Zimbabwe’s AIDS War Gets New Blood

Death has a way of bringing the living to their senses. Or so says Brilliant Mushipe, a 20-year-old bank clerk who is among the leaders here of an unusual crusade against dying young.

When young adults die in Africa it generally means one thing: AIDS. Across the continent, about half of infections from HIV, the virus that causes AIDS, strike those younger than 25. In Zimbabwe, about 1,000 people die weekly of AIDS-related illnesses, most of them in the prime of their lives. Morgues have trouble keeping up with the dead.

Mushipe is just two years out of Harare High School. Already, 15 people he knows have died of AIDS. The oldest was 35.

“Each year it comes closer and closer to you,” he said. “Everyone has lost a close relative, colleague or friend.”

But Mushipe is determined to be different. And so are thousands of other recent high school graduates who are pledging to donate blood 25 times during their late teens and early 20s as part of a national campaign to keep young people HIV free.

The drive to create a youth corps of dedicated blood donors is based on a simple premise: HIV infection rates among blood donors have been low throughout the AIDS epidemic, with less than 1% of donors testing positive last year. By comparison, the United Nations estimates that 25% of sexually active adults in Zimbabwe carry the human immunodeficiency virus.

“By going for school leavers [graduates], we are targeting the most sexually active group of the population,” said Everisto Benyera of the National Blood Transfusion Service. “We think it is really making a difference.”

Under the rules of the blood center’s Pledge 25 Club, members agree to donate blood once every three or four months until they have given 25 times. They remain members only if they keep the schedule and continue to test negative for HIV. Graduating seniors in nine of the country’s 10 provinces are recruited by club leaders, who also distribute literature and preach the club’s credo of abstinence and safe sex.

“In this day and age, the cool thing is to be HIV free,” said Mushipe, vice president of the club’s chapter in Harare, the capital. “The culture is to be responsible as far as sexual behavior is concerned. Maybe you still do it, but you make sure the kind of behavior is HIV free.”

The club has been around since 1994, but health officials say it has never been so popular nor its rewards so tangible as now. It took the deadly reality of acquired immune deficiency syndrome to penetrate every aspect of Zimbabwean life, they say, for people to begin embracing prevention campaigns such as this one.

“This is good news, and good news in Africa is 10 times better than good news anywhere else in the world,” said Dr. Timothy Stamps, the minister of health and child welfare. “The HIV situation in Zimbabwe is bad, but I now have indications that it is getting better.”

Later this year, the first 20 or so Pledge 25 Club members will reach their goal of 25 donations. The Health Ministry plans to make a big hoopla about the accomplishment; certificates and plaques are being prepared. The club’s other members will be invited to celebrate as an inspiration to stay the course.

No money is involved. Club members say the motivation is both selfish and selfless: Sticking to the goal becomes a personal challenge, while giving blood--and encouraging others to do the same--helps save lives and builds a sense of community.

“There is a general tendency for people to stop giving when they finish school, but that is exactly when they want to investigate and experiment sexually,” said Shalom Jani, 23, a marketing assistant at a gasoline company who has made 14 donations. “It is just at that time that Pledge 25 is constantly bothering you to be safe.”

There is no way of knowing if Zimbabwe’s decline in reported HIV infections over the last few years can be attributed to the blood donor program. The club grows by about 20% annually, yet there are still only 3,000 regular members. Several thousand new recruits are enlisted every year, but the vast majority drop out. Officials say the most common reason for leaving is a move to rural areas where there are no blood centers. But they also suspect that some members quit because they are embarrassed to acknowledge their HIV status.

“If anyone has high-risk behavior, they naturally defer themselves before we know it and we categorize them as a ‘lost contact,’ ” said Benyera of the transfusion service. “We know that we are only reaching the [top] group of students in the schools. The message is not getting down to the groups lower down. That is our next goal.”

Stamps is also careful not to overstate the club’s effect on curbing the epidemic. He says, nonetheless, that he is encouraged because the HIV infection rate among the country’s 12,000 blood donors has dropped dramatically since the club’s inception. In 1993, 4% of donors tested HIV positive; last year, the number was 0.8%, he said.

In addition, the number of reported new HIV infections among the general population has been nearly halved from a high of 13,356 in 1995 to 7,291 in 1998, according to the Health Ministry. Statistics for 1999 are not yet available.

Dr. Deogratias Barakamfitiye, the World Health Organization representative in Zimbabwe, says the international agency has been so impressed by the blood club that it encourages other countries to create their own. So far, health officials from Uganda, South Africa, India and the Philippines have embraced the idea, he says.

Though the AIDS epidemic in Zimbabwe remains one of the worst in the world, leaders of the Pledge 25 Club are optimistic about the future. The Zimbabwean authorities reacted slowly to the AIDS crisis, but awareness in schools about HIV risks is now high, members say. And with thousands of people around them dying of the disease, young Zimbabweans cannot escape its consequences.

“When you see somebody deteriorate from a healthy being to nothing, it really does change your thoughts and attitudes,” said Jani, who has seen six people die of AIDS. “There really has been a turnaround among young people in this country.”