Malawi minister breaches deadly wall of silence surrounding Aids

The true state of the HIV/Aids crisis in sub-Saharan Africa was laid bare February 18 by a Malawian government minister, who took the unusual step of disclosing that three of his children have died of Aids. While the present Malawian government has campaigned to raise awareness of Aids since it came to power in 1994, it is rare for African dignitaries to let it be known that the pandemic has affected them personally.

February 18, Thengo Maloya, the lands and physical planning minister, took the difficult and emotional step of revealing his family's loss to members of his staff during an Aids awareness workshop. Mr Maloya, 56, said he had lost two sons and one daughter to the disease in the last 10 years. "It is very painful," said Mr Maloya. "They would have taken care of me and buried me but instead I have buried them at such an early age." The minister said it was time Malawians realised the extent of the disease in their country. He said that in the last six years alone his ministry has lost close to 100 key staff members to Aids. His ministry is now understaffed and many who are still working are themselves ill and too sick to come to the office regularly, he said. Those who are not ill have lost many work days because they are either caring for a sick relative or attending a funeral. "This is a very serious issue, let's agree that Aids is killing people," Mr Maloya said. Out of the population of 11 million, around one million are estimated to be infected with HIV and 300,000 need treatment urgently.

The Malawian minister has joined a small number of African politicians who have chosen to break the taboo surrounding Aids. His outspokenness was especially unexpected because Malawi is one of southern Africa's most conservative countries and few talk openly about sex, condoms or sexually transmitted diseases. Kenneth Kaunda, the former president of Zambia, set an example when he revealed that his son had died of the disease. The former South African president Nelson Mandela has admitted that several of his relatives had succumbed to Aids. Such honesty remains unusual as families routinely pretend that loved ones have died of other diseases such as tuberculosis. It is an open secret that South Africa's former minister for sport, Peter Mokaba, died of Aids, but his colleagues in the ruling African National Congress refuse to say so publicly. Two years ago Malawi's parliamentary speaker, Sam Mpasu, shocked the nation when he announced that parliament had lost 28 lawmakers to Aids in a four-year period. But awareness of the implications of HIV infection is now widespread, because around 15% of the population is infected with the virus. The figure rises to 25% in the towns. Every family knows someone who has died.

In an interview with the Guardian for Saving Grace, a special report on the lack of access to medicines for a continent where 30 million face death from HIV/Aids, the vice-president of Malawi, Justin Malewezi, said his government was determined to educate people about the disease. "Barely three months after coming into government, the president led an awareness march in Blantyre which kicked off the campaign to make the people more aware and to start breaking the silence around this disease," he said. "So awareness is the first stage. "We have had very good success in raising awareness. Awareness is now almost universal. People know about HIV/Aids, they know how it is caused and they know in theory how you can avoid it, but obviously moving from awareness to behavioural change is a big step which we haven't achieved to the same level as we would wish."

In Malawi as in many other countries, there are customs and cultural taboos around the use of condoms and the practice of safe sex which are proving hard to shift. Posters in the capital, Lilongwe, exhort people to take care of themselves. "Aids is killing Africa," says one. "Malawians change your behaviour now! Let us save our country." But until recently, the stigma attached to the disease and the knowledge that HIV infection would inevitably lead to death from Aids within a few years prevented most people from going to be tested. However, in Lilongwe's flagship Aids clinic, the Lighthouse, antiretroviral drugs that can keep people with HIV well for years have begun to be provided and staff are finding that people are far more willing to come openly for testing as a result (Guardian /London)