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Africa: Hope and Disappointment
AFRICA ACTION
Africa Policy E-Journal
May 30, 2003 (030530)
Africa: Hope and Disappointment
(Reposted from sources cited below)
This posting contains excerpts from two recent speeches by Stephen
Lewis, the UN Envoy for HIV/Aids in Africa. The first, from early
May, highlights the new commitment to action on AIDS under the new
government in Kenya, and the hope that that country could join
other African countries such as Uganda, Senegal, and Botswana as
another example of strong efforts to fight back against the
pandemic. The second, on the eve of the G8 summit of rich countries
in Evian, France, highlights the failure of rich countries to match
promises with real action in addressing Africa's problems, or,
indeed, to account for the damage their own policies continue to
cause in Africa.
African leaders and non-governmental organizations in Africa and
around the world continue to demand that the G8 address global
issues of peacekeeping, debt cancellation, and health, that have
particular impact in Africa. But news reports suggest the G8 are
retreating even from earlier commitments. According to a May 30
article in the Toronto Globe and Mail, the Bush administration has
pressed for exclusion of any mention in the summit statement on
health of either the Global Fund to fight AIDS or of the World
Trade Organization Doha Declaration prioritizing public health over
patent rights.
Today Africa Action joined with other U.S. based advocacy groups in
calling on President Bush to keep his promises to devote additional
resources to Africa and to immediately reschedule his trip to
Africa that was cancelled earlier this year. See
http://www.africaaction.org/desk/pr0305b.htm
Appearing on the PBS Newshour on May 28 to discuss the crisis in
the Democratic Republic of the Congo, Africa Action executive
director Salih Booker called on the U.S. and other rich countries
to provide adequate resources for support not only for
immediate humanitarian action but also for the longer-term
implementation of the peace plan in that country. See:
http://www.pbs.org/newshour/bb/africa/jan-june03/congo_5-28.html
Also on the eve of the G8 summit, two British groups, Christian Aid
and ActionAid, released reports documenting the failure of G8
countries to keep their promises to Africa. See
http://www.christianaid.org.uk/news/media/pressrel/030529p.htm
and
http://www.actionaid.org/newsandmedia/pr280503_g8.shtml
+++++++++++++++++end summary/introduction+++++++++++++++++++++++
New Action on AIDS in Kenya
Briefing by Stephen Lewis, UN Envoy for HIV/Aids in Africa
United Nations (New York)
May 2, 2003
[excerpts; for full text see:
http://allafrica.com/stories/200305020319.html]
These notes by Stephen Lewis were issued to journalists on May 2 at
a press briefing in the United Nations, New York, regarding his
recent visit to Kenya.
Just last weekend, I returned from a trip to Kenya, during which I
met, at length, with the new President, and Ministers of Health,
Education and Information. I also met with the leadership of the
National AIDS Control Council, the UN country team, various
representatives of civil society and People Living with HIV/AIDS,
and made a trip to Kabera, the huge, sprawling, abject slum in
Nairobi, to meet with over a hundred commercial sex workers, all of
whom are involved in a program of HIV prevention. ...
All too often, when I report back to the media after a visit to
Africa, I'm consumed by gloom and apocalyptic utterance. But not
this time. This time I came away with a greater degree of hope and
optimism than I've felt for months. It's hard to describe the sense
of change from the previous administration: suffice to say, where
HIV/AIDS is concerned, the change is night and day. Where before,
senior officials' attention to AIDS was perfunctory, on this
occasion every conversation, without exception, demonstrated a new
leadership that is intense, committed to confronting the pandemic,
determined to put policies and programmes in place, and consumed by
the recognition that every single family in Kenya is affected in
some way by the ravages of HIV/AIDS.
I guess it's a trifle presumptuous to make personal comment on a
conversation with President Kibaki, but I'm going to do so
nonetheless. The President has appointed an HIV/AIDS Cabinet
Committee of nine members, which he personally chairs. He's
providing very open and public leadership on the issues of AIDS,
and demands the same of his cabinet colleagues. What was
particularly impressive --- and unusual --- in the meeting with the
President (there were ten senior members of the bureaucracy
present) was his refusal to accept, at face value, any reassurances
that his administration has the pandemic well in hand. President
Kibaki frequently challenged what others said, asserting --- almost
by instinct ---that the crisis is far from under control, and
insisting that the fight against the pandemic must be intensified.
... [this was followed by a meeting with the Minister of Education.
