Inter Press Service - August 29, 2000
Lewis Machipisa

The three southern African countries, Namibia, South Africa and Zimbabwe have rejected the United States' offer of One billion US dollars in yearly loans to finance the purchase of anti-AIDS drugs.

The US Export-Import Bank made the loan offer to 24 African countries, but none have formally accepted the offer so far, fearing that it would enrich American and western drug manufacturers while creating an extra debt burden for African nations.

Nearly 40 percent of Africa's annual budget goes to servicing foreign debts estimated at 350 billion US dollars in 1998.

According to the World Health Organisation (WHO), debt remains a barrier to accelerating growth and improving the distribution of the benefits of growth.

"African leaders seem to be waking up," says Faleyimu Bode- Law, a member of an e-mail discussion forum HIV/AIDS in Africa.

"The loan was definitely a debt trap that will lead to poverty, which is actually the co-factor for both HIV transmission, development of AIDS and its progression," says Bode- Law.

"I think African leaders need to follow the Brazil way of getting cheaper non-generic drugs rather than wait for these loans that their great grand children will not be able to pay, as is the case for us, in Nigeria," adds Bode-Law.

The loans, part of President Bill Clinton's initiative to combat HIV/AIDS in Africa, offered interest rates of about seven percent. President Clinton this week toured Nigeria where he talked about the need to work toward halting the spread of HIV/AIDS.

Although the southern African region has one of the highest HIV/AIDS infection rates in the world, health experts do not see any country jumping to take up the US loan offer.

Life expectancy at birth in southern Africa, which climbed from 44 in the early 1950s to 59 in the early 1990s, is expected to drop back to 45 sometime between 2005 and 2010.

The UNDP estimates that fewer than 50 percent of South Africans, currently, alive can expect to reach the age of 60, compared with an average of 70 percent for all developing countries and 90 percent for industrialized countries.

The Geneva-based UNAIDS, says each country has the right to decide whether they would like to accept these loans or not.

Hailing the rejection, Professor Norman Nyazema, a pharmacist in Zimbabwe wonders:"Why the sudden magnanimity to give the loans. Why not give us the drugs free? Anti-retrovirals should not be made available in a poor and non-existent health structure such as ours in Zimbabwe."

Nyazema calls for better treatment of opportunistic infections, such as tuberculosis and pneumonia, which cause unnecessary and premature death. About 78 percent of HIV positive people in Zimbabwe have TB, he says.

"This agenda (for anti-retrovirals) is being pushed by people who can afford these drugs. If the west is serious about helping us, then we need essential drugs for TB, diarrhea," says Nyazema.

"It does not make political and economic sense to get a loan to buy anti-retrovirals. We don't know much about these drugs. Even for vaccine research, who does the research? It is the US who will then patent the drugs and it becomes their intellectual property but they will have used our own people for the research," says Nyazema.

Pharmacists in Harare say prices for antiretrovirals have actually increased, despite claims from manufacturers that prices would be reduced for African nations.

The cost of a month's supply of one antiretroviral drug has increased from 11.000 Zimbabwe dollars in June to 14.782 currently. (one US dollar equals 51 Zimbabwe dollars.)

"Even for rich countries, antiretrovirals are completely off their means. We should direct action to treating diseases such as TB and other opportunistic diseases and pain relief," says Dr. Sunanda Ray, deputy director of programmes Southern Africa AIDS Network (SAFAIDS).

"Few people will get access to the treatment. We can understand why the governments rejected the offer. We welcome it. Loans don't come free and it would increase our indebtedness," says Ray. "Our emphasis should be on stopping new infections and supporting people already infected."

Over the next decade, the UN warns, AIDS will kill more people in sub-Saharan Africa than all the wars of the 20th century. There are an estimated 14.000 new HIV infections in sub-Saharan Africa everyday.

According to the World Bank, between one billion US dollars and 2.3 billion US dollars are needed annually for prevention alone in Africa, but official assistance for AIDS is something in the region of 160 million US dollars.

The situation is grave. More than 23 million Africans are estimated to be infected with HIV. Since the pandemic began, 50 million people worldwide have been infected with HIV, of whom 16 million people have died.

In Sub-Saharan Africa, 55 percent of infected adults are female. UNAIDS estimates that 12.2 million African women and 10.1 million African men aged 15 to 49 are living with HIV.

The UN's analysis suggests that, because of AIDS, by 2005 the gross domestic product (GDP) of most southern African countries will have shrunk by at least 14 percent. Per capita income will drop by 10 percent. Labour costs are rising due to morbidity and absenteeism, and training new workers brings an added burden.

AIDS will reduce life expectancy in Africa by 20 years. It is destroying families and wiping out economic gains as fast as nations can make them.

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