An HIV Test Fit for a King

Nana Ofori Panin II is a powerful man, a local king in the Akyem Abuakwa state in central Ghana. He counts two million people as his subjects; an estimated 60,000 of them are infected with HIV.

Earlier this summer, just before the royal durba, a traditional gathering with local princes, Panin granted an audience to researchers of GAIFAR, a German-American research institute based in Potsdam. GAIFAR scientists were in Africa to talk to local leaders about their new strategy to stop the spread of HIV/AIDS on the continent, part of which includes a newly developed quick test for HIV infection that can return results in 30 seconds.

Panin was impressed with what the scientists had to say and in the contents of their book on reigning in HIV/AIDS in Africa, Knowledge Protects. After the council had gathered for the meeting, Panin stood up from his throne, walked to a central table, and asked someone to administer GAIFAR’s new test. A drop of blood and 30 seconds later a negative result was announced. It was answered by cheering crowds.

Removing the Stigma

The king then ordered all of his regional princes in attendance to undergo tests as well, which they did. Dr. Heinrich Repke, developer of the diagnostic tool and GAIFAR’s overall HIV control strategy, said the king made such a public showing because he wanted to remove the stigma that still surrounds HIV/AIDS on much of the African continent.

"He argued that HIV/AIDS has to finally join the ranks of normal infectious diseases," said Repke in an interview. "In his opinion, having this disease should be no more shameful than having tuberculosis or malaria."

But that kind of thinking is not widespread in Africa. Although the continent is home to 70% of adults and 80% of children living with HIV in the world, a combination of factors – denial and lack of understanding, strong dependence on traditional customs, lack of medical facilities - have meant having the virus remains a shameful and deadly secret for many.

Domino Effect

This lack of knowledge and denial are two of the most important reasons for the dramatic spread of HIV in developing countries, according to Repke. He calls it the domino effect. Since most people in developing countries have little access to medical facilities and therefore almost no opportunity to determine their HIV status, most every HIV-infected person becomes an inadvertent killer by spreading a disease they are unaware they have.

GAIFAR is hoping its quick tests can be a first step to countering that. In 30 seconds, people can learn whether they are infected or not, and hopefully take the appropriate actions.

King Panin’s public test served as a catalyst in central Ghana. Locals began clamouring to be tested and in two days, 700 people found out their HIV status, more people than most African labs can test in a year. Panin was the first African ruler to make such a public move and GAIFAR hopes he will set off his own domino effect and more will follow his example, since it got results.

"It was really unbelievable to see what happened," said Vincent Wang of GAIFAR, "because people in the past have always been too afraid."

Expanding the Program

Panin wants more of his subjects to get tested. His goal is to reach half a million by 2005. But as with many projects in Africa, money is a problem. While GAIFAR’s test is easy to administer, it isn’t free. A test costs four dollars per person, too expensive for many Africans. Add in follow up counseling and prevention, those costs go up to around $30 (30.25 euro).

Now GAIFAR is looking to outside sources, like UNAIDS, the Gates Foundation, or other programs in the US or EU for $3.5 billion (3.53 billion euro) to cover the costs of a five-year program. Repke admits that is no small sum, but seen from the point of view of the seriousness of the epidemic and what the global consequences could be if it is not brought under control in Africa, "it’s not all that much," he said.