Lessons from Senegal: How Other African Countries Can Curb the Spread of AIDS
DJ Awadi sets a blunt tone for his rap group’s bass-ridden track Écoute Fils (“Listen Son”). “Don’t think that AIDS is for other people, it can catch you / Listen, son. The vicious virus is around.” The ballad came out in 2005 on Positive Black Soul’s album “Run Cool” along with a host of other songs dedicated to promoting abstinence, fidelity, and safe sex among Senegal’s youth.
In this way, significant figures in Senegalese culture, like Positive Black Soul, are taking steps to promote AIDS awareness. Senegal’s famous wrestling groups teach men about the risks of unsafe sex. Imams speak about AIDS in mosques to convince conservative Senegalese Muslims that AIDS is not a myth or a curse from God for lapses on earth. Women’s groups travel from town to town to spread information.
Evidence shows that this is paying off, and Senegal’s achievements in the fight against AIDS merit a closer look at their efforts. The small west African country has cut new infections by almost three-quarters since 2010 and remains one of the least affected countries in Africa. While 4.8% of sub-Saharan Africans test positive for HIV, in Senegal only 0.5% have the virus.
Senegal has never had as high a rate of HIV as southern African countries such as Botswana, whose rate has been slowly declining since reaching its peak of 26% of the population in 2000. Overall, the AIDS epidemic has befallen over 20 million people in east and southern African: nearly four times as many as in west and central Africa. Nevertheless, in comparing Senegal to its neighboring country, the Gambia, the improvements are plain to see.
Civil society in the country is helping to further these improvements as well. For example, AWA, a women’s association for sex workers, takes the grassroots approach to enriching Senegalese citizens with accurate information about the disease. The group travels across Senegal visiting bars, nightclubs, brothels, and truck stops to promote an AIDS awareness program. AWA women go head to head with AIDS skeptics, persuading them to believe that AIDS exists and can be prevented by the use of condoms.
AIDS denialism still stands as one of the most pressing issues confronting efforts to stop the spread of AIDS in sub-Saharan Africa. Former South African President Thabo Mbeki expressed severe doubts about the mere existence of AIDS, insisting that the HIV virus could not cause a syndrome such as AIDS. Evoking memories of state-sponsored AIDS denialism in the early 2000s, Mbeki’s Minister of Health Manto Tshabalala-Msimang promoted beetroot, garlic and African potato as treatments.
As in many parts of sub-Saharan Africa, including regions of Senegal, the temptation to disregard AIDS research in South Africa stems from a longing to embrace traditional African remedies and a distrust of Western influence.
The women who volunteer for AWA, often former sex workers themselves, come clad in T-shirts bearing their logo -- a pair of hands beating a tam-tam with “HIV” on the drumhead -- and use street theater to convince their fellow Senegalese of the dangers of AIDS.
Some of the Senegalese government’s unique policies regarding sex work may help to curb the spread of the insidious disease as well. Prostitution is both legal and regulated. Sex workers may register to solicit clients only if they have health check-ups every month. If they contract HIV, it is still legal for them to continue working as long as they keep up with free treatments, lessening the incentive to work underground.
In 1998, Senegal became the first country in sub-Saharan Africa to publicly fund a program to treat people with antiretroviral therapy. The treatment both extends the lives of those affected by HIV and prevents its passing from mother to child. Antiretroviral treatment was made free in Senegal in 2003, years before the World Health Organization recommended other countries to do so.
There is still ground left to cover in Senegal. Only 40% of people living with HIV receive antiretroviral treatment. That’s 10% below the average in sub-Saharan Africa. Moreover, gay men are kept from clinics by more than fear of prejudice -- homosexuality is punishable by up to five years in jail. The number of registered sex workers is also unclear and those who don’t register are persecuted by law enforcement agencies, driving them underground and making it difficult to provide HIV treatment.
Nevertheless, the Senegalese have discovered for the rest of Africa two time-honored keys to a lower HIV rate: broad cultural efforts to decrease the stranglehold that stigma and disbelief have on the effort to stop the spread of AIDS, and freely available antiretroviral treatment for all citizens.