This is the arena where the full force of the new Government has
been felt. As most people doubtless know, the key promise of the
election campaign was the abolition of fees for primary school. No
sooner was the present Government elected, than the promise was
fulfilled. And an extraordinary thing happened: when school
reconvened in January, 1.2 million new children poured into the
educational system within one week --- an increase of over 20 per
cent! --- and the numbers are still rising, expected to reach one
and a half million by June.
The implications are stunning. One million two hundred thousand
children who had not been in school turned up for school. Kenya has
an estimated one million two hundred thousand children orphaned by
AIDS. Are they identical cohorts? Of course not. Is there a
significant overlap? Everyone agrees that the overlap is large.
What, then, is the situation on the rest of the continent for
millions of other children orphaned by AIDS, particularly in the
high prevalence countries? How is it possible that a campaign to
eliminate school fees has not been launched across Africa? Where is
the leadership to come from? Why should such vast numbers of
children, who have lost one or both parents to AIDS, who have
little if anything to eat, who have no guarantee of shelter, no
guarantee of health or nutritional care, no guarantee of a home or
of love or of nurture & why on top of it all, should they be denied
the right to go to school and the prospect of a future simply
because they're impoverished? There's something truly dreadful
about all of this.
If the experience of Kenya proves anything, it proves that those
who have argued for the abolition of fees, as a way of liberating
the lives of millions of children, were right. ...In the view of
the Minister of Education, the policy is driven by the guarantees
contained in the Convention on the Rights of the Child and the
internationally agreed principles of "Education for All". ,,,
I don't want to pretend for a moment that there isn't a very tough,
hard slog ahead. The new government and the voters understood that
abolishing school fees would be costly in financial terms, but the
free education campaign slogan said it all: "If you think education
is expensive, try ignorance." The Ministry is scrambling to put
together the dollars to finance the policy (a government task force
announced in March that it would cost $97.1 million through June,
and another $137.1 million through the 2003-2004 school year)& a
major portion of it from the Kenyan national treasury, part of it
from the World Bank, part of it from bilateral donors. ...
For the orphaned children of Kenya, the policy is a salvation. Why,
then, is it not in place across the continent? The time has more
than come to champion this cause with every Government, and to
champion it with unrelenting tenacity. No one should forget that
all of the governments in question have ratified the Convention on
the Rights of the Child, article 28 of which reads, in part: "Make
primary education compulsory and available free to all".
Let me now move to the Minister of Health. Again the conversation
was illustrative of a Government determined to break the grip of
the pandemic on Kenyan society. This Minister speaks with
passionate clarity, knowledge and resolve about the need to proceed
simultaneously on care, prevention and treatment. More, in a
fashion with few parallels, this is a Minister who understands the
appalling toll being taken on the women of her country, and the
need to address their extreme vulnerability.
The Government of Kenya has just received money from the Global
Fund. The $56 million allocated to the next two years will help to
provide anti-retroviral treatment for another three thousand
Kenyans. There are roughly seven thousand in treatment now, mostly
in the private sector, so that will bring the total to ten
thousand. Already the new Government has set a target of 40,000 in
treatment by the year 2005.
How will they achieve it? In four ways. First, the Government is
examining legislation to introduce a National Health Insurance
Plan. It is the intention of the Ministry of Health that treatment
for opportunistic infections, and for full-blown AIDS, be covered,
at least in part, by the Plan. In my respectful view, that's an
astonishingly enlightened and courageous position, worthy of
international support. Second, the Government hopes to persuade the
private sector to further expand its coverage. Third, the
Government has set aside, in this fiscal year, with increased
recurrent funding in mind, the sum of $4 million for laboratory
infrastructure to address HIV/AIDS, and it is hoped that,
inevitably, some of the money will be directed to treatment.
Fourth, the Government is even now preparing its next proposal for
the Global Fund, which will include financing for the treatment of
another ten thousand people. In that regard, it should be added
that the Government will wish to purchase generic drugs, from the
WHO list of approved anti-retrovirals, probably from India, in
order to keep the prices down. This, then, emphasizes yet again the
desperate urgency of adequate resources for the Global Fund.
