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Opinions of Tuesday, 22 October 2002

Columnist: Mahama, John

The Minister For HIV/AIDS

At the peak of the Gulf War, there were demonstrations in the developed world by HIV/AIDS victims and activist requesting their governments to intervene and compel the big drug companies to make the newly developed anti-retroviral drugs available and affordable for AIDS patients. One of such demonstrators carried a placard which read – “Forget the war; We have AIDS.” With this simple placard, a lone demonstrator was telling the world, that perhaps AIDS is the single greatest political and socio-economic challenge facing the globe at the present time.

Ghana has been quite fortunate to have not yet reached the proportion this scourge has had on other nations of the continent. In parts of East and Southern Africa, AIDS has taken a deadly toll. There has been talk of a shortage of classroom teachers in one East African Country because the death rate from AIDS had exceeded the rate at which trained teachers were being churned out of the Teacher’s Colleges. One Southern African nation’s airline was nearly grounded because most of its trained pilots had succumbed to the AIDS disease. They had to hire expatriate pilots from Eastern Europe to keep the airline flying. In Ghana our prevalence rate was stated as 4.6% up until the end of the year 2000. Recently I have heard health officials speak of a 3.6% prevalence rate. While no official explanation has been given for this, I have surmised that with the more reliable population figure provided by the recent census, the number of reported HIV/AIDS cases reported as a percentage of the new population figure gives a lower prevalence rate than previously thought.

Several significant steps have been taken in Ghana in the fight against HIV/AIDS. These include the establishment of the Ghana AIDS Commission and the Ghana AIDS Response Fund (GARFUND). These two significant instruments in our war against AIDS were precipitated by the visit of a delegation of the International Partnership against HIV/AIDS

In 1999, serving as Minister of Communications, I was one of a number of ministers and high level public officials selected to meet with this partnership. It was a UN sponsored delegation tasked to identify the state of preparedness of various nations to access funds that developed nations and international institutions had committed themselves to provide for the fight against HIV/AIDS. The delegation was led by a powerful Kenyan woman, Miriam Wereh and ably supported by representatives of local UN agencies, such as Moses Mukasa, Cynthia Eledu, and Dr. Mandara. A critical criterion for the delegation was that senior officials of government including the President were concerned and committed enough to want to do something about the AIDS scourge. The delegation met first with President Rawlings and came away quite happy at the level of his concern about HIV/AIDS prevention.

Following several meetings with other ministers including the Hon. Muhammad Mummuni who was then the Minister of Employment and Social Welfare, the Inter-Ministerial Committee on HIV/AIDS was born. Part of the task of this committee was to help in the drawing up of a new national strategy for HIV/AIDS prevention and control. It also had the task of sensitizing government about the need for a serious commitment to the fight against HIV/AIDS. At one stage Hon. Mummuni and myself were required to present a proposal to cabinet for the holding of a high level cabinet retreat to discuss the setting up of a new Ghana AIDS Commission based on the Ugandan model. HIV/AIDS was certainly not a pleasant topic for cabinet discussion on a Thursday morning, and there were many nervous faces when the Vice President, Professor Atta Mills announced quite seriously that he had received a new test kit for HIV/AIDS and intended to have everyone tested at the next cabinet meeting. It turned out he was joking, but I if he were serious cabinet might have recorded one of its lowest attendance’s in history. Probably to get this unholy topic over and done with, Hon. Mummuni and myself were pleasantly surprised to see all the proposals we presented to cabinet quickly endorsed without much argument.

The subsequent cabinet retreat at Akosombo led to the inauguration of the Ghana AIDS Commission with the President as Chairman and a rotating Vice Chairmanship, with Muhammad Mummuni nominated for the first turn of a one year term.

Alongside these developments, a new initiative on HIV/AIDS was just beginning. The Johns Hopkins University had posted a young energetic man to start a new programme on HIV/AIDS awareness and control. His name was Ian Tweedie. He called on me in my office and solicited my assistance with a new programme initiated in collaboration with Ghana Social Marketing Foundation (GSMF) called the “STOP AIDS; LOVE LIFE” campaign. Perhaps of all the HIV/AIDS prevention programmes implemented in the history of this country, this was the most effective. It had the objective of creating awareness of the disease, encouraging behavioural change by preaching abstinence, faithfulness, or condom use. It also had the objective of demystifying the disease and encouraging compassion and non-discrimination against persons living with HIV/AIDS (PLWH). Well thought out and targeted messages were produced for all types of media, print and electronic. There was a high profile launch of the campaign, which was performed by the First Lady Nana Konadu Agyemang Rawlings.

