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Finding Africa's Solutions To HIV/AIDS

Jul 26, 2012
Originally published on July 26, 2012 1:40 pm



I'm Michel Martin, and this is TELL ME MORE, from NPR News. Coming up, all eyes will be on London tomorrow when the city opens this summer's Olympic Games. And I don't know how this happened that our tickets got lost in the mail, but since they did, all this week, we are meeting some of the athletes who will be representing the United States. Today, we meet water polo player Tumua Anae. We'll talk with her and see how she's getting ready in just a few minutes.

But first, this week we're bringing you stories from the 19th International AIDS Conference here in Washington, D.C. Today, we're focusing on Africa, where many countries continue to be devastated by the HIV/AIDS pandemic.

Nearly one in four people in Botswana, Lesotho and Swaziland are infected with HIV, according to the United Nations. Some countries have made progress in getting people tested and treated, but there's still widespread stigma and a lack of access to medicine across the continent.

Today, we are joined by someone who's trying to change that. Dr. Teguest Guerma is the director general of AMREF, the African Medical and Research Foundation. That's an African-led health development organization. She is the first woman to lead that group, and Dr. Guerma has worked in public health in Africa for more than 20 years, and she's with us now.

Welcome. Thank you so much for joining us. Thank you for taking the time.

TEGUEST GUERMA: Thank you for having me.

MARTIN: Now, could you tell us a little bit about how your organization is different from other HIV/AIDS organizations? It is African-led, of course, and you say they look for, quote, "African solutions to African problems." Why do you think that's so important?

GUERMA: It's a time of country ownership, and we have to take over responsibilities on the epidemic and other health problems in Africa. So that's why AMREF is trying to find African solution for African problems with African expertise.

MARTIN: Why do you think that hasn't happened to this point, or hasn't happened to the degree that you would like it to have done?

GUERMA: It's a challenge, you know. We need to have human resources for health. And we don't have enough human resources for health, but we're trying. We're getting there. And we also want to focus on communities. We want to empower communities for them to change their own health from within, because we believe in a lasting health change. We don't want to tackle the symptoms, but we want to tackle the root problem of the problem.

MARTIN: When you say, though, African solutions to African problems, I think that pushes some people's buttons. The international community has tried to invest in addressing this health crisis. I mean, the U.S. government, for example, has committed nearly $39 billion through the president's emergency plan for AIDS relief, much of that in Africa. So people kind of wonder: Do you feel that those efforts have been misdirected or not important?

GUERMA: Saying African solution for African problems means we have to find the solutions ourselves, with the support of the international community. We're not closing the door for the international community. We are for global solidarity. But if we don't know what we want to do, we don't want others to come and tell us what to do. That's what it is.

MARTIN: Give us an example, if you would, about some of the initiatives that you hope to bring forward, or that you're working on now.

GUERMA: Yeah. For example, we feel that, if we want to train health workers in Africa, we need to use innovative technology. For example, stand up for African mothers. We want to train 15,000 midwives. And these 15,000 midwives are going to be trained traditionally at a school, but also using E-learning and M-learning. So this is an initiative that is owned by Africans, and we want to put it there because we know it's a need, but we need the support of everyone.

MARTIN: If you're just joining us, you're listening to TELL ME MORE, from NPR News. We're talking about HIV and AIDS research and medicine in Africa with Dr. Teguest Guerma. She is the first woman to lead AMREF, the African Medical and Research Foundation.

Talk a little bit more, if you would, about what you see as the areas that you'd like to focus on. I mean, do you feel that more work needs to be done in research? Do you think more work needs to be done in education, access to medicine? What's your...

GUERMA: In HIV/AIDS, more work needs to be done in access to medicine. We only have 6.2 million people having access to treatment when we need to have 15 million. We need to have the next generation free of HIV. The pregnant women need to receive antiretroviral therapy to prevent their infant from having HIV, and we also need to have access to all key population, like male having sex with male, sex workers and injecting drug users, because it's a human right issue, and the right for access to treatment should be there.

We also need to have a combination prevention. Treating people reduces transmission by 96 percent, according to the research which has been done this year. We also need to have male circumcision. And all these things have to be together, and needs to be combined to the structural intervention, which are reducing stigma and discrimination.

MARTIN: It bears repeating again that, you know, Africa is a very large place. It's a continent, not a country, and there are vastly different experiences, you know, across the continent around this issue. But just looking at it on the whole, what makes you optimistic?

GUERMA: We have gone so far since the beginning of the epidemic. A few years ago, we were not even able to access treatment. AIDS was a death sentence. Today, 6.2 million people have access to treatment, and they live more than 30 years. You know, they die from something else. AIDS has become a chronic disease, like, you know, high blood pressure, diabetes or any other diseases.

And I know now, we can end AIDS. The solution are all there. We just have to implement it. If we really keep the promise, I think it's now time to end AIDS and (unintelligible). It will be with us all the time, but people will live for 50 years for it, and they will die from something else. So AIDS...

MARTIN: And they'll be able to raise their children and be productive.

GUERMA: Exactly. Exactly.

MARTIN: But what's keeping you up at night? What is the thing that wakes you up in the middle of the night?

GUERMA: You know, the international community made promises, but they jump from one global health issues to the other global health issues. We haven't achieved what we're supposed to achieve in AIDS. We have gone to (unintelligible). And then we have jumped now to non-communicable diseases. If we don't really focus on one and finish what we have to do in one, we will not have enough resources to do what we have to do. So that, sometimes, really keeps me awake, because I know it's an issue.

MARTIN: Why do you think that is?

GUERMA: There are many reasons, you know. It's a global economic and financial crisis. There's a lot of push from private sector and other things for non-communicable diseases or anything, you know. And the priorities shift all the time, according to the situation. So that's how it happens, but I wish we can really focus on something and, you know, I feel that we need to finish a job to go to something else.

MARTIN: But, on the positive side, you know, West Africa has generally been - the rate of increase of infection there has generally been low. Rwanda, for example, has greatly increased access to HIV medication. We heard earlier from the minister of health in South Africa how South Africa has substantially increased its testing regimen and access to treatment regimen.

Are there any other bright spots that you would wish to highlight?

GUERMA: Oh, there are many, many countries which have made a lot of progress. Rwanda, Botswana, Namibia have already reached universal access for treatment. Other countries, like Zimbabwe, have made really big progress. Countries like Ethiopia and others have stabilized their epidemic because of impact of prevention. So there is progress in Africa, and the epidemic has been stabilized. The number of deaths has been reduced, but we need to finalize this and end this epidemic. You see, we are at the last stage of that, and I hope we will make it happen.

MARTIN: Dr. Teguest Guerma is the director general of AMREF, the African Medical and Research Foundation. She is the first woman to hold that position, and she was kind enough to join us here in our Washington, D.C. studios to tell us something about her work.

Dr. Guerma, thank you so much for speaking with us.

GUERMA: You're welcome. Transcript provided by NPR, Copyright NPR.