AIDS in Africa

CMAJ 1998;158:1129

The tragedy of HIV and AIDS in Africa, mentioned in the article "Ottawa students mark '5 wonderful years' in Malawi" (CMAJ 1997;157[9]:1191 [full text]), by Dr. Kevin Chan, is beyond the comprehension of physicians whose experience of medicine is limited to the developed world. The World Health Organization has just revised its estimates of HIV infection worldwide, and more than 20 million Africans are now believed to be seropositive. I have worked in large hospitals in Africa where the medical wards were primarily "palliative care centres" with, in fact, very little palliation to offer.

But however bad the situation is in countries such as Malawi, it is hardly likely that between 30% and 40% of Malawians are infected with HIV. Such misinformation only reinforces the perception of hopelessness among physicians of goodwill, whom we must mobilize to provide help. I am not aware of the most recent estimates for Malawi, but in general the seropositivity rate for adults is rarely above 20% in the African countries most severely affected — a figure that is nevertheless stunning.

Milton Tectonidis, MD
Médecins Sans Frontières
Montreal, Que.
miltekmd@classic.msn.com

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