While all of these intentions are truly exciting, and a dramatic
departure from the previous administration, it must be pointed out
that over two million people are living with the virus in Kenya,
and it is estimated that two hundred thousand would qualify for
immediate treatment. As always, the gap between need and reality is
measured in the appalling foreshortening of hundreds of thousands
of lives. With additional resources, Kenya could treat thousands
more. With additional resources and a transfer of technology, Kenya
could establish an indigenous capacity to manufacture
anti-retroviral drugs. When will the resources come? When will the
needless carnage end? ,,,
It's hard to convey the startlingly changed atmosphere in the
political precincts of Nairobi and by extension, in the population
overall. If ever there was a time to turn the pandemic around in
Kenya, that time is now. There is no reason in the world, given the
commitment of the new Government to tackle HIV/AIDS, why Kenya
cannot become the next Uganda. But they'll need lots of help: they
must get it.
'Africa Reaps What the World Sows - With a Vengeance'
United Nations (New York)
May 28, 2003
By Stephen Lewis
Washington, DC
Speech by Stephen Lewis, UN Special Envoy for HIV/AIDS in Africa,
to the Global Health Council's Annual Conference,
Washington, Wednesday, May 28, 2003
[excerpts; for full text see:
http://allafrica.com/stories/200305280031.html]
I sometimes think that the continent I love, and the continent to
which my UN role is devoted - Africa - is under some kind of
other-worldly curse. So many factors conspire against it that one
could imagine inexplicable forces at work, except that we know, we
emphatically know, that every factor haunting Africa has a quite
straightforward explanation.
It's the relationship amongst the factors that we sometimes fail to
understand. What I therefore want to do in this speech is to make
the connections and attempt to demonstrate that Africa reaps what
the world sows, and with a vengeance.
In January of this year, along with James Morris, Executive
Director of the World Food Program, and a number of UN agency
experts, I made a trip to four countries in Southern Africa on the
verge of famine: Lesotho, Zimbabwe, Malawi and Zambia. The reason
was to explore the link between food shortages and HIV/AIDS. Morris
had been there in September of last year and was palpably stunned
by the carnage exacted by AIDS. I was there in December of last
year, and I was equally aghast at the way in which AIDS was
deepening hunger and hunger was deepening AIDS.
The assumption, shared by many, was that drought and erratic
rainfall were the primary culprits leading to the food shortages,
and that poor agricultural policies and poor planning had made a
bad situation desperate. We came to a different conclusion. While
there's no question that weather played a powerfully destructive
role, there's equally no question that HIV/AIDS was the heart of
the matter. ...
In previous episodes of hunger and famine, the toll was taken on
the very young and the very old. In this age of AIDS and food
insecurity, it is the productive age group in its twenties,
thirties and forties who are paying the ultimate price. In previous
episodes of hunger and famine, there was always a huge quotient of
resilience which allowed beleaguered communities to bounce back. In
the present circumstance, even where sound policies are in place,
the coping strategies of communities and families are so mangled
and eroded by AIDS that full recovery simply isn't possible. ....
Inevitably, [this] theory of the New Variant Famine has its
detractors. That always occurs with the pandemic: denial is
Pavlovian. But I must admit that I have little patience for it.
You need no more than empirical evidence, your own eyesight, your
own commonsense to understand what is happening. When one travels
through those rural villages and hinterlands, as I have done for
the last two years, the human toll is desolating. The immune
systems of huge numbers of women farmers are desperately weak;
seven million agricultural workers have died of AIDS since 1985,
FAO estimates that another sixteen million may die by 2020; the
household assets have been exhausted by attending to parental
illness; children have been pulled out of school to care for sick
and dying parents, losing, in the process, the one meal a day that
might have been available from a school feeding program;
malnutrition is everywhere evident; fields are left untended; crops
aren't grown; food isn't taken to market, and if it is, no one has
money to pay for it & what we're talking about here is the way in
which this virus - the cause of the most appalling communicable
disease in human history - attacks the fabric of every sector,
making the interplay of health and agriculture but one more
shortcut to carnage. ...
To say that, however, is only part of the story. The other part is
indeed the destructive weather patterns which I referred to earlier
on. This is where the plot thickens.
The weather cycles for large swathes of Southern Africa are
decidedly unfriendly. Even while our mission was traveling, we
witnessed violent extremes in individual countries & intolerable
heat and drought in one region, massive downpours and flooding in
another. ...
What we're dealing with in southern Africa, entwined with
everything else, make no mistake about it, is the most ominous
environmental threat on the planet: climate change.
