Inter Press Service - June 26, 2001
Lewis Machipisa

Numerous speakers rose Tuesday to decry the role that donors have played - or rather, failed to play - in helping them cope with the impoverishment that both feeds and is reinforced by HIV-AIDS.

Mildred Aristide, Haiti's first lady, recalled that countless people in her country go to the doctor and are given prescriptions, but lack the money to buy the medications they've been told to take.

Aristide, Haiti's senior delegate at this week's UN General Assembly Special Session on HIV-AIDS, said: "Poverty is a co- factor in HIV-AIDS, yet international aid to Haiti has been frozen despite its HIV-AIDS pandemic." Five percent of Haiti's population is infected, the highest rate outside Africa, she added. "Its time new additional resources are made available to Haiti."

"In the fight against HIV-AIDS, there is only one fight: The fight against poverty," she declared.

A number of officials from other countries echoed Aristide's conclusion, as did UNAIDS, the joint UN agency fighting the disease.

"While HIV-AIDS must be seen as an emergency of the highest order, steady progress in reducing poverty is still the long-term and sustainable solution to the health crisis in the developing world. In the long run, prevention and care will only succeed if people and nations can lift themselves out of poverty," the agency said in a report prepared for this week's talks.

Despite the catastrophic nature of sub-Saharan Africa's AIDS crisis, overseas aid to the region has slowed to a trickle. The World Bank said development aid to Africa fell to 18 dollars per person in 1999, down from 31 dollars in 1995.

Nevertheless, officials from donor countries, development agencies and multilateral lenders like the World Bank have been on hand to talk up their employers' good works. Even some of their most prized accomplishments, however, also have come in for a bashing.

Debt relief, for example: Government and multilateral creditors have gone to pains to explain their generosity and constraints in writing down the debts of poorer countries.

According to Burkina Faso Prime Minister Ernest Yonly, however, existing debt relief programmes have served mainly to shift focus away from aid and to give creditors additional leverage over debtors.

"I would appeal to our development partners to lessen the conditionalities attached to debt relief initiatives and to de- block financing," Yonly said. Perhaps the most pointed scolding of the day was reserved for Andrew Natsios, the chief of the US Agency for International Development (USAID).

Natsios has earned notoriety for telling US lawmakers and the media that Washington need not spend millions of dollars on anti- retroviral drugs for Africa because people there can't tell time, and therefore can't be trusted to follow the drug regimen, and because African countries lack the infrastructure to deliver the medicines under refrigeration to outlying areas.

"Many people in Africa have never seen a clock or a watch their entire lives. And if you say, 'One o'clock in the afternoon', they do not know what you are talking about," Natsios said earlier this month. "They know morning, they know noon, they know evening, they know the darkness at night."

His remarks unleashed calls for his resignation from both activists and academics. The former lambasted him for being out of touch with African realities and the latter derided his lack of basic knowledge about the drugs: Contrary to Natsios's assertions, the medications only need be taken twice a day and should not be kept frozen.

On Tuesday, it was Timothy Stamps's turn.

"We are compelled to inform Mr. Natsios that, though we may not have clocks or roads in Africa, we do know the time and time is ticking away inexorably for some of our states," said Stamps, Zimbabwe's health minister and lead delegate.

"Because of world globalisation, lack of roads can be compensated for by world Coca Colanisation," Stamps added. "We use Coca-Cola trucks to get vaccines and medicines to the people very effectively. We know that anti-retrovirals are only a part of the solution to the problem, but while they are denied to us, the message of prevention, especially knowing one's HIV status, is inadequately supported," said Stamps.

The last statement was a rebuke aimed at Natsios's attempt to separate the issue of AIDS treatment and prevention and to argue that Washington should only support preventive efforts on the continent.

Officials and activists at this week's talks took shots at that position, armed with UN reports.

More than 25 million of the 36 million people worldwide who already are infected come from Africa, according to UNAIDS.

So far, AIDS has left behind 13.2 million orphans - children who, before the age of 15, have lost either their mother or both parents to the disease, said UNAIDS.

In African countries that had long, severe epidemics, AIDS is generating orphans so quickly that family structures can no longer cope. And in the absence of effective efforts to assuage the effects of AIDS, whole societies will become dysfunctional, with negative consequences for basic security.

Sub-Saharan Africa's labour force will dwindle by between 10 percent and 30 percent by 2020 because of HIV-AIDS, according to the International Labour

Organisation. The consequences already are being felt in agriculture. (END/IPS/WD/HE/IF/lm/aa/01)
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