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Tuesday, August 5, 2008

AIDS in Afghanistan: The Perfect Storm

A couple weeks back, I wrote this piece about the explosion of AIDS in South Africa. The factors that lead to AIDS being an epidemic in that country included a poor an uneducated population, a male dominated culture, and an absent government that looked the other way while the epidemic took hold.



The Chicago Tribune has a startling piece today about how a similar phenomenon is taking shape in Afghanistan. What is truly frightening about this report is that everything that held true in South Africa is also true in Afghanistan only in even more intense doses.



In Afghanistan, the rise of AIDS can be traced to the explosion of the poppy crop, the originating ingredient in heroine, in Afghanistan. For all their evil, the Taliban were effective in limiting the production of poppy in Afghanistan. Once they were deposed, one of the unfortunate side effects was that this nation became the number one producer of poppy.



Along with making millions for international drug dealers, the poppy farmers became the suppliers for a growing, and difficult to quantify, group of underground drug users within the Afghan culture. Because education in Afghanistan is so stunted, many of these addicts believe that injecting is the safest way of using heroine. Lack of education also leads many of these folks to share needles. Furthermore, the country has an underground network of prostitution that the government rarely acknowledges for cultural and religious reasons. With the fall of the Taliban, many refugees returned to Afghanistan, and among them, was a niche of drug addicts from Pakistan and Iran.



Adding to the perilous situation is a government that all but refuses to do anything about the situation. Many within the government refuse to acknowledge the existence of the disease. Some in the government believe all those that are inflicted deserve to die. As such, there is nearly no testing and no substantial treatment or education policy within the health ministry. So far, the ministry has only acknowledged 435 cases. Only about 6700 tests were conducted in 2007 and most of those were done on folks about to travel overseas. Doctors are usually reluctant to treat AIDS cases because of the stigma associated with the disease.



All of this may lead to a perfect storm of an epidemic that can skyrocket out of control before anything substantial is done. What we saw in South Africa were many of the same elements on a much less severe scale all contributing to an epidemic that now afflicts four in five males between 18-35. In Afghanistan, the elements line up so that this epidemic could spread even more severely. The government is not only terribly underfunded, totally ineffective, but for the most part they refuse to even acknowledge that there is a problem. The society shuns all such individuals, and most Afghans don't even know that AIDS exists.



Ironically enough, the most important element of this story will be just how potent the strain that flows through Afghanistan is. In fact, the more potent it is the less severe the epidemic will be. That's because a potent strain will kill off those that carry it before they have a chance to infect any others. If the strain is weak, much like it is in South Africa, that sets this up to be an epidemic of biblical proportions. Of course, this is something that is totally unknown since the government does absolutely no study of the virus. Now is the time for the Afghan government along with the international community to attack this looming epidemic head on BEFORE it becomes a real epidemic. Unfortunately, all the elements set up so that this problem will be swept under the rug by all until it is too late.

4 comments:

Anonymous said...

I would like to know where you get your evidence that the government of Afghanistan knows nothing and is doing nothing. IN fact the government has not placed a high priority on AIDS because right now infection rates are very low and they have more pressing problems, like on of the very worst TB epidemics in the world and a high rate of polio. Why direct precious and limited resources at a rare and largely untreatable disease when children die of a disease prevented by a taste of a cheap effective vaccine.

Further I would also like to know why you state the government has only tested under 300o people because I know for a fact that the Afghanistan blood bank routinely tests all blood donations for AIDS and that screening of both IV drug users and prostitutes has already been undertaken in selected populations in cooperation with the World Health organization. At this time, there is no association between prostitution and AIDS but there is indeed a strong association between AIDS and the Taliban fighters coming back and forth across the border from Pakistan. Rather than praising the Taliban, you should be looking at how infected individuals from Africa and America and Europe travel to northern Pakistan to train as militants and they are the incoming primary source for AIDS infection in the region.

Superficial and poorly researched!

mike volpe said...

First of all, AIDS is very treatable. Second, with education, you can significantly limit the spread of it entirely.

This is NOT an either or. If the government ignores the spread of AIDS in order to provide resources for TB then they will significantly limit one disease and another will become an epidemic. You give yourself away when you claim that AIDS is rare. That is the talk of an AIDS denialist. AIDS is not rare. Once AIDS affects one wrong person it can spread like a wildfire. If the government looks the other way while an epidemic starts, that is a recipe for disaster.

All my numbers are sourced from the article that I linked.

Furthermore, I am stunned that you would claim that there is no link between prostitution and AIDS. Of course, there is a link. The link between unprotected and random sex and AIDS has long been established.

What is truly ironic is that you proclaim me to be a propagandist while filling your response with nothing more than propaganda.

I didn't praise the Taliban. I pointed out that the nexis of this crisis started when the new government didn't hold down the production of poppy. Of course, the Taliban are evil folks. That I have already pointed out. That isn't the point. The point is that the new government is impotent in holding down the production of poppy and thus it has lead to the explosion of heroine use which among other things, has lead to the spread of AIDS.

Finally, after you spend two paragraphs denying that AIDS is a problem in Afghanistan, you say that it is the Taliban that is spreading AIDS in AFghanistan. Which one is it?

Jay said...

The first person who commented is an idiot. If anyone thinks there's no relation between prostitution and HIV, they need only look at AIDS rates in certain areas of India where prostitution abounds and education is not great.

AIDS is treatable, yes, but keep in mind that the retroviral therapy that the treatment entails is well out of the budget of Afghani citizens (and it isn't always successful, either). Even if the government did care, there would be little that they would be able to do, other than implement a public health plan to increase safer sex practices and decrease needle sharing. Those with HIV already would find little solace in a caring Afghan government.

Also, you have to take into account whether these people will respond to an AIDS campaign. The stigma is so great that many who have the disease don't tell anyone, and keep infecting others. Even in America, a remarkably accepting country in many respects, people fear HIV, and fear leads to hate. Many with AIDS in America either don't know, or don't tell. It's a shame.

Anonymous said...

An "Afghani" is the currancy of Afghanistan, also call "Afs".

In Pakistan the people are said to be Pakistani. In Afghanistan the people are said to be Afghan.

Some feel calling the people of Afghanistan "Afghani" is being racist. I know that wasn't the intent, and I only point this out to educate.

Granted, since English is not a primary language in Afghanistan, some Afghans who do speak English sometimes use the term, just as some Americans use racist words with no racial intent.