Halting the march of HIV/AIDS in Africa

Across eastern and southern Africa, the socio-economic impact of HIV/AIDS on individuals, households, communities and society as a whole, is devastating. No sector has been left untouched, including health, education, agriculture, transport, small and big business, trade and civil society. What can the rural transport sector do to help lesson the impact of the disease?

A study by the International Forum for Rural Transport and Development in Kenya, South Africa, Tanzania, Uganda and Zimbabwe reveals very little integration of HIV/AIDS issues within national transport programmes. Transport costs are a major obstacle to seeking or supplying healthcare treatment. Immunisation and disease control programmes are problematic because the safe and timely delivery of medicines is often disrupted. Poor access prevents patients from seeking healthcare and from returning for further treatment.

Yet, improving rural access can be risky: the spread of HIV is intensified as people become more mobile. Transport hubs, road corridors and locations of infrastructure construction and maintenance all act as catalysts for the rapid transmission of HIV and other infectious diseases.

Evidence shows that, on average, HIV prevalence among long-distance truck drivers is considerably higher than among other transport workers and the general population. In Tanzania, truck stops attract commercial sex workers, as well as petty traders, bar maids and so on from surrounding areas. The primary transport sector response has been to focus on prevention by targeting transport and commercial sex workers, without acknowledging that people near transport activity areas also need safeguarding.

The Council of Scientific and Industrial Research in South Africa recently completed a pre-implementation study for the South African government on integrated rural mobility and access (IRMA) in three districts. People with HIV/AIDS need regular contact with healthcare professionals and the availability and affordability of rural transport services is crucial in lessening impact. IRMA seeks to:

• improve patients' attendance at clinics
• improve flexibility as to where healthcare professionals are posted
• introduce transport technologies that reduce the burden of domestic activities so that women particularly, can take up paid employment or have more time to care for members of their household living with HIV/AIDS
• provide rural clinics with motorcycles to improve their access to better-equipped hospitals or, for instance, to transport blood samples or deliver medical supplies.

The study highlights the important role transport plays in reducing the impact of HIV/AIDS. The transport sector needs to educate and counsel its personnel and be more involved in reaching communities along transport corridors. For rural transport to become more effective in the battle against HIV/AIDS there is a need:

• to identify the most vulnerable and people living with HIV/AIDS
• for community based organisations and households to engage in action research to identify the most appropriate solutions
• to institutionalise a multi-sectoral partnership approach, with the transport sector playing a central role, anchored in the realities of people living with HIV/AIDS and other vulnerable groups
• for more work to strengthen coping mechanisms and strategies that will ensure the sustainability of rural livelihoods long after external inputs have ended.

Mac Mashiri
Coordinator South Africa National Forum Group, CSIR Built Environment, PO Box 395, Pretoria, South Africa
T +27 12 841 2942
Mmashiri@csir.co.za

See also

Community Responses to HIV/AIDS along transit corridors and areas of transport operations in Eastern and Southern Africa, IFRTD/CSIR, Final Report, April 2004
www.ifrtd.org/new/reg_wrk/reg_hiv.php

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