The Future of Resilience

How One African Country Used Conservative Islam to Keep AIDS at Bay

Senegal’s HIV/AIDS prevalence rate is a shockingly low 0.7 percent.

A mosque in Senegal, where officials have worked with religious leaders to fight HIV/AIDS. Photo credit: Jeff Attaway via Flickr

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In 1986, when Senegal’s first six cases of HIV/AIDS were detected, two health experts, Souleymane Diop and Ibra Ndoye, immediately went to visit the president. Diop and Ndoye explained to President Abdou Diouf the urgency and magnitude of the problem. Diouf’s reply was straightforward: “You are the experts. Tell us what we must do and we’ll do it.”

That response was in sharp contrast to the reactions of many other African countries, which pandered to their conservative voting blocs by ignoring the problem or demonizing the disease’s victims. But Senegal had a well-established scientific community, of which Diop and Ndoye were respected members – Diop eventually became a world-famous AIDS researcher, while Ndoye went on to head Senegal’s National Council Against AIDS, which was set up that very year in 1986.

Almost as soon as the first six cases were reported, donated blood was being screened for the presence of HIV, testing and condom use were being promoted on a large scale, and AIDS awareness became a fixture in the state secondary school curriculum. These policies – more advanced than what was being practiced in much of the Western world at the time – remain in place to this day, and the government of Senegal’s fourth president, Macky Sall, has pledged to keep up the fight.

The results of this fast and effective response to the AIDS crisis have been astounding, and hold lessons not only for the rest of Africa, but the entire world. Today, HIV/AIDS rates in Senegal are incredibly low – the latest UNAIDS figure (from 2012) puts the country’s prevalence rate at 0.7 percent. By comparison, Kenya’s prevalence rate is 6.1 percent, Uganda’s is 7.2 percent, South Africa’s is 17.9 percent and Swaziland’s is 26.5 percent.

Senegal’s success in keeping infection rates down has a lot to do with its swift and science-based response to the disease, but another, also crucial factor is frequently overlooked: religion. “The action taken by religious leaders was crucial, given the place of religion in the Senegalese community – 95 percent of people here are Muslim,” says Selly Ba, a sociologist who authored a study that examined the way the state engaged Islamic religious leaders and how they then spread the prevention message.

A scene that takes place in Senegal’s mosques after prayer illustrates the strategy. “Everyone takes part in what is known as a daara. It is a Koran-based time and space where people help each other and discuss many different issues. And this is the precise time and space that religious leaders used to teach about the risks of HIV and AIDS.” The mosques began this practice at the request of the state, which asked them very early on to join the battle against the disease.

It didn’t happen overnight. “There was hesitation, even resistance, and the initial work of the health professionals was difficult,” says Ba. “After all, there are religious circles where AIDS is seen as the result of depravation, an immoral disease. But thanks to the hard work of people like Awa Marie Coll Seck (an AIDS researcher and currently Senegal’s health minister) a lot of that resistance has been gradually removed. But I must tell you that, yes, in some places AIDS is still considered a form of divine punishment.”

Ironically, the conservative interpretation of Islam that prevails here has helped to keep the infection rate down. The use of alcohol and drugs, which can lead to risky sexual behavior, is frowned upon, as is promiscuity and extramarital sex. In 1995, Senegal’s largest Islamic NGO, Jamra, published a booklet that was simply called The Islamic Guide to AIDS. In it, Jamra counsels against pre-marital sex and infidelity. The word Ba uses for these guidelines is “sexual hygiene.”

“It’s about behavior,” she says. “Islam is a system of living, and good behavior conserves the community and prevents harm.”

There is elegance and subtlety in these guidelines, says Ba. And more importantly, the message has reached the vast and deeply religious masses. ‘Religious discourse differs from that of health technicians because it touches peoples’ spirituality.” You can also see it in the way people who live with HIV/AIDS have been addressed, she says. “The message is: you are not condemned, and if you do everything you can to prevent AIDS from spreading, you are even blessed.” It’s a form of open religious discourse that would be considered unimaginable in many Western circles.

Still, pockets of fire and brimstone remain – homosexuals are excluded from this eloquent forgiveness. The social climate has also been hardening of late, and activists like Djadji Diouf, who heads AIDES, an organization that assists people living with AIDS and works towards prevention, particularly in the gay community, have been stepping up their fight for equal rights for sexual minorities. “We must be afforded the same rights as everyone else and must be able to contribute to society as citizens of this country,” Djadji says. In his mind, his activism and the battle against HIV/AIDS are closely connected. Hopefully, president Sall is listening.

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