The uncontrollable epidemic 

Every day, some 500 people in Mozambique are infected with HIV - despite the ready availability of information on how to avoid the disease. Prejudices and the fear of being ostracized all help to keep the epidemic alive.

"In Mozambique, AIDS treatment is available across the entire country. Actually, we have more life-prolonging drugs than are being taken up by those in need."

Patricia David e Silva, psychologist and HIV/AIDS expert at AustralCOWI in Mozambique, effectively debunks the myth that Africa is dying of AIDS because the life-prolonging drugs are too expensive or simply unavailable.

But in a country where 16.2 per cent of the inhabitants are HIV positive, where 500 new cases appear every day and where the rate of infection is accelerating, prolonging the life of the sick is only a temporary solution. The epidemic is still out of control, and it is threatening efforts to bring sustainable development to the impoverished state of Mozambique.

Second national AIDS strategy

The fact that the country is currently in the process of implementing its second national AIDS strategy, and as such far ahead of many other African countries, simply underlines how difficult it is to halt the spread of this disease.

Photo: Eric Miller
According to anthropologist Carmeliza Rosario (left) there's no lack of information about HIV in Mozambique. The challenge is that the disease is not a static problem, but develops.


Austral, the consulting company acquired by COWI in the spring, has been involved in drawing up both the first and the second national AIDS strategy. The company possesses unparalleled expertise in HIV/AIDS in Mozambique.

"Basically, the challenge with the disease is that HIV and AIDS are not a static problem. The problem grows in line with developments within society, and we have to constantly adjust our efforts just in order to keep up," says Patricia David e Silva.

Not just a health problem

According to Patricia David e Silva and her colleague, anthropologist Carmeliza Rosario, the epidemic must be seen not just as a health problem, but as a psychological, social and cultural problem. 

"Traditional values and cultural practices all play a role. If a man dies, for instance, his brother will take on his widow. The fear of talking openly about the disease also often stands in the way of safe sex. People are afraid of being ostracized or being left by their partner if they admit to being infected. That's why many avoid confronting the issue," explains Carmeliza Rosario.

The "leper effect"

In order to get around the "leper effect", the Ministry of Health in Mozambique is working hard to make AIDS prevention an integral part of the health services on offer in the country.
 
"We're now trying to make an AIDS test a natural part of any visit to the health centres. Only by turning this disease into an ordinary health issue like other diseases, so people feel it is something ordinary, will we be able to overcome the wall of silence," says Patricia David e Silva.
 
By: Janne Toft Jensen, jaje@cowi.dk
Published: 29.10.2007


AustralCOWI HIV/AIDS projects in Mozambique 
  • Analysis of the treatment capacity for HIV/AIDS at Mozambique's health centres
  • Adviser on Mozambique's first and second national AIDS strategies
  • AVANTE - administration of a large private sector project designed to tackle AIDS in the workplace
  • Prevention and control of HIV/AIDS in the Beira corridor, a transport corridor through Mozambique
  • Co-founder of Business Coalition against AIDS, a group of large companies that have pledged to make an effort to combat AIDS