What's happening should come as no surprise. Back in June of 1988,
I found myself chairing, in Canada, what became known as the first
International Conference on Climate Change. It consisted of
visceral exchanges between scientists and politicians, with the
scientists ultimately prevailing. The conference statement began
with one of the starkest pronouncements yet uttered about global
warming; a pronouncement with which many would now agree: "Humanity
is conducting an unintended, uncontrolled, globally pervasive
experiment whose ultimate consequences could be second only to a
global nuclear war". The statement then went on to identify a
number of damaging consequences of climate change, amongst which
two stand out: the direct peril to human health, and the diminution
of food security, as a result of uncertainties in agricultural
production, particularly in vulnerable regions.
Let it be understood that the findings of that original conference
have since been confirmed time and again by the Intergovernmental
Panel on Climate Change, a multilateral consortium of several
thousand scientists whose words, carefully chosen, are seen -
except by professional apologists for corporate and political
interests - as definitive positions on global warming.
The 2001 "agreed statement" of the IPCC, in a section specifically
devoted to Africa, raises the following concerns: Quote: "Adaptive
capacity of human systems in Africa is low due to lack of economic
resources and technology, and vulnerability high as a result of
reliance on rainfed agriculture, frequent droughts and floods, and
poverty". ,,,
These problems must be seen as global, in every sense of the word.
So must the solutions be global.
Just yesterday at the White House, there was a celebratory signing
of the President's laudable initiative to provide $15 billion over
five years to fund the fight against HIV/AIDS. It is no caviling on
my part to point out that only $200 million of that large sum is
guaranteed, per year, to the Global Fund on AIDS, Tuberculosis and
Malaria. The Global Fund is the best new international financial
instrument in the last many years to confront these annihilating
communicable diseases, AIDS in particular. It was fashioned by
experts with a worldwide overview of this vast pandemic, and a
clear understanding of how to address it in a coordinated way. The
Global Fund has already programmed over $1.5 billion for 150
projects in 92 countries, and it's been programmed in response to
proposals submitted by the countries themselves, reflecting a
government/public consensus on the priorities within those
countries.
And now the Global Fund is virtually out of money. According to the
GAO, the Government Accounting Office here in the United States,
the Fund needs at least $5 billion for 2003 and 2004 alone, and
that money is nowhere in sight. A third round of proposals for the
Fund is to be held this October, but you can't approve proposals
without the dollars to make them real. The G8 meets in three days'
time. There is not a single G8 country which has even pledged, let
alone delivered, an equitable amount to the Fund. Will that change
next week? I very much doubt it, and even if it marginally does, it
will leave the Fund limping into next year, unable to deliver on
its promises, and on the huge human expectations which hang in the
balance.
It's not possible to rescue the vulnerable countries in southern
Africa without the resources. The United Nations can appeal for and
distribute food aid to stave off starvation, and it has
magnificently done so, but everything is stop-gap, everything is ad
hoc, unless the pandemic itself is turned around. What is so
intolerable about the continued funding crisis - UNAIDS estimates
that we will need, globally, $15 billion a year by 2007 for AIDS
alone - is not just the staggering loss of life, so much of it
completely unnecessary, but it's what it says about us, the donor
nations, and our lamentable, incomprehensible behaviour. Is it that
the price tag is simply too high for the world to bear? I think
not. This week's Economist gives us a clue to our priorities: the
global perfumes industry is worth $15 billion - per year. ,,,
When you're dealing with AIDS, every major international public
policy has an impact, and so far those policies are a nightmare for
Africa. Official Development Assistance has fallen to abysmal
levels. Environmental legislation is hostage to the insatiable lust
for resources. North American and European agricultural subsidies
doom African agricultural trade. Debt relief for developing nations
is a profound disappointment. Despite what was thought to be a
breakthrough at Doha, access to pharmaceuticals remains suffocated
by patents and intellectual property rights.
We know what we're doing, and we do it anyway. It's as though we
have chosen to pursue and protect our own prosperity and comfort at
all costs, and then have dehumanized Africa so that we can live
with ourselves. It's as though the communities, families, women,
children, orphans are figments, illusions, abstractions. We're not
barbarians; we don't choose willfully to kill and to maim. But in
watching and neglecting and allowing and, incredibly enough,
abetting the cumulative loss of life in Africa, which we know we
could bring to an end, we have become the latterday King Leopolds
of the continent.
+++++++++++++++++++++Document Profile+++++++++++++++++++++
Date distributed (ymd): 030530
Region: Continent-Wide
Issue Areas: +security/peace+ +health+ +economy/development+
The Africa Action E-Journal is a free information service
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