Ukusasazeka KukaGawulayo EAfrika

“Sijamelene nentlekele yodwa.”

LOO mazwi awathethwa nguStephen Lewis, ongummeli weUN for HIV/AIDS eAfrika, abonisa inkxalabo yabantu abaninzi ngokuphathelele uGawulayo kummandla weAfrika okumazantsi eSahara.

Zininzi izinto ezibangela ukusasazeka kwentsholongwane iHIV. Ukanti, uGawulayo ubangele nezinye iingxaki. Nazi ezinye zezinto ezibangela ukwanda kukaGawulayo kwamanye amazwe aseAfrika nakwezinye iinxalenye zomhlaba.

Ukuziphatha. Ekubeni iintlobano zesini ziyeyona ndlela esasazeka ngayo intsholongwane iHIV, kuyabonakala ukuba ukungabikho kwemilinganiselo ecacileyo yokuziphatha kunegalelo ekusasazekeni kwesi sifo. Noko ke, abaninzi bavakalelwa kukuba akuncedi nto ukukhuthaza abantu abangatshatanga ukuba bangabi neentlobano zesini. Kwiphephandaba laseJohannesburg, eMzantsi Afrika iThe Star uFrancois Dufour uthi: “Akuncedi nto ukulumkisa abakwishumi elivisayo ukuba bangabi neentlobano zesini. Mihla le babukela imifanekiso evuselela inkanuko yesini nebonisa indlela abafanele bakhangeleke ngayo nabafanele baziphathe ngayo.”

Indlela oluziphethe ngayo ulutsha iyakungqina oku. Ngokomzekelo, uhlolisiso olwenziwe kwelinye ilizwe lubonisa ukuba malunga nomntwana omnye kwabathathu kwabo baneminyaka eli-12 neli-17 ubudala ukhe waba neentlobano zesini.

Ukudlwengula kuye kwachazwa njengeyona ngxaki iphambili eMzantsi Afrika. Ingxelo yephephandaba laseJohannesburg iCitizen ithi “le yeyona ngxaki ixhaphakileyo kangangokuba ibek’ esichengeni impilo yamabhinqa eli lizwe ngaphezu kwayo nayiphi na ingxaki yaye ngoku sele kudlwengulwa nabantwana.” Kwaeli nqaku lathi: “Kutshanje ukudlwengulwa kwabantwana kuye kwanda ngokuphindwe kabini . . . Kubonakala ngathi eyona nto ibangela oku yinkolelo yokuba xa umntu onentsholongwane iHIV edlwengula umntu ongazange abe neentlobano zesini uyanyangeka.”

Izifo ezidluliselwa ngeentlobano zesini. Izifo ezidluliselwa ngeentlobano zesini zixhaphake kakhulu kulo mmandla. ISouth African Medical Journal ithi: “Umntu onesifo esidluliselwa ngeentlobano zesini usengozini yokwasulelwa yintsholongwane iHIV-1 kangangezihlandlo ezi-2 ukusa kwezi-5.”

Ubuhlwempu. Uninzi lwamazwe aseAfrika luthwaxwa bubuhlwempu, yaye oku kunegalelo ekusasazekeni kukaGawulayo. Izinto ezigqalwa njengezisisiseko kumazwe afumileyo azikho kwaukubakho kwinkoliso yamazwe asakhasayo. Iindawo ezihlala abantu abaninzi azinawo umbane yaye akukho manzi okusela acocekileyo. Iindlela zasemaphandleni aziphangalalanga, zimbi okanye kwezinye iindawo azikho kwaukubakho. Abantu abaninzi abahlala kwezo ndawo abondlekanga yaye ambalwa kakhulu amaziko ezempilo apho.

UGawulayo ubangela ukuba kungabikho nkqubela kwezoshishino. Njengoko besanda abasebenzi abanesi sifo, iyehla imveliso yemigodi. Ngenxa yoko, ezinye iinkampani sele zicinga ngeendlela zokwenza eminye imisebenzi ngoomatshini. Kuthelekelelwa ukuba ngowama-2000, komnye umgodi weplatinum inani labantu ababenoGawulayo laphantse labaphinda kabini abasebenzi baloo nkampani, yaye abasebenzi balapho ababa nesi sifo babemalunga nama-26 ekhulwini.

