Aids in Africa

Aids in Africa
Response to UCLA Symposium held on April 15th, 2005

The face of the impoverished is becoming all too familiar for those that travel frequently to Sub Saharan Africa. Although each country in Africa is unique in some way, be it language, culture, geography, or current conflict status, the face of struggle is similar across poverty stricken nations. The plight of women, the level of crime, the lack of resources, and the general lack of hope is widespread.

Currently over 40 million people worldwide are HIV+, 70% of them live in Sub-Saharan Africa. Almost half of the least developed countries in the world are in Sub Saharan Africa.

At the Aids in Africa Symposiam held at UCLA on April 15th, 2005, Keynote Speaker Stephen Lewis did an amazing job painting the human emotion to these statistics. In one story he recalled meeting a group of HIV positive women that had built a cabbage field to sustain themselves and the orphans living with them. Mr. Lewis asked if they had enough food for themselves, they replied “Yes”. He asked if they had cabbage left over to sell to the markets and they replied “Yes”. He asked if they had money left over after living expenses, and they again replied “Yes”. Mr. Lewis then asked what they did with the money that remained. Puzzled, the women responded matter-of-factly that they used the money to pay for the coffins for all the people that were dying around them.

Other incidents are all too common to travelers in developing countries. Local Mothers and Fathers asking for assistance from the ‘developed’ man for their dying children, knowing quite well that drugs are plentiful in the ‘developed’ man’s country… and knowing quite well that the ‘developed’ man has the power to save their children.

Everything is connected to poverty:
A person diagnosed with HIV in the developed world may not even notice any symptoms of AIDS until 10 years after contracting the virus because of the availability of cheaper drugs and state of the art health facilities. In the developing world, however, someone infected with HIV may only live another 6 to 10 years because of the rapid progression of AIDS due to lack of nutrition, lack of drugs, and lack of general health care.

Everything is connected to poverty. A lack of drugs, lack of trained professionals, lack of food and safe water, lack of infrastructure, missing education facilities, corruption, unsafe traditional/cultural practices are all causal elements of an impoverished nation.

Even education is hindered in the developing world. Second Keynote speaker Laurie Garrett, spoke about nurses that got educated in Africa. Immediately after getting educated they moved to the UK to getter better salaries.

South Africa has an interesting program where they have reduced the number of years it takes to graduate from med school but now students are also forced to work in South Africa for at least one year after completion. It helps keep the talent in house.

So what keeps a country poor:
Many causal relationships have been made to the current economic situation in Sub Saharan Africa. In the past underdeveloped countries have been hurt by their unique situations: high malaria prone regions, drought prone regions, isloated in geography that limit trade, and a lack of natural resources.

Colonialism which author Arundhati Roy refers to as the “rape” of the developing world has been largely blamed for the historical lack of economic resources and psychological dependency in sub Saharan Africa.

Current payments on ill borrowed long-term debt by long-past regimes also takes significant resources away from the countries development initiatives. See neocolonialism.

Money is not the answer:
One of the speakers made an amazing comment on how funding for AIDS could cripple Africa. If we start throwing large money at this problem, the limited skilled labor force in Africa will start focusing their attention on how they can receive a portion of the AIDS pie and neglect all the other things are important in that continent (education, malaria, etc). An analogy was made to local health workers in the US that get extensive training on bio-terrorism but neglect other very important health matters.

Organizations working on AIDS relief were advised to focus on building an infrastructure that could be used for AIDS relief, as well as everything else that is important to healthy community.

AIDS is not the problem:
Second Keynote Speaker Laurie Garrett mentioned how the world community has actually helped further the stigma associated with AIDS. She stated that because we continue to refer to AIDS as this huge scary problem, people become more afraid to discuss it and to get tested for it.

Think inside the box!
Many times the western world comes with outside approaches to Africa’s local problems. In many cases these solutions do not apply. What we experienced in Kenya was that many folks would approach us for some form of financial assistance. The western world has bred this mentality with the advent of well-intentioned non-profit organizations and faith-based groups. Wanting to help in some way, these groups come and offer short term assistance that in turn immobilize the local community and encourage dependency on others.

In other cases, some of the implemented programs are not entirely thought out. An increase in rape was noticed at refugee camps and after further investigation it was revealed that this would happen when women would go to defecate or to collect wood. Alterations of the refugee camp to keep latrines nearby and have wood brought to the campsites have reduced this problem. Similarily, micro credit programs that require women to sell small items at local markets, need to consider the possibility that women could possibly get raped along the way.

