Download HIV CDC Investigation

Center for Disease Control
Histories Mysteries Division
Internal Department Use Only- Not To Be Distributed
Subject: AIDS Epidemic in the Republic of South Africa
Summary:
Researchers estimate that sometime in the 1930s a form of simian immunodeficiency virus, SIV,
jumped to humans in central Africa. The mutated virus became the first human immunodeficiency
virus
The first known case of HIV in a human occurs in a person who died in the Congo, later confirmed as
having HIV infection from his preserved blood samples
The earliest case of AIDS in the United States involved a female baby born in New Jersey in 1973 or
1974 to a sixteen-year-old girl, who was identified as a drug-injector who had had multiple male
sex partners. The infant died in 1979 after having shown the symptoms of AIDS for 5 years; her
stored tissues later tested positive for HIV-1
As of 2012, there are estimated to be upwards of 34 million persons living with HIV/AIDS worldwide.
With 5,600,000 is the leading country among persons living with HIV/AIDS.
Problems:
Our analysts estimate that the HIV/AIDS epidemic has taken an enormous toll on developing
nations, especially those on the African continent. More than two-thirds (69 percent) of all people
living with HIV, 23.5 million, live in sub-Saharan Africa—including 91 percent of the world’s HIVpositive children.
Determination:
Historians tell us of the economic and social impacts that the Black Plague had on Europe in the 1300s.
We must use this knowledge to develop a plan to help the Republic of South Africa effectively deal
with this modern pandemic.
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Exhibit A
Stigma of Being an AIDS Victim
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Exhibit B
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Exhibit C
AIDS Map of Africa
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Exhibit D
Getting Access to AIDS Treatments is a
HIV/AIDS Vital Statistics
Struggle
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Exhibit E
African Superstitions on AIDS
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Exhibit F
Health Care compared US vs. S. Africa
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Exhibit G
Black Death Eyewitness
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Exhibit H
Black Plague Suggested Medical Cures
Table of Contents
Exhibit A
Stigma of Being an AIDS Victim
“Last week, in announcing that his eldest son had died of complications of AIDS, Nelson
Mandela urged South Africans to stop treating the disease as a sickness for which "people
will go to hell and not to heaven."
The announcement by Mandela, the former president and a national icon, was a highly public
attempt to fight the stigma that has accompanied AIDS across South Africa, hampering
both testing and timely treatment of the disease, even as it has become the country's top
killer, with 1,000 people a day dying from its ravages, according to the United Nations.
The message, like appeals made by other regional leaders in the past few years, was greeted
with relief by people suffering from the affliction. Yet many interviewed in recent days said
they were still treated as contaminated sinners by neighbors, friends and their own
families. Some are ordered to use separate toilets or to wash outside. Others are banished.
A study of 144 HIV patients at two Johannesburg hospitals found that 38 percent had not told
a single family member that they had HIV, and 21 percent had not told their sexual
partners. One in 10 said diagnosis of the disease was followed by suicidal thoughts. A small
number of women reported that their partners beat them after learning of the presence of
the infection.
Such violent reactions remain rare, although an AIDS activist was killed outside Cape Town in
2003 after she told a group of men who had gang-raped her that she had HIV. Another
woman with AIDS was stoned to death in a township near Durban in 1998. Simple
shunning is far more common and deeply hurtful, say those with the virus. The reaction
compounds feelings of terror and self-loathing that can accompany the diagnosis of a
disease that many here believe, incorrectly, to be fatal in all cases and contracted
exclusively through promiscuous sex.”
Source: http://www.washingtonpost.com/wp-dyn/articles/A7822-2005Jan13.html
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Exhibit B
HIV/AIDS in Africa Vital Statistics
•In Mozambique 73% of young people aged 17-23 said they did not know how to protect themselves from
getting HIV/AIDS
•5,500 people die from HIV/AIDS EVERYDAY in Africa alone.
•Affects people regardless of age, ethnic groups, income, or social standing.
•11% of infected are African children
•Hospitals often do not have money for clean needles, gloves, and methods of testing
•Rates of HIV/AIDS infection up to 30% in Sub-Saharan Africa in the past 10 years
•17 million have already died in sub-Saharan Africa
•Out of 34 Million people world-wide who have HIV/AIDS 24 million live in Sub-Saharan Africa
•The top 10 countries with the highest incidence of HIV/AIDS are all in southern Africa
•Out of the top 10 countries with HIV/AIDS, 8 of them also rank among the world’s poorest
•Poverty and lack of education helps to keep African HIV/AIDS rates among the highest in the world.
•Many people are ashamed to admit they have AIDS for fear of being shunned or beaten by their family and
neighbors.
