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Dear Ethiopians and friends of Ethiopia:

Greetings. This is to invite you all, no matter what your background is

(nationality, race/ethnicity, gender, age, field of interest, employment),

to join a discussion group on HIV/AIDS in Ethiopia. We all have something

to contribute to reducing the burden of this horrible epidemic. Here are

the facts:

• By end of 1997, 2.6 million Ethiopians were LIVING with HIV or AIDS; of

these 2.5 million were adults ages 15-49 and 140,000 children;

• ~20% of pregnant women (most representative of the general population) and

~95% of prostitutes in Addis Abeba have HIV or AIDS;

• 80% of deaths among adults ages 15-49 currently are due to AIDS;

• 700,000 children, currently living, have lost their mother or both parents

to AIDS;

• 60% of males ages 15 to 49 could die by 2009 if current trends continue;

• 87% of new HIV infections are due to the practice of multiple partner

sexual contact;

• In urban areas, 22% males, 8% females, 24% female high school students,

and 53% female high school students engage in sex with multiple partners;

~25% of farmers engage in extra-marital sex and most with prostitutes;

• Only one condom is available for one person for a year;

• Only 48% of the 15-49 age group admitted to using condom during last

intercourse;

We can not be ignorant of the scale of this disease and our bleak future

given:

1. Current deaths reflect infections that occurred several years earlier

because of the 3-10 years lag between HIV infection and deaths.

2. The policy of NOT notifying people with HIV/AIDS that they have the

disease; persons with HIV/AIDS transmit the infection to others without even

realizing it.

3. Health officials also know only about a tiny fraction of the people

who have the disease because of our population's poor access to health

service units (only 40% population does) and HIV testing capability of these

units (especially in rural areas).

4. Setbacks in economic development (30-240 work days lost per year for a

person, healthy workers time off to attend funerals,...) health care,

social structure (women forced upon husband's death to sell sex to obtain

income with less time devoted for the children) and child survival (become

devoid of proper care and supervision so critical during that period of

their lives) caused by the epidemic. Ethiopia is being robbed of both her

present and her future as the disease primarily affects children and the

economically productive age group, the age when people are also forming

families and having children. The staggering health care costs (425-3140

birr during course of the illness given their higher hospital admission rate

and longer average length of stay ) has caused a strain in the

already inadequate and limited Ministry of Health budget.

The statistics on the human toll was very visible when I visited Ethiopia in

December ‘98. Unfortunately, prevention and control efforts were much less

visible. The problem also has hit home and now neighbors, friends and

relatives are succumbing to this scourge of our time. These are the reasons

for initiating this discussion group.

The discussion group may initially focus on what we can and should do

about the epidemic individually and together. Here are some suggestions:

1. Collect the latest information that will allow understanding of the

burden of HIV/AIDS and prevention/control efforts. Is the population

receiving information on the risks of HIV/AIDS and encouraged to practice

responsible sexual behaviors? Are condoms, HIV counseling and testing and

blood screening readily available? What interventions are targeted at

prostitutes who are the focal sources of spread of the disease and at the

youth who tend to engage in high risk sexual behaviors? What are the

reasons for NOT granting people's right to know about their HIV status and

how do we justify NOT doing it given the public health implications of

mainly spread of the disease? What special efforts are exercised to

improve blood product safety and to prevent the spread of the disease to

the rural population which constitute 90 percent of our population? Given

the cost of the war, will HIV/AIDS become more or less of a priority

meaning funded more or less?

2. Disseminate information via all forms of media in as many languages as

possible and person to person;

3. Establish a foundation or an organization to provide funds to assist

in the control and prevention efforts;

4. Raise funds;

5. Create a resource directory including local and international

organizations working on HIV/AIDS as a first step to establish

collaborations and networks;

6. Write to policy-makers including U.S. Senators and Representatives to

increase funding for HIV/AIDS.

Even the short list above requires the talents and energies of many

individuals. For instance:

-- Is there someone going to Ethiopia in the near future who will be

willing to collect the latest

information on the epidemic?

-- Is there someone with a good grasp of languages who can translate

English write-ups into various languages?

-- Can someone help design posters and/or create a web site?

-- Has anyone gone through a process of setting up a

foundation/organization? Does anyone know of a lawyer who can donate

his/her time for this effort?

-- Can our musicians and singers be willing to write a song about the

problem, to be spokespersons, help in fund-raising, and/or dedicate

percentage of sells from records or shows to the cause?

I hope you can see why I said we need everyone. Are these the right

things to do? What should our role be? One thing I have come to

understand and believe is that we can not afford to be complacent in the

face of HIV as with each passing day, the problem gets worse.

Well-designed, carefully-focused and sustainable prevention efforts, that

have worked in places like Uganda, Senegal and Thailand, are needed

urgently. We should be asking questions like: why does the HIV/AIDS

epidemic continue to explode at a time when we know prevention works and of

prevention measures that work? We must examine the gap between what we know

how to stop the disease and what is being done. The moment has arrived for

the death toll among young adults have become very visible. I don't think

we need to wait, like in some other African countries, to see villages get

wiped out before we join the fight.

In any and all of our efforts, as much as possible, I suggest that we

avoid trying to find scapegoats or someone to blame and politicizing of the

situation but make people focus their attention on the problem.

Whatever happened has already happened and we should deal with what is

happening now. Join us and invite others who have genuine interests to

help to join the group.

Sincerely,

Tadesse Wuhib, MD, MPH

1643 Josephine Street, #512

New Orleans, LA 70130

[email protected]