By Richard Chirombo
Lothiar Ngulube: Stigma takes many forms and should be avoided
It started as a strange idea then, an infection without medication;
now, at a three-decade distance, HIV and AIDS remain the world’s
Martha Kwataine, Malawi Health Equity Network’s National Coordinator,
pins this scenario down to the multifaceted nature of HIV and AIDS.
“It is not about (the) health (sector) only, there are many other
sectors involved, each facing unique challenges,” says Kwataine.
This has rendered efforts against HIV and AIDS difficult because, in
the process of this collaboration of convenience, other sectors pull
the string of success in opposite directions. After all, the analysis
of collective action has always been a risky adventure.
For one thing, there are too many experts around. It is less like
addressing the issues of eating, breathing, and sneezing: almost
everyone claims to know enough about these aspects of life to survive
on their own terms, and no one likes to be told they are ignorant
about some element of the same.
But the situation is more delicate than that. Deep in every
deliberation of collective action stirs the lava of volcanic
disagreements because such action rests on power, influence, prestige
and politics and, inevitably, raises such questions as who is right or
wrong, just or unjust, and more competent than the other.
Additionally, the very setting of the challenge (HIV and AIDS in this
case) is likely to include judgements about who has the right act, and
what good it does.
This situation, in the face of HIV and AIDS, is so precarious it is
suicidal. More so because issues of HIV and AIDS border on the extreme
opposites of life and death, hope and hopelessness, success and
failure, with no luxury of extra-time involved.
Yet, claims Anthony Kasunda- acting chairperson for the Media
Institute of Southern Africa, Malawi Chapter (Namisa)-there seems to
be one crucial sector that is taking all the time in a world that
offers no extra-time: the media.
The Malawi media is suffering from an ailment called laxity in the
midst of a health crisis that continues to rob the country of her most
product citizens as it eats through the very fabric that symbolizes
progress, the youth. The departed youths are leaving behind shadows of
child and granny-headed households, an ageing workforce, squandered
government resources, and breeding hopelessness.
This ailment, says Kasunda, is apparent in the way media practitioners
fan discord through negative HIV and AIDS reporting.
“We are struggling on non-discrimination writing. People still
complain about some negative terminologies used in the media. We need
to improve in the way we tackle (issues of) stigma and discrimination
in the context of HIV and AIDS,” says Kasunda.
The encouraging thing is that this media disease, like the HIV virus,
can be avoided and stopped from evolving into a regrettable scourge.
Practitioners have realized this and tried to put in place structures.
The Journalists Association of Malawi (JournAIDS), Media AIDS and
Health Watch (Mawa), Association for Journalist against HIV and AIDS
(Ajaah), Network of Journal Living with HIV and AIDS (Nejoha) are
fruits of these efforts.
“These are good efforts, but I strongly feel that real success is
hindered by too much obsession with (professional) objectivity. Media
practitioners report HIV and AIDS issues as if they were not affected,
as if they are on a different planet and are watching things from
afar. I think the media has failed this nation in their response to
HIV and AIDS,” says Madalitso Kateta, one of the few Malawian
journalists to have declared their HIV sero-status.
Kateta, who is Nejoha’s deputy secretary general, adds that Nejoha,
Ajaah, Mawa, and JournAIDS’s efforts have been frustrated by the
National AIDS Commission (Nac) and other responsible government
departments, and points at the general lack of funding and support
from Nac and the Department of Nutrition, HIV and AIDS, National TB
Control Programme, among others.
“These organizations have not helped matters, and pay lip service over
HIV and AIDS issues. The media, on the other hand, should be stripped
of whatever objective clothing it wears on HIV and AIDS,” adds Kateta,
who is in the process of writing an autobiography on his lifespan, and
the reality of living with HIV and AIDS in Malawi.
Save for handful Nac-funded media institutions- which include FM 101
Power, Malawi Broadcasting Corporation, and Namisa- it remains a hard,
lonely battle for media institutions already grappling with
resource-constraint challenges. To print media institutions,
government has added one more layer of burden by introducing 16.5 per
cent Value Added Tax.
But, in a way, HIV and AIDS have also forced individuals and
organizations into a unity-of-convenience. The result is that people
are now casting their nets wider than their sphere of competence, and
analyzing weaknesses in other sectors in a drive to consolidate
efforts and fast-track victory.
