"In my experience I've found that really it is the church that has been taking care of the dying and even making some attempt at HIV/AIDS prevention," said Ann Doherty, director of programming for Catholic Medical Mission Board. The not-for-profit charity, based in New York, is gearing up to launch its own AIDS/HIV counseling program on the continent this fall.
"And it is the churches who come forward to take care of orphans of AIDS victims," Doherty said. "The churches have been there all along, so it only makes sense to work together."
Any real dent in the AIDS epidemic cannot be made without the help of African churches, said Debbie Dortzbach, director of an HIV/AIDS prevention program in Africa run by World Relief, the international aid arm of the National Association of Evangelicals.
"The church is already established in the community. It is usually well-respected, and it has a ready audience," said Dortzbach. She was one of several World Relief staffers who attend the 13th International AIDS conference in Durban, South Africa, which ended Friday. "When churches use their position in the community to distribute accurate information, they can sometimes be more effective than clinics and other health institutions, which are so busy with so many numbers of patients that they don't really have the time to sit down and counsel very often," she said.
Churches play a large role in encouraging responsible personal behavior, said Dortzbach, and can offer a spiritual context for prevention messages in secular campaigns.
"Messages about abstinence and faithfulness are out there but it is the church that can really illustrate and address those issues most effectively." said Dortzbach. "The church gives the necessary context about faithfulness and abstinence until marriage."
In Rwanda, World Relief has teamed up with churches to distribute about 2,000 manuals for people who provide home care to people infected with the virus. Some caregivers are as young as 10 years old, said Dortzbach.
"We went that young because our experience has shown us time and time again that the children are often the primary caregivers for their parents dying of AIDS," she said, noting the manual will be adapted for use in other countries including Malawi, Mozambique and South Africa. "The need for home care is overwhelming, and the resources for meeting that need outside the home are nonexistent nearly everywhere."
Catholic Relief Services, the overseas relief arm of the United States Catholic Conference, plans to do the same in Kenya, a nation often considered the epicenter of the AIDS crisis, said Susan Hahn, who served as the organization's East Africa regional director for the past seven years and is now director of program quality support. She said the group's AIDS/HIV prevention programs in Africa stretch back 10 to 15 years, and include mobile clinics and programs in Catholic schools in Burundi.
"You can't be involved in health and social services in Africa without dealing with the AIDS crisis," said Hahn. "We have shifted our focus from hospital-based care to community-based care, and local churches are definitely a huge help with that."
The Medical Mission has already entered a five-year partnership to fight AIDS with the Southern African Catholic Bishops Conference and pharmaceutical powerhouse Bristol-Myers Squibb. The mission will donate $1 million--25 percent of its healthcare budget--to AIDS/HIV prevention programs in South Africa for the next five years.
"AIDS is such an extraordinary epidemic, the religious community is obligated to help," said Doherty. "Sometimes a religious leader is the only person the community resident can go to in a time of crisis."
In countries where African churches have collaborated with local governments and non-governmental organizations to stop the spread of AIDS, infection rates have decreased, said Dortzbach, citing Uganda as an example.
"In Uganda, the church has been involved from the very beginning and it has paid off," said Dortzbach, noting that by the end of the last decade Uganda was the first African nation whose rate of new infections was on the decline. "The church has partnered with all sectors of society, and together they have lowered the prevalence of AIDS in that country. Now I think there's a real commitment on the part of governments to see the church involved more--Uganda is considered a success story."
On a continent where an estimated 5,500 people die of AIDS every day, the African church's role in HIV/AIDS prevention cannot be ignored, said Clive Calver, president of World Relief.
"This is the biggest epidemic to hit this world since the black plague during the Middle Ages," said Calver, who has personally visited Ethiopia, Kenya and Sudan to work on HIV/AIDS prevention programs in those countries. "We've got to do something, and we've got to do it now.
Opportunity for hope is slim. The expensive drugs available to AIDS and HIV patients living in wealthy countries are an economic impossibility for people in developing countries. In May five major pharmaceutical companies, including Glaxo Wellcome and Bristol-Meyers Squibb, offered a glimmer of hope by offering to offer to reduce the cost of some drug treatments for infected people living in developing countries.
But health officials point out that many African countries still have no health care system able to distribute the medicine or monitor patients to ensure the medicines are effective.
In South Africa, where about 20 percent of the people are infected with the virus, the government has refused to cover the cost of life-saving drugs that could prevent mothers from passing the HIV virus to their children. Some say South African president Thabo Mbeki himself is a stumbling block to stopping the spread of AIDS.
Mbeki has publicly questioned the link between the HIV virus and AIDS. His speech at the Durban conference's opening ceremonies, criticized by many for not going far enough to acknowledge a link between the HIV virus and AIDS, prompted hundreds of conference participants to walk out.
For years the majority of churches in Africa remained on the sidelines as the AIDS epidemic mushroomed, hesitant to tackle a subject that required frank talk about human sexuality and other subjects long considered taboo in the religious community, said Dortzbach.
"For a long time the church has not wanted to address effectively issues like sex or male/female roles, so there's also a lot of stigma surrounding this issue that the church has helped create that we need to come to grips with," she said. "I also think churches sometimes have chosen not to be aware of AIDS--there's been sort of a self-righteous attitude that this can't be in our church, and that's true in the United States as well. But now the epidemic has grown so much the church is finally realizing its something we can't ignore."
"Church leaders in Africa have been coming to a growing recognition of the AIDS dilemma, and now they're waking up to the problem," he said. "Now they desperately need the resources to fight it."
That's where faith-based relief organizations step in to help, said Dortzbach.
"Our work is set out for us, but the church is the institution that will be there for the long haul," said Dortzbach. "The church is God's instrument in a crisis like this, we have no choice but to help."