The journalist says prevention is the key step that no effort has been able to successfully deliver on yet.

Question: How should we confront the African AIDS crisis?

Richard Dowden: It’s a long process. What’s been wonderful and, you know, the United States had led on this, is the money for anti-retroviral. And that’s been really, really important, particularly, because it’s kept alive the parents and the people who need it now to bring up the next generation and also, the professional middle class, which is so vitally needed in Africa.

Nobody, as far as I can see, has completely convincingly crack the prevention problem. You can see the figures go down, and you wonder why, and you look at it, and you think, yeah, maybe the big publicity campaign or something like that. But then they start to creep up again, inexplicably. So they’ve leveled off in many places, but that may be for a whole lot of factors. And nobody has yet come up with a way of convincing a large number of Africans to take prevention seriously. And, I think, that’s the big one.

Because it’s, really, only--I say only--but it’s a huge problem in Southern Africa. Zwaziland is, for example, is a catastrophe, nearly 40% infection rate. It’s just horrific. But the East Africa, it’s stabilized.

West Africa, it hasn’t happened, as people predicted. And we’re not quite sure why. Maybe it’s the levels of circumcision, which seems to help prevent the disease spreading and it maybe Islam as well. That the society are not promiscuous. But to stop the spreading elsewhere, nobody’s crack that yet.

Question: Have African leaders spread misinformation about AIDS?

Richard Dowden: One of the things that strikes you in Africa is is a very spiritual view of the world. Which in some ways, wonderful because we’ve lost it. We’ve very mechanical in the way we deal with things. But it has its downsides. And one of it is that when something happens, when something bad happens to you, you don’t say, that was a bad accident, that was bad luck. You say, who has made this happen to me? And there’s an element of that use of spiritual power. So you’re feeling as an enemy, has got someone who has powerful; has got a spirit to come and make you have that accident.

Nothing happens by accident in Africa. There’s always somebody behind it and who has manipulated the spirits in some way to make it happen.

And I wonder whether, if you apply that to sex and AIDS and so on, two things may happen. Carrying on the having children spreading humanity, spreading life, a very powerful instinct there.

On the other hand, if something bad happens to me, it’s not my fault someone has done this to me. So there’s a lack of agency, of personal agency in your life.

And I think that that, maybe, have to be broken down if AIDS is to stop spreading.

Recorded: March 16, 2009