Comment:

Clouded in obfuscation, confusion, ignorance, myth or reality? Demystifying the figures

By John Kiwanuka Ssemakula, 10th August 2002

With the recent conclusion of the 14^th HIV/AIDS conference anyone with an interest in the HIV/AIDS problem is sure to have come away with the impression that it is a bad, bad situation. All involved have had our heads filled with facts, figures and statistics about how the HIV/AIDS epidemic is the worst since the Black Death. But do most people beyond the experts really understand what these statistics mean?

Is it true that half of Botswana is infected with HIV?  Is the population of Africa shrinking as a result the AIDS epidemic? With all the wars in Africa is AIDS really the biggest killer of Africans? Is AIDS a bigger killer than Malaria? Why is Uganda with an HIV prevalence rate of 6% regarded as a success, whereas Nigeria with a similar HIV prevalence rate of 6%, but with a higher incidence of HIV is regarded as on the verge of an AIDS explosion?

Come to that, what does prevalence mean? What is the difference between the incidence and prevalence of a disease such as HIV? Are they the same? How is the infant mortality rate defined and how does it become a comparative measure of health development of a nation?

These are all terms that are commonly used in scientific publications and journals where they are most likely to be understood by the readers of those journals, presumably because they have training or a background in the subject. But too often, these same journals are read by and reproduced by journalists for non-scientific newspapers and magazines, who often do not have a background a scientific background. This means that quite often, scientific terms, definitions, facts and figures are used in incorrect ways that give an unrepresentative or completely misleading picture about the subject.

Apart from misinforming and confusing the general public, misrepresentative and wrongly reported scientific data can result in impressions that are out of step with reality. In extreme cases they can have unfortunate consequences, that may result in prejudice against wholly innocent persons, or lead to policies that discriminate people wrongly such as the Canadian Immigration policies that require mandatory HIV testing of people of African origin, denying entry to those who test positive. At the very least it is a considerable source of distress and anger to people from the affected nations, who quite often feel there is some kind of conspiracy or underhand plan behind all these misrepresentations.

This is not to say that the reporting from within Africa is any better. Not having ready access to data like their counterparts from developed countries, journalists in many African nations (many of whom have no scientific background) are forced to rely on data from media sources in the West and these are those same distorted or misreported facts, and so the lie goes on. The local readers are then fed stories based on wrong information from the West about their own situation. For the more intelligent or sharper readers such misinformation will cause them to be totally suspicious of health information, particularly about AIDS published in any media outlet. Hence the commonly held view of some kind of conspiracy theory about AIDS still held by many people across Africa.

This is unfortunate, because the media is one of the means of educating and informing the general public about public health issues and forms part of any prevention campaign. But if people don’t trust the media, how will they become alerted to potential problems or educated in how to prevent or protect themselves from new or emerging diseases?

This website also regularly presents reports and data from numerous sources.  Medilinks makes no apologies for this. However one can say with assurance that data is not presented without being cross checked against other sources, and of course against that of the experience of the researchers at Medilinks. This is not absolutely infallible, because the information sources may all be based on the same corrupt data source. However it is one way of ensuring that our readers do get accurate information.

Medilinks was created as source of information to educate and inform the public. So if one is to believe one’s own hype, taking this one step further, Medilinks over the next few months, will be presenting a series defining and explaining some common epidemiological terms that are commonly used in the public health arena. Demystifying or demythifying the figures. The hope is that this will go someway in illuminating and clarifying what the data really means.

And to start off short answers to some of the questions asked at the beginning.

1. Is it true that half of Botswana is infected with HIV?  NO
2. Is the population of Africa shrinking as a result the AIDS epidemic? NO
3. With all the wars in Africa is AIDS really the biggest killer of Africans? Yes but it depends on who you ask!
4. Is AIDS a bigger killer than Malaria? Yes but it depends on who you ask!
5. Why is Uganda with an HIV prevalence rate of 6% regarded as a success, whereas Nigeria with a similar HIV prevalence rate of 6%, but with a higher incidence of HIV is regarded as on the verge of an AIDS explosion? Nigeria’s incidence (number of new cases) of HIV is much higher meaning the epidemic is growing at a faster rate, whereas Uganda has brought down the prevalence (number of people infected with HIV/AIDS) and the incidence of HIV.

There will be more answers and more detail in the report series. You’ll just have to check back regularly. Happy reading!