctors, and ARVs.
Compared to the rest of Africa, the mortality rates for mothers and children under the age of five was higher in South Africa.
Surprisingly, a child below the age of five in South Africa was more likely to die from malnutrition, diarrhoea or pneumonia than HIV/Aids, he said.
Coovadia cited a number of social conditions that contributed to the high rate of HIV infections. Among them were the prevalence of violence and the abuse of women and children, usually viewed as a social problem, but which Coovadia said was a major factor in the spread of Aids.
If this violence were not discouraged, South Africa’s high prevalence of HIV/Aids would continue.
Another social issue related to the epidemic was the disruption of family life and structure – when, for example, men left their families. Women were left to raise the children and might resort to prostitution, which put them at risk, Coovadia said.
The masculinity of men in society – how they related to women and how they solved problems – also needed to be considered as contributing to the epidemic.
The aggression and violence in some men was most likely the reason they committed sexual offences.
The division between the government and healthcare professionals on HIV/Aids is painful for Coovadia.
“Being on opposite sides of the fence is not pleasant.”
Coovadia knew former President Thabo Mbeki well and was one of the few people to publicly oppose him on his HIV policies. During his term, Mbeki was strongly influenced by Aids denialists and blamed ARVs for killing his spokesperson, Parks Mankahlana.
Strong political leadership was necessary to fight the epidemic, Coovadia said. From 1999-2007 an additional 343 000 deaths could have been averted if the national government had rolled out ARVs to prevent mother-to-child transmission, he said.
Previously, mother to child transmission constituted 32% of HIV/Aids cases, but since President Jacob Zuma had taken over this had been reduced to 2%, he said.
Coovadia noted that the efforts of health minister Aaron Motsoaledi, under the Zuma administration, were commendable. Among other things, ARVs had been made available.
South Africa had more money and better infrastructure and resources than some developed countries – but this was useless without freedom from hunger.
“The way people – scientists, government and business – talk utter nonsense and no one challenges them,” he said. “We need to base our discourses on the truth.”
