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HIV/AIDS and Christians in Africa


Africa for more than a century has been the great Christian mission field. If, like me, you belong to a church in the evangelical stream, the chances are you are helping support Christian mission activity somewhere on the continent. You probably get occasional reports from the field, detailing the challenges and successes.


Are we wasting our money?


Last week’s United Nations “Barcelona Report” on the global HIV/AIDS epidemic is devastating in its portrayal of the crisis that has engulfed sub-Saharan Africa, where a dozen countries have an adult (those aged 15 to 49) infection rate of more than 10%.


The report doesn’t have much to say about the role of religion, which is possibly just as well for those of us who are Christians. For the question needs to be asked: What has Christianity been doing as this crisis developed?


Using the Operation World Christian handbook, I have taken rates of religious adherence for each African country and placed them next to the adult HIV/AIDS rates from the Barcelona Report. What a depressing exercise.


Here are the 10 most Christian countries in Africa (according to Operation World) and their adult HIV/AIDS infection rate:


                                    Christians (%)      HIV/AIDS rate (%)

Congo (Dem. Rep.)       95.3                       4.9

Equatorial Guinea         95.1                       3.4

Angola                          94.1                       5.5

Congo                           91.3                       7.2

Burundi                         90.1                       8.3

Uganda                         88.7                       5.0

Zambia                          85.0                     21.5

Swaziland                      82.7                     33.4

Rwanda                         80.8                       8.9

Malawi                           80.0                     15.0


But where the figures get really depressing (for an evangelical Christian) is when you realise that in general the HIV/AIDS rate is highest in those countries where Protestants and other non-Catholic Christians predominate.


Here are the 20 most non-Catholic Christian countries in Africa and their adult HIV/AIDS infection rate:


        Non-Catholic Christians (%)            HIV/AIDS rate (%)

Swaziland                   78.0                                         33.4

South Africa                 65.2                                         20.1

Ethiopia                       64.4                                           6.4

Namibia                       64.0                                         22.5

Botswana                    63.2                                         38.8

Zimbabwe                    63.0                                         33.7

Malawi                         57.1                                         15.0

Kenya                          56.0                                         15.0

Ghana                         53.2                                           3.0

Central Af. Rep.           51.7                                         12.9

Zambia                        51.6                                         21.5

Congo (Dem. Rep.)      50.8                                           4.9

Uganda                        46.7                                           5.0

Eritrea                          43.7                                           2.8

Cameroon                    42.5                                         11.8

Congo                          42.0                                           7.2

Nigeria                         39.2                                            5.8

Rwanda                       38.2                                            8.9

Mozambique                36.8                                          13.0

Lesotho                       35.8                                          31.0


If you are not already sufficiently depressed, look at a table for the 10 most Muslim countries in Africa:


                               Muslims (%)      HIV/AIDS rate (%)

Somalia                      100.0                1.0

Morocco                       99.9                 0.1

Algeria                         96.7                 0.1

Libya                            96.5                 0.2

Senegal                       92.1                 0.5

Gambia                        88.8                 1.6

Mali                              87.0                 1.7

Egypt                           86.5                 0.1

Sierra Leone                70.0                 7.0

Sudan                          65.0                 2.6


In church we are told that one of the reasons we should support Christian missionary activity in Africa is to stop the spread of Islam. In the words of Operation World: “African Christians as well as mission agencies need to make Muslims a priority for demonstrations of the love of Christ and culturally sensitive approaches must be developed for planting churches among them.”


Yet as AIDS rips at the heart of the continent - devastating families, gutting townships, wrecking national economies, creating millions of orphans - it looks to be Islamic culture that has solutions of a sort.


Nicholas Kristof wrote a nasty article in the New York Times on Tuesday, blaming “conservative Christian pastors” particularly, for contributing to hate speech about Islam in the US. (He even managed to find two such pastors, one of them quite well-known.)


But he also wrote this:


Islam already has 1.3 billion adherents and is spreading rapidly, particularly in Africa, partly because it also has admirable qualities that anyone who has lived in the Muslim world observes: a profound egalitarianism and a lack of hierarchy that confer dignity and self-respect among believers; greater hospitality than in other societies; an institutionalized system of charity, zakat, to provide for the poor. Many West Africans, for example, see Christianity as corrupt and hierarchical and flock to Islam, which they view as democratic and inclusive.


