Plagued by Names and Numbers: Africa and AIDS

Natalie Tan – Singapore

Africa is perceived as a continent ravaged by HIV and AIDS. Almost uniformly, across most mainstream media outlets, we are confronted with horrific statistics and gruesome images of people and places. Difficulties in measurements only exacerbate the problem. How, then, should we interpret all this information?

It is laughably easy—but now wildly inappropriate—to make the statement that the African continent is being ravaged by HIV and AIDS. Popular news outlets casually throw out figures quoting the number of HIV-positive patients, or the rates of prevalence in various African countries, but typically fail to provide sufficient context for these statistics. Since the majority of the people reading these articles are not well-versed in the background of HIV/AIDS and its treatment, there is a severe lack of understanding of these measurements; they often perpetuate the stigma associated with these diseases, instead of helping to eradicate it.

If one came across any of UNICEF’s advertisements on people in Africa, they could not be faulted for assuming that the nation appears to be populated by poor, photogenic children who are slowly dying of incurable diseases. This is the image that NGOs must show to the world, so that funding, aid, and resources can be provided to governments that, because of the reality of limited resources and competing priorities, find themselves unwilling or unable to do so., one of the most respected organisations for the provision of information regarding HIV and AIDS in the world, stresses that with “36.9 million people living with HIV worldwide”, the need for awareness is tremendous. Its website comments in detail on the “epidemic” of HIV or the “pandemic” of AIDS, neither explaining what these terms mean nor why they are significant to our understanding of the spread of these diseases.

The so-called ‘pandemic’ of HIV and AIDS in Africa is an incredibly misleading term, particularly because the term ‘pandemic’ has no meaning that is agreed upon neither in the scientific community nor the broader public sphere. It sows confusion that could be somewhat rectified by using, for example, the label ‘epidemic’ instead. Epidemics occur when an agent and susceptible hosts are present in adequate numbers. This definition is still vague, as it could imply that the common cold is an epidemic in a similar fashion; epidemics, however, typically refer to an unusually widespread frequency of cases at a given point in time. Concerning HIV or AIDS, the reason it is more accurate to call the diseases epidemics is because Africa has the highest number of cases in the world, and in turn, increases the risk of exposure to these diseases of otherwise completely healthy individuals. 

The fact is that the number of people living with HIV has continued to increase, both in Africa and around the world. This statistic has been used by multiple media outlets to emphasise the dangers of HIV and AIDS. But though this inference may be intuitive, it is incorrect. The increase in the number of people living with these diseases is actually a positive phenomenon. More people living with AIDS is a strong indicator of access to antiretroviral therapy and consequently, longer and healthier lives. In addition, growing awareness of the disease coupled with investment in infrastructure and facilities in disease-prone areas such as Southern Africa have resulted in HIV/AIDS being successfully diagnosed at a higher rate. In other words, people can seek treatment earlier, and, on average, live longer.

Readers of the subject, especially casual readers, should be wary of the confirmation bias of statistics. The problem of misinterpreted data or judgments from incomplete information exist across many disciplines; researchers in the life sciences are not exempt. Journalistic reporting, which can be less stringent than academic citations, are how most people find out about diseases and their effect on populations. Try as they might, even ‘respectable’ media outlets cannot verify the data that studies have shown. In fact, researchers have, rather self-referentially, conducted studies evaluating the effect of HIV/AIDS stigma on fellow scientists’ and policy work. They found that the stigma associated with HIV/AIDS is one of the greatest challenges organisations and governments face in effectively responding to and treating the disease. Moreover, these statistics do not identify those who may be experiencing heightened stigma as a result of biased reporting or measurements. Existing statistics regarding HIV and AIDS, therefore, appear to act in a vacuum, illuminating the chain and the pedals, but not the bicycle itself.

UNAIDS, the Joint United Nations Programme on HIV/AIDS, states its long-term goal is to “end the epidemic” by 2030. But ‘ending the epidemic’ is notoriously inexact phrasing. Good reporting would then go on to clarify that the agency defines ‘ending the epidemic’ as the reduction of the number of deaths related to AIDS to 10% of the figures in 2010. In Africa, treatments such as antiretroviral therapy, viral-load suppression, male circumcision, the use of condoms, and prophylactic drug treatment for those at particular risk are expected to continue to lower the rate of new infections, which, incidentally, is perhaps the most reliable way to measure the spread of HIV/AIDS.

The numbers do not lie. But, without context, they gloss over important truths.

Where should we draw the line between healthy skepticism and chronic cynicism? In climates where the dangers of diseases are apparent but not easily measured, should programs not focus on treatment instead? Let us know in the comments below.