Africa Outbreaks: Rwanda HIV outbreak
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Written by Ritchie Aseke, a Physician Associate , 12th August 2020
What was the outbreak:
Since the first reported case in 1959 in the Democratic Republic of the Congo [1], by the end of 2019, the Human Immunodeficiency Virus (HIV) had infected over 38.0 million people globally and is responsible for the death of over 690,000 people [2]. More than any other region in the world, countries in Africa have sustained the predominant impact of the global HIV outbreak; in 2001 more than 70% of people living with HIV resided in sub-Saharan Africa, a region which only represents 12% of the global population [3, 4].
HIV is a virus that is transmitted through contact with bodily fluid such as semen, and through blood passed between mother and baby, sharing injecting equipment, and contaminated blood transfusion & organ transplant. HIV survives within the human body by attacking and damaging immune cells responsible for protection against infections. When left untreated, the disease can lead to Acquired Immunodeficiency Syndrome (AIDS); a disease characterised by a significantly depleted immune system which gives way to opportunistic infections that subsequently cause death [7].
The current review will centre Rwanda and its ongoing efforts to combat the HIV outbreak. With a population of 12.3 million, the small landlocked and Central African country is one of the most densely populated countries in Africa ;of which 83% of the population reside in rural areas. In 1983, Rwanda was one the first African countries to document a case of AIDS [5], and as of 2018, an estimated 220,000 people are living with HIV and in the same year an estimated 2,900 died due to HIV-related causes [6].
What was the country’s response:
Rwanda’s initial efforts in tackling the HIV outbreak began in 1984 with the establishment of the national HIV/AIDS surveillance system in hospitals and health centres. At first, reported AIDS cases between 1990 and 2002 increased steadily. This was then followed by a dramatic rise between 2003 and 2004 due to improved reporting and better availability of HIV testing, care and treatment services. In comparison to other African countries, Rwanda’s early response to the epidemics was rapid and sustained [5].
