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Real courage

Zambia: On the Front Lines Waging War Against HIV and Malaria


The AIDS epidemic in Zambia is a sobering reminder of the big health challenges many African countries face. However, we are beginning to see encouraging signs of progress.

The government of Zambia and non-profit health clinics like the Coptic Mission Hospital that I visited in Lusaka are doing great work treating HIV patients. I wish more people could have an opportunity to meet people like Florence Daka, a mother of four who is alive today in Zambia because of the effectiveness of HIV drugs. Florence’s story is even more compelling because the drugs she takes also prevented transmission of HIV to her newborn son. The spread of HIV from mother-to-child is one of the most frequent ways AIDS has spread in Zambia—where more than 15% of the adult population is living with the disease but many do not know it.

Even more encouraging, I talked with men who are courageously setting aside cultural views and getting circumcised because they understand it significantly reduces their risk of getting or transmitting AIDS. The goal with AIDS is to have a vaccine that will prevent anyone from getting the disease. But we're more than a decade away from having that. So one of the best tools we have right now, other than behavior change, is male circumcision.

One of the important things we’ve learned about the spread of AIDS is that it occurs less often in communities where men have been circumcised for cultural or religious reasons. But the big question was whether you could convince a large percentage of adult men who weren’t circumcised as infants to come in for the procedure. An important breakthrough was the invention of a small device called a Shang Ring. It is considered safer than the standard surgical procedure, costs less, and is acceptable to men. This is great news because it enables health officials to scale up the procedure.

Many countries in Africa are launching national programs to encourage circumcision. In Zambia, the government has set a target of circumcising 80 percent of the male population—nearly 2 million men. Kenya, South Africa, Botswana, and Tanzania are also starting to show leadership in this area.

I was also heartened to see the progress in Zambia against malaria, which like AIDS is a devastating disease that disproportionately affects the poor. Fifty years ago, the only way to slow malaria was to spray DDT—a highly toxic chemical—on walls. But in recent years, countries like Zambia have launched an intensive effort to distribute mosquito bed nets, medicines, diagnostics and insecticides that have dramatically reduced the number of young children dying from the disease.

Zambia was one of the first countries to pilot widespread distribution of bed nets and the foundation has been a funder of that effort. Zambia’s program is so well run and effective that the government hopes to eliminate malaria in five regions by 2015 and completely eliminate it throughout the country by 2030. That kind of goal would have been unimaginable even a decade ago.

Combined with the successes I saw in Ethiopia providing basic health services for women and children and boosting agricultural productivity for small farmers, there are a many reasons to be optimistic that many people in Africa are on the road to self-sufficiency. One of the jobs of our foundation is to make sure other donor countries and governments understand the important progress being made—progress that is really changing the quality of life for millions of people in Africa. 


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