AIDS used to be a silent killer, but massive strides in education, diagnosis and treatment have vastly reduced the impact of HIV.
Today, there are 34 million people who are living with HIV, of those 25 million now have access to Anti-retrovirals (ARV’s) and that is a wonderful achievement so far.
The average cost of treating HIV has gone from $20,000 to under $100 a year per patient in some cases.
It is a credit to all those who fought the scourge and a comfort to those who face the stigma of HIV to know that 30 years after it was discovered the HIV virus is a treatable ailment even though it is still incurable.
The fight against AIDS is complex; after Educating, diagnosing and treatment, we find that social factors still hinder progress.
For example a patient can be given ARV’s but not have the food to digest the medicine, or not have clean water to sip the pills with.
A prostitute can get free ARV’s but still sleep around to pay her bills because no other options is available. The disease and the impact have had differing effects, in economics, in social matters, and even politically but these effects cannot be treated with ARV’s.
Almost every family in the country has been affected or knows someone who was, yet stigma exists.
Some of our greatest soldiers fell to the disease, others fought wars fearlessly both against the enemy and the virus. HIV is no physical impediment to success if treated and yet few will openly admit to it.
In Rwanda, the prevalence rate went down from 9% to under 3%, ARV’s are free, there are special programs for HIV groups, and a continuous mass-awareness campaign.
The focus has shifted towards treating the effects, AIDS orphans, widows, social breakdown, economic empowerment, reintegrating HIV positive people back into society, and preventing future cases.
HIV is no longer feared as it was among urban elite types, there is a chance that it could rise again if the youth are complacent.
When we look at our AIDS campaigns we see it was a collective effort to tackle so many aspects of poverty and inequality. The “Singurisha” campaign, “Hakanira ba Sugarmummy” to the condom adverts, to testing adverts, we see that it took so many angles to solve this issue.
The problem could arise again in marginalised groups like drug-users, homosexuals, prostitutes or any group and re-emerge in the wider poulation.
With the free movement of people, the spread of the disease regionally has always followed trade routes and human work patterns, so we need a regional body to coordinate disease prevention in general.
The future of HIV prevention in Rwanda depends on how we anticipate and manage future shifts in sexual patterns, particularly in young women.
Boys will be boys, as the saying goes, the problem is when the same free abandon appears in young girls. There is no stopping the images of sex and sexuality that young people are exposed to daily but what they need is a context to put all those sexual images in.
Rwanda will follow the same path of all developing societies, a gradual separation of sex and reproduction, a redefinition of gender roles and aspirations, the breakdown and reappropriation of family values.
All this is inevitable because our society is changing whether we like it or not, we have to be ready for it.