On no young woman would I wish genital mutilation, minimal education, a life behind a veil and a husband with several wives. But what if the alternative were a husband who contracts HIV/AIDS from frequent visits to cheap prostitutes, giving his wife a painful death at age 30 and leaving behind six young children?


I simply don’t have answers. I’m no expert on HIV/AIDS or on Africa. I’m just an ordinary guy sitting in front of a computer, playing with figures on a spreadsheet. I’m sure it’s all a heck of a lot more complicated than the numbers suggest.


Yet I believe we Christians are called to be accountable for our actions, individually and as a church. And so I cannot help wondering if Christian leaders in Africa and their supporters in the West are not responsible in some measure for the crisis over there.


Two months ago I wrote a commentary about Papua New Guinea. I noted that it is, according to the Operation World handbook, the fourth-most Christian large country on earth (97.3% of the population are said to be Christian), yet it is facing an Africa-style AIDS crisis. My sarcastic conclusion then is perhaps also appropriate now:


What on earth are church leaders teaching their 97.3% flock (or is the problem all the fault of the other 2.7%)? What messages are the missionaries bringing? Should I be directing my tithes elsewhere? Or should I just sit back content in the knowledge that so many are going to heaven?


July 12th, 2002


As a result of many responses, I posted a follow-up item the next day:


HIV/AIDS in Africa

Thank you for the response to my commentary yesterday, “HIV/AIDS and Christians in Africa”, in which I noted that the African countries with the highest HIV/AIDS rates seemed to be those that also had the most Christians (and, in particular, the most non-Catholic Christians).


Jerry B. emailed a considerable amount of information about the unreliability of HIV/AIDS reporting in Africa, and provided a link to a detailed article from Rolling Stone magazine, “AIDS in Africa – In Search of the Truth”.


Instapundit wrote:


Over the years I’ve seen a lot of charts co-relating AIDS incidence with everything from language to circumcision rates.


Roth also notes that Islamic areas tend to have lower rates. This may well be true (among other things, the widespread Muslim custom of washing before and after sex may help). On the other hand, they may have lower reporting rates, for reason of stigma. (This may be true of the Catholic Christian areas, too.)


Why AIDS has spread so extensively in Africa, and why rates are so different in different parts of Africa, remains a mystery. Religion might be the explanation, but there are a lot of other candidates.


Medpundit commented:


The incidence…is more likely to be related to famine than to religion. The highest rates are in those countries whose populations are starving….None of the Muslim countries make the list. Famine is always followed by pestilence. The body can’t fend off infection when it’s emaciated, even when given drugs to help. That’s why the solution to AIDS and other diseases in places like Africa is not likely to be found in just throwing money and drugs at them.


Ted Esler provided a link to the Mission Review website, which gives access to a huge amount of material detailing the many positive initiatives being undertaken by mission organisations to combat the global HIV/AIDS epidemic.


And Nathan M. wrote:

In presenting the Gospel anywhere in the world, we have to figure out how to better present the “go and sin no more” aspects of it. There needs to be grace, but there needs to be change as well. Those looking for a high count of those saved will emphasize the first. Those looking to control…will try and force the second…. Christianity can and must hold both in balance. We needn’t wait to get our house perfectly in order before spreading the Gospel (we won't be there until we reach Heaven), but that doesn't excuse our own lack of seriousness towards God's demands.


I should say that my article was to some degree intended to be thought-provoking. I was always dubious about the accuracy of HIV/AIDS reporting.


I also wonder about the claims that certain African countries are highly Christian. The Operation World handbook does an excellent job in standardising and presenting global statistics from a myriad of sources. But many of these statistics are, to put it mildly, of dubious reliability, for a variety of reasons.


Take my own country Australia. It is said to be 67.5% Christian (based on census data), despite being a hugely secular and materialistic place, with a strong anti-Christian strain prominent in the media and throughout some other institutions. Church attendance is low, and I’d hardly call us a Christian country at all.


But let’s end on a note of optimism. The African country with the largest number of evangelical Christians is Uganda. According to Operation World, more than 40% of the population are evangelical Christians, one of the highest rates in the world. Uganda also has a low (for Africa) adult HIV/AIDS rate of just 5%.


According to Operation World:


Uganda is the first country in the world with a massive AIDS problem to…reduce the numbers of the afflicted, from possibly 25% in 1992…. Both government and churches faced up to the terrible calamity and have successfully worked to achieve this reduction.


Praise the Lord.

July 12th, 2002