That is how lawyer, and former Malawi Law Society executive director,
Mandala Mambulasa comes into the media HIV and AIDS coverage equation.
Whereas some legal practitioners spend a couple of hours daily,
browsing through and scrutinizing newspapers in the tiresome search
for libelous material, and then calling the people and institutions
they feel have been ‘defamed’ for business opportunities, it is a
different case with him altogether.
Mambulasa finds some time to appreciate media efforts on HIV and AIDS,
as well as time to reflect on any unexplored angles. He says issues of
HIV and AIDS are like a “circle”: people may decide to go whichever
direction but, at last, they find themselves where they begun.
Relating this cycle to HIV and AIDS, Mambulasa says all issues
pertaining to stigma, discrimination in media coverage boil down to
human rights. Thus negative HIV and AIDS reporting infringes on human
“Human rights are supposed to be enjoyed by every person. However, HIV
and AIDS can lead to violation of human rights when people lose
employment opportunities or the right to live in communities owing to
their HIV sero-status. This is where the media comes in,” says
Media practitioners can tackle this aspect of human rights by zooming
in on Constitutional provisions guaranteeing the right to life, and
That way, issues of people being denied employment will make more
headlines in the Malawi media. This has happened in South Africa,
where the issue of Hophman Versus the South African Airways drew the
curtain on workplace-fueled stigma and discrimination.
Hophman had applied for a job as an attendant, only to be rejected for
being HIV-positive. Unrelenting and undisturbed, he went to the
Constitutional Court, which subsequently found the airline’s behavior
wanting. Among other reasons, the court said the practice was
discriminatory in that there was no evidence that people already
employed underwent similar tests (since people can also contract HIV
while on the payroll), and that HIV has different stages, with the
possibility of merely relocating people during the terminal stages
(instead of firing them).
In Malawi, the only case that was recipe for wide media coverage, but
went largely unexposed, was that of N. Mangani versus Malamulo
District Hospital. Mangani was infuriated at the negative behavior of
a medical practitioner who prescribed drugs in a negative manner (by
alluding to the plaintiff’s HIV sero-status in the presence of third
parties, and in a way, putting him in negative light).
“The media need to do more than we have been doing,” adds Mambulasa.
In which case, ‘doing more’ means scrutining new regimes of ARVs, and
doing more research on clinical trials that certified such ARVs as
being fit for human consumption. This is important because, as
experience has shown, the current regime of ARVs was rejected
elsewhere in countries like Zambia and have, no wonder, ended up
deforming many people around, people who were supposed to be
‘beneficiaries’ of free government life-prolonging drugs.
These ARVs are now being phased out, as announced by health officials
recently, but the deformities remain. Reports also indicate that the
new regime is twice as expensive as the one phased-out. With the
Zero-deficit budget, where will the resources come from? In fact,
following World Health Organization’s (WHO) new guidelines, at least
600,000 more people are supposed to be enrolled. Where will we draw
the resources, with the Global Fund’s back now against us?
It is more likely that, with little capacity to generate local
resources, government will look up to foreign financiers, and this has
not helped matters either. Big international pharmaceutical companies
take advantage of this and influence WHO to discourage the use of
generic, as opposed to original, drugs thereby thwarting the growth of
Africa’s nascent pharmaceutical industry. They do this in the name of
promoting Trade Related Intellectual Property Rights (Trips).
However, Blantyre City Council’s HIV and AIDS Coordinator, Lothiah
Ngulube, hopes for the better.
“We can solve this problem by fighting for the use of generic drugs.
In Brazil, for example, people fought so hard for generic drugs that
they (Brazilian pharmaceutical companies) now manufacture 12 types of
generic drugs. Theirs has become a success story,” says Ngulube.
Ngulube says, by paving room for generic drugs’ manufacturing, and
making them available, nations will also solve challenges associated
with stigma and discrimination.
Stigma is defined as any act that devaluates, or discredits, an
individual on the basis of status, class and condition, and may be
manifested by isolating, blaming, and judging others. It has three
main types, namely: self-stigma inflicted by the individual himself;
felt stigma, perpetuated by others, and; enacted stigma, also called
“Provision of ARVs helps in reducing stigma, as well as solving the
problems of suicide, depression and alcoholism,” says Ngulube.