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Excerpt: The Hyperborder in a Globalized World

Southern Africa: Cross-Border Health Initiative to Combat HIV/AIDS

According to the Joint United Nations Programme on HIV and AIDS (UNAIDS) and World Health Organization’s December 2005 AIDS Epidemic Update, approximately 40.3 million people are living with HIV across the globe,14 — 65 percent of whom live in Sub-Saharan Africa, the pandemic’s most afflicted region. In 2005, the region’s HIV prevalence among adults was 7.2 percent, and 2.4 million people died as a result of the disease — a sum that accounts for 77 percent of the worldwide AIDS death toll. Within Sub-Saharan Africa, southern Africa is the region most severely affected by HIV/AIDS. According to us Agency for International Development (usAID), it is estimated that more than one-fifth of the respective adult populations in Botswana, Lesotho, Namibia, South Africa, Swaziland, and Zimbabwe are living with the disease.15 Prevalence of HIV among pregnant women in the region is particularly high, demonstrating that rather than being concentrated in specific sub-groups (which tends to be the case in other parts of the world) the disease has grown to severely impact the general population. At the same time certain sub-populations, particularly in border regions, maintain a greater level of risk. Statistics show that in southern Africa mobile groups like migrant workers, truck drivers, and sex workers are three to six times more likely than the rest of the population to contract the virus.16 These groups’ tendency toward mobility across borders and throughout the region makes them both difficult to diagnose and more likely to spread the disease — reasons for which they are the principal targets for new prevention and treatment programs.

In 2000, usAID introduced the Regional HIV/AIDS Program for Southern Africa (RHAP/SA), designed to complement existing programs and to coordinate prevention and treatment efforts across borders.17 The advantage of collaboration and cohesive action between countries throughout the region was recognized by the Southern African Development Community (SADC) as the most effective way to confront the epidemic’s spread across the nations’ porous borders. Knowing this, the primary focus of RHAP/SA is to reduce the levels of transmission among populations — particularly those that are mobile — found along critical cross-border points, in an initiative called Corridors of Hope. This program has significantly increased access to HIV/AIDS prevention methods by providing education and risk-reduction counseling as well as distributing condoms at forty-one different cross-border sites in southern Africa. According to usAID, during the fiscal year of 2004 more than two million people at different border sites were informed about preventative measures as a direct result of the RHAP/SA and Corridors of Hope activities. Emphasizing the success and value of this type of regional development, the World Health Organization reports that a thorough program encompassing both prevention and treatment throughout Sub-Saharan Africa could avert 55 percent of potential infections by 2020.18 Although the HIV/AIDS pandemic continues to be rampant throughout southern Africa, organizers involved in the cross-border health and prevention initiatives are optimistic that regional approaches and strategies will produce positive results and prove that prevention is an issue that requires cooperation rather than isolation.

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14. UNAIDS and World Health Organization, “AIDS Epidemic Update,” special report on HIV prevention (Geneva: UN-AIDS, Dec. 2005), http://www.who.int/hiv/epi-update2005_en.pdf (accessed Oct. 17, 2006, link no longer available).
15. usAID, “Health Profile: Southern Africa Region,” Dec. 2004, (accessed Sept. 7, 2006).
16. Ibid.
17. Ibid.
18. UNAIDS and World Health Organization, “AIDS Epidemic Update.”