There were several reviews of the campaign messages held in the conference room of our ministry, the Ministry of Communications. Several of the messages were quite bold and for a country with a population that is very shy in matters relating to public discussion or display of sex, we reacted in very much the same way as the general public did when the adverts started to air. I remember on one occasion when we had listened to one of the ads ending with the quite unnerving “if it is not on, it is not in” slogan Deputy Minister Rebecca Addotey screamed “no this is terrible, we cannot allow this on our airwaves.” After much debate for and against the slogan, my opinion was sought to undo the logjam. In an inspired mood I said quite calmly to Mrs. Addottey, “this is no time to be squeamish, I think it should go.” As it turned out, the slogan became quite popular with the youth and helped push the message quite strongly within the youthful target group. The “Love Life; Stop Aids” programme with its ads, mobile campaign team, drama sketches, musical messages including the popular All Stars AIDS song helped raise awareness of the disease even further. It also encouraged behavioural change and shot condom sales through the roof.

A few religious groups expressed displeasure at the ads, but in the main most religious leaders were quite open minded about the campaign especially in respect of the “ABC of AIDS.” The ABC message stresses abstinence as the first safeguard. If you cannot abstain, it stresses faithfulness to one’s partner. If you cannot be faithful then use a condom. Apart from a few fundamentalists, the mainstream of the clergy was prepared to go with the message and accepted it.

One significant aspect of the campaign was the use of live HIV/AIDS patients in the campaign. A few courageous people who were HIV positive stepped forward and allowed themselves to be portrayed in adverts, films, on talk shows, in live interactions with the public, and other such fora. It also led to the formation of support groups including an association of people living with HIV/AIDS which was subsequently christened the Wisdom Association.

It was through this programme I met and became great friends with Mr. Douglas Sem, the well-known anti AIDS crusader. Douglas was the first HIV positive person I interacted closely with. After a meeting where he spoke quite bravely about his HIV positive status and his experience with the disease. I walked up to him and congratulated him. We conversed for a while and I gave him my complimentary card. After that anytime he was in Accra, he dropped by my office for a chat or caught up with me at Parliament House. We had lunch together whenever we had the opportunity. I took him along when I attended some public functions. I procured a mobile phone for him and he conscientiously called me from whichever part of the country he was during his anti AIDS campaigns. He spoke openly about his battle with the disease and showed me a rash on his body that was not responding to treatment. He became friends with my driver (Mohamed) too. We had even arranged for him to come with me to my constituency on one of my visits to help educate the youth.

Even though we knew that death for an AIDS patient could come at any time, we had gotten used to Douglas’ courageous battle against the disease such that we did not expect he would succumb so soon. This was especially after he announced to me that he had started to receive treatment with anti-retroviral drugs. His death came as a shock. He called me from Kumasi on his mobile phone one day and said he was not feeling very well. He said he was going to the hospital but expected to be in Accra the following week and would surely come over to see me at Parliament house. After a few days I called his phone and it gave back a message announcing that the mobitel I was calling was either switched off or out of service area. That evening sitting at home watching TV I saw a replay of one of his many adverts. At the end of it a written message announced that Mr. Douglas Sem had recently died at the Komfo Anokye teaching hospital. I was shocked and frozen in my seat for all of one hour.

A lot of work is taking place now with HIV/AIDS. With a bulging GARFUND, swollen with $25 million from the World Bank and other generous funding from DFID, USAID and other bilateral donors, money can no longer be an excuse for lack of progress in our fight against HIV/AIDS.

One paradox about HIV/AIDS in Ghana is that public awareness of the disease is very high, but behavioural change is the problem. Even though random test indicate that in Accra and Kumasi more than 80% of commercial sex workers are HIV positive, the red light districts are packed with patrons who are prepared to pay a premium for unfettered access without condom.

Disease surveillance needs strengthening. There must be compulsory or at least random testing of pregnant women. There must also be random testing of sample groups in order to extrapolate for the larger population. Reliable statistics will give us a fair idea of the size of the problem we confront. These tests can be done anonymously because of the scare the HIV test evokes in everyone. Having confronted this dreadful test twice in my short life I can say with all certainty that giving the sample is not as dreadful as the two-day period you need to wait for the results. The loss of appetite, the sleepless nights, the nightmares dreaming of the prospect of a positive result are nothing any sane human being will relish. But the euphoria of a negative result, the knowledge that one is free of the virus, is the most wonderful feeling in the world. It beats being born again. It evokes vows to walk on the straight and narrow. Never to look at any son of Adam or daughter of Eve twice. But such vows can be quite short-lived and leave one wondering all over again what his/her HIV status is.

I do have one crazy journalist friend though who takes an HIV test voluntarily each year. What insanity!! He/She will make an excellent Minister for HIV/AIDS when the President starts to unleash his army of ministers: Minister for Railways, Minister for Ghana Airways, Minister for HIV/AIDS?

John Mahama
Minority Spokesman on Communications
Parliament House, Accra, Ghana

Views expressed by the author(s) do not necessarily reflect those of Ghanaweb.
This article was originally written for the 'Network Herald'