•Governments are trying to educate the population in hopes of slowing the spread of the disease.
AIDS victims are not able to access modern medications such as Anti-Retroviral (ARV’s) which can help because
most cannot afford such expensive medicines.
Exhibit C
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Exhibit D
Getting Access to AIDS Treatments is a Struggle
AIDS is a catastrophe of unprecedented historical proportions. Since the epidemic began, 22 million people have
died, 17 million in Africa. There are 13 million AIDS orphans in Africa and it is estimated that the number will
grow to 40 million by the end of this decade without massive intervention.
In rich countries, drug cocktails have been remarkably successful in making AIDS a chronic disease like diabetes
or hypertension. AIDS mortality dropped by over half within a few years of making such treatment available. In
poor countries, less than 1/10 of 1% of the people with AIDS are being treated. Without access to medicine,
almost all of the 36 million people living with AIDS will die. In the past several months, the principal objections
to enhancing access to AIDS treatment have been overcome; now is the time to advocate for universal
treatment.
Treatment cost over $15,000 per person per year until activists and developing country pharmaceutical
companies forced the big companies to reduce prices to as low as $350 per person per year. The medical
infrastructure required to manage AIDS has now been simplified; after the first several weeks, only 2-4 blood
tests per year are required for monitoring. Adherence to medications (two pills, one each in the morning and
evening) has been shown to be as good in poor countries as rich ones. Prevention efforts, which have lagged in
much of Africa, have been given a huge boost by availability of treatment in Brazil and Botswana. Experience
has shown that people are much more likely to be tested and stigma easier to reduce when treatment is
available.
How much money is really needed for AIDS treatment?
Estimates vary, depending how broad the interventions might be. A Harvard Faculty Consensus Statement has
estimated that the cost of treatment for the 1-3 million HIV-infected Africans would be $1,100 per patient per
year for a total of $1.1 - $3.3 Billion/year; this quantity includes drugs, testing, directly observed therapy,
clinical support and research. Extending this program to the rest of the world, the total tab would be $4.2
Billion. Additional money would be needed to sustain prevention efforts. All in all, it is a small price to pay. The
figure is about one cent per $100 in the GNP of rich countries and significantly less than the worldwide
development assistance target of 1% of GNP.
The United States has proposed a contribution of $200 million to the Global Fund, although they have suggested
more money will be made available next year, if the fund performs acceptably. In this way the Bush
Administration is setting the bar so low that the fund will be starved of resources before it starts. Given the
shortage of money, policy makers will argue against providing treatment at all choosing instead to focus solely
on prevention. If history is our guide, HIV prevention efforts will have limited success without availability of
treatment.
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Exhibit E
African Superstitions on AIDS
Nurse Mugobi, a clinical nurse from a private clinic in northern Botswana,
explained Botswana's extensive efforts in battling the superstitions.
"Africans are very superstitious people," said Mugobi. "When someone gets sick
they do not think it is a virus or bug, they think someone has put a hex on
them. People think their neighbor or someone they upset wished bad things
upon them," she said. This thinking deters people from going to see the
doctors.
She explained that it is customary to see a traditional healer if a medical
conditions becomes serious. "They will go to see the traditional healer to get
well and he will give them a cure." While the methods of traditional healers for
some practices using herbs or animal products may alleviate some of the
problems with some illnesses, the methods for HIV/AIDS treatment are
worthless.
"I will give you an example. If you get sick and go to the healer," Nurse Mugobi
said, "he will take some water and bless it and say, 'Drink this water and you
will get better.'"
According to Mugobi, teaching and convincing traditional healers about
HIV/AIDS including its transmission and side effects, was very challenging.
"People would be very confused. They were taught one thing at school. Then,
they go see a healer and they tell them something completely different," she
said. "Then, they go to a clinic and a doctor tells them something completely
different."
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Exhibit F
United
States
South Africa
South Africa
United States
Average Income
$8,048
$48,000
Doctors per 1000
people
.77
2.3
Health Care
spending per
person
$843
$7900
Black Death Eyewitness Account: # 1
"One man shunned another... kinsfolk held
aloof, brother
was forsaken by brother, oftentimes husband
by wife; nay, what is more, and scarcely to
be believed, fathers and mothers were found
to abandon their own children to fate,
untended, unvisited as if they had been
strangers."
Exhibit G
Black Plague Suggested Medical Cures
The swellings should be softened with figs and
cooked onions. The onions should be mixed with
yeast and butter. Then open the swellings with a
knife.
Take a live frog and put its belly on the plague
sore. The frog will swell up and burst. Keep
doing this with further frogs until they stop
bursting. Some people say that a dried toad will
do the job better.
Exhibit H