Eyona nto ibuhlungu kakhulu kukuba abazali ababulawa nguGawulayo bashiya iinkedama ezininzi. Ngaphezu kokufelwa ngabazali nokungabi namali yokuziphilisa, aba bantwana bafanele banyamezele ihlazo elayanyaniswa noGawulayo. Izalamane okanye abanye abantu basekuhlaleni badla ngokungakwazi ukubanceda ngenxa yokuba nabo bengamahlwempu ukanti abanye badla ngokungafuni kwaphela ukubanceda. Uninzi lwezi nkedama luyayeka ukufunda. Ezinye ziba ngoonongogo yaye ngaloo ndlela ziba negalelo ekusasazeni esi sifo. Kumazwe aliqela kuye kwasekwa iinkqubo zikarhulumente okanye zabantu abathile ukuze kuncedwe ezi nkedama.

Ukungabi nalwazi. Abantu abaninzi abanentsholongwane iHIV abazazi ukuba banayo. Abaninzi abafuni kuya kuhlolwa enoba banayo kusini na le ntsholongwane ngenxa yokuba kugqalwa njengehlazo ukuba nesi sifo. Ingxelo yeJoint United Nations Programme on HIV/AIDS (UNAIDS) yathi: “Abantu abanale ntsholongwane iHIV okanye ekurhanelwa ukuba banayo, bayajikiswa kumaziko ezempilo, abanikwa zindlu yaye abaqeshwa, bayagatywa ngabahlobo babo, abanikwa inshorensi yaye abavunyelwa ukungena kwamanye amazwe.” Abanye baye babulawa emva kokuba kufunyaniswe ukuba banentsholongwane iHIV.

Isithethe. Ngokwezithethe zamazwe amaninzi aseAfrika, amabhinqa akanalungelo lokubuza amaqabane awo ngabantu abasemacaleni athandana nabo yaye akanalungelo lokwala ukuba neentlobano zesini okanye ukucebisa ngeentlobano zesini ezinokuthintela ukwasulelwa zizifo. Ezi zithethe zidla ngokubonisa ukuba abantu basebumnyameni yaye abafuni kuyamkela into yokuba kukho isifo esinguGawulayo. Ngokomzekelo, kusenokuthiwa umntu onesi sifo uthakathiwe kuze kufunwe uncedo emagqirheni.

Ukungabikho kwamaziko empilo aneleyo. UGawulayo ubamise mantsantsa abasebenzi baloo maziko ezonyango ahleli embalwa kakade. Kwizibhedlele ezibini ezikhulu kunikelwa ingxelo yokuba kubaguli abalele apho bangaphezu kwesiqingatha abanentsholongwane iHIV. Igosa eliyintloko kwezonyango kwesinye isibhedlele KwaZulu-Natal lathi amagumbi abaguli kweso sibhedlele azele kangangokuba akukho nendawo le yokunyathela, azele nge-140 ekhulwini. Maxa wambi, kuye kunyanzeleke ukuba abaguli ababini balale ebhedini enye, ngoxa owesithathu elele ngaphantsi kwaloo bhedi!—ISouth African Medical Journal.

Nangona le meko yaseAfrika imbi ngolu hlobo, kubonakala ngathi izinto ziza kuba mbi nangakumbi. UPeter Piot weUNAIDS uthi: “Esi sifo asikenzi nto.”

Kucacile ukuba kwamanye amazwe kwenziwa imigudu yokulwa nesi sifo. Yaye okwesihlandlo sokuqala ngoJuni 2001, iUnited Nations General Assembly yaqhuba inkomfa ekwakuxutyushwa kuyo imibandela ephathelele iHIV/AIDS. Ngaba imigudu yabantu iya kuze iphumelele? Uya koyiswa nini lo Gawulayo ugqugqisileyo?

[Ibhokisi/Umfanekiso okwiphepha 5]

IMPIKISWANO NGEYEZA LIKAGAWULAYO INEVIRAPINE EMZANTSI AFRIKA

Yintoni inevirapine? Ngokutsho kwenye intatheli uNicole Itano, “liyeza elilwisana nentsholongwane kaGawulayo ekuye kwafunyaniswa ukuba linokuwanciphisa amathuba okuba [umama] adlulisele esi sifo kusana lwakhe.” Enye inkampani yaseJamani eyenza amachiza yathembisa ukuba iza kunika uMzantsi Afrika eli yeza kangangeminyaka emihlanu ngaphandle kwentlawulo. Ukanti kwada kwaba ngoAgasti 2001, urhulumente welo engekawamkeli loo mpoposho. Kwakutheni?

Bazizigidi ezisisi-4.7 abantu abanentsholongwane iHIV eMzantsi Afrika, elona nani liphakamileyo ehlabathini lonke. NgoFebruwari 2002, iThe Economist yaseLondon yathi uMongameli waseMzantsi Afrika uThabo Mbeki “akayikholelwa into eyaziwa nanguthathatha, yokuba uGawulayo ubangelwa yintsholongwane iHIV” yaye “akayiqondi into yokuba kuchithwe imali eninzi kuthengwa la mayeza, kungaqinisekwanga enoba ayamnyanga kusini na uGawulayo. Akali ukuba abekho eMzantsi Afrika, kodwa oogqirha balapho abakhuthazwa ukuba bawasebenzise.” Yintoni ebangela ukuba kuxhalabise kangaka oku? Kaloku, nyaka ngamnye eMzantsi Afrika kuzalwa amawaka abantwana abenentsholongwane iHIV, yaye amabhinqa akhulelweyo angama-25 ekhulwini kwelo anale ntsholongwane.

Ngenxa yoku kubetha-bethana kwezimvo, abantu bamangalela urhulumente bezama ukumnyanzela anike abantu inevirapine. NgoAprili 2002, INkundla Yomgaqo-siseko yaseMzantsi Afrika yachaza uluvo lwayo. Ebhala kwiThe Washington Post, uRavi Nessman wathi inkundla yayalela “urhulumente ukuba alungiselele ukuba la mayeza abekho kumaziko ezonyango aza kukwazi ukulawula indlela asetyenziswa ngayo.” Nakuba urhulumente waseMzantsi Afrika ebesele esenza ulingelo lokusebenzisa la mayeza kumaziko ezonyango ali-18 kulo lonke elo, kuthiwa ngenxa yalo myalelo wenkundla onke amabhinqa akhulelweyo anentsholongwane iHIV atsho anethemba.

[Ibhokisi/Umfanekiso okwiphepha 6]

INTSHOLONGWANE ENGENA KWISELI NGOKUNGAQONDAKALIYO

Makhe sihlolisise eyona ntsholongwane incinane ebizwa ngokuba yihuman immunodeficiency virus (iHIV). Esinye isazinzulu sathi: “Nakuba sele kudlule iminyaka emininzi ndihlolisisa iintsholongwane ngemikroskopu, isandimangalisa yaye ibangel’ umdla indlela enobugocigoci nentsonkothe ngayo intsholongwane nangona incinane kakhulu.”

Intsholongwane incinane kakhulu, ingaphantsi nakwiseli yomzimba womntu. Ngokutsho kwenye incwadi, intsholongwane iHIV incinane kangangokuba “[amasuntswana eHIV] azizigidi ezingama-230 anokufakwa kwichaphaza elisekupheleni kwesi sivakalisi.” Ukuze intsholongwane ikwazi ukuziphindaphinda kufuneka ingene kwiseli ize iguqule indlela iseli esebenza ngayo.

Xa intsholongwane iHIV ingena emzimbeni, kufuneka ilwisane nezibulala-ntsholongwane ezisegazini ezikhusela umzimba.a Ezi zibulala-ntsholongwane ziiseli ezimhlophe ezenziwa ngumongo. Iiseli ezimhlophe zineentlobo ezimbini zeelymphocytes, ii-T cells nee-B cells. Ezinye iiseli ezimhlophe zibizwa ngokuba ziiphagocytes, okanye “iiseli ezicoca umzimba.”

Iintlobo-ntlobo zee-T cells zisebenza ngeendlela ezahlukahlukeneyo. Olunye uhlobo lwee-T cells lunendima ebalulekileyo ekukhuseleni umzimba kwiintsholongwane. Olu hlobo lwee-T cells lukhupha iiseli ezingakumbi ezilwa nentsholongwane engene emzimbeni. Xa intsholongwane iHIV ihlasela, iqala kolu hlobo lwee-T cells. Olunye uhlobo lwee-T cells lubulala iiseli esele zihlaselwe ziintsholongwane. Ii-B cells zikhupha izibulala-ntsholongwane ezilwa nezifo ezisegazini.

Indlela Engena Ngayo Intsholongwane

IHIV luhlobo oluthile lwentsholongwane. Intsholongwane iHIV ineRNA (ribonucleic acid) kungekhona iDNA (deoxyribonucleic acid). IHIV yinxalenye yodidi lweentsholongwane ezibizwa ngokuba ziilentiviruses, ngenxa yokuba inokuhlala ixesha elide emzimbeni kungekho zimpawu zibonakalisa ukuba umntu unale ntsholongwane.

Yakuba intsholongwane iHIV ingene kwiseli, iye itshintshe yonke indlela esebenza ngayo iseli. “Itshintsha” iDNA ekwiseli ukuze yenze iintsholongwane ezininzi zeHIV. Kodwa ngaphambi kokuba ikwazi ukwenza oko, intsholongwane iHIV kufuneka iziguqule “ingabonakali ukuba yiyo.” Ukuze ikwazi ukusebenza kuloo seli, imele iguqule iRNA yayo ibonakale ngathi yiDNA. Ukuze iphumeze oku, intsholongwane iHIV idibanisa iiRNA ezimbini zayo ukuze zibonakale njengeDNA yaloo seli. Emva kokuba yenze amawaka eentsholongwane zeHIV, loo seli iyafa. Ezo ntsholongwane zidlulela nakwezinye iiseli zomzimba.

Xa kusele ii-T cells ezimbalwa kakhulu emzimbeni, umzimba unokuhlaselwa lula ziintsholongwane. Umzimba uhlaselwa zizo zonke iintlobo zezifo. Xa kunjalo ke, umntu unesifo uGawulayo. Ngoku intsholongwane iHIV itshabalalise yonke inkqubo yomzimba yokuzikhusela.

Le yinkcazelo nje elula ngokuphathelele le ntsholongwane. Sifanele sikhumbule ukuba kusekuninzi okungaziwayo ngabaphandi ngokuphathelele iintsholongwane, inkqubo yomzimba yokuzikhusela nendlela ehlasela ngayo intsholongwane iHIV.

Kangangamashumi amabini eminyaka, ehlabathini lonke iingcali zonyango ziye zazibhokoxa zisenza uphando ngale ntsholongwane incinane, yaye ziye zachitha nemali eninzi kakhulu ekwenzeni olu phando. Ngenxa yoko, kuninzi okuye kwafundwa ngale ntsholongwane iHIV. Kwiminyaka emininzi eyadlulayo, uGqr. Sherwin B. Nuland wakha wathi: “Oko sele sikufundile . . . ngale ntsholongwane namalinge okulwisana nayo asele enziwe ayamangalisa kakhulu.”

Sekunjalo, uGawulayo uqhubeka egqugqisa ngendlela eyoyikisayo.

[Umbhalo osemazantsi]

[Umfanekiso]

Intsholongwane iHIV ingena kwii-“lymphocytes” zenkqubo yomzimba yokuzikhusela ize isebenzise zona ukukhupha iintsholongwane zeHIV ezingakumbi

[Inkcazelo]

CDC, Atlanta, Ga.

[Umfanekiso okwiphepha 7]

Amawaka olutsha aphila ngokuvisisana nemilinganiselo yeBhayibhile