Laurie Garrett mentioned that a majority of all the grant applications being sent to the United Nations Global Aids Fund are being written by Western Med Students, who have never even stepped foot in Africa. However, if you took the handful of existing grant writers in Africa to start sending in applications to the Global Aids fund then all their existing programs for Malaria, TB, etc. would dwindle away.

Creative solutions will be necessary to deal with current problems. Many believe that the only way to help is to empower, support and nurture the local community to lead their own efforts.

Collaboration:
Many speakers talked about how ‘collaboration’ or better put ‘cooperation’ would have to be strengthened in order for significant changes to be made with the AIDS crisis. At the conference they had representatives from Pharmaceutical Companies and Mining Companies speaking alongside Professors, Artists, Doctors, Government officials, CEOs, United Nations Organizations and of course grassroots change makers.

Keynote speaker Stephen Lewis mentioned a recent incident where the South African Health Minister defended a billboard advertisement that stated “vitamins and nutrition therapy alone could prevent AIDS-related deaths”. The amazing thing about this incident is that the three of the larger development organizations actually collaborated on a written statement to condemn the advertisement. Mr. Lewis remarked that even the collaboration on the letter was a step in the right direction for these organizations. The advertisements have subsequently been removed from circulation.

Corporations:
Although there were a few representatives from the business world, many attendees expressed their desire to see more support from the corporations at these conferences. Mr. Michael Steinberg, former CEO of Macy’s West and Honorary Chair of the event recalled how many invitations they had sent to the business community and what little response they had received in return.

Two speakers however did show up from the corporate world. A pharmaceutical company representative talked about what they were doing in Tanzania, and a mining company talked about how they are working on providing relief to individuals who were once laid off from the mines because of changes in the industry. The mining company actually presented a business case on how it made sense to the corporation to help people who were infected with HIV as opposed to laying them off. I didn’t catch the economics from the quick slide show but I believe the business case is valid only because of the strict controls that are placed by the government of that specific country.

One speaker mentioned how much business Coka Cola was reaping in Africa and how little they were doing to build infrastructure or give back. When the three of us were in Nairobi, Kenya, we did notice that Coke was more readily available than food or water. An another side note, Coke is recently being blasted in India for using contaminated water in their processing.

The Big Picture:
Ultimately, the conference didn’t provide any practical solutions either. They too started the event stating that they could not give us a magic bullet that would fix this. Many folks said that collaboration among NGOs, business, politicians, and academia was all going to be needed to make this work. During one workshop a few ballet dancers came out and did a theatrical representation of AIDS in Africa. It was mind blowing. It had several narrators and many people speaking to the audience at once… it gave us a glimpse into how many players there are in Africa and how all their messages and intentions are a little different.

The Big Solutions – Erasing World Debt:
Ultimately if we look at reducing the debt to the third world countries we also have to look at how these countries will utilize the funds that remain. Countries that are still struggling with internal conflicts may continue to prioritize military spending above health and education concerns. In addition, this reduction of debts owed to the developing world will ultimately result in a change of lifestyle for all of us. What will this mean to the over 3 trillion that the US currently owes in debt? How will this effect State of California budgets and ultimately how we prioritize our own domestic spending? Are you and I ready to make changes in our own personal lives?

One speaker mentioned how infectious diseases was becoming a security issue for the United States so that we can protect our troops and ourselves from the HIV/AIDS pandemic. Although the reasons are selfish, the money going to the military budget could end up being used towards innovative solutions.

The Big Solutions – G7 to contribute 0.7% of economy into Foreign Aid:
If developed countries do eventually contribute the agreed upon 0.7% of their economy to foreign aid, we will need to closely scrutinize the channels in which these funds are distributed. Historically we have seen Foreign Aid used as a weapon to keep countries ideologically consistent with the donor countries beliefs. The money can be used as a form of control and can further the destructive mentality that the benefiting country needs the Western World to help it achieve its goals.

Be the Change:
Bono, after receiving a recent TED prize, spoke immediately on how Africans, because they are black and look different from the rest of the developed world, are ignored. He stated that if the people of Africa contained skins of whiter color, the global community would immediately rise to the challenge of support. It seems that we do separate the world into categories of ‘us’ and ‘them’. Until we can break through these barriers in our own minds, empowering our brothers and sisters will continue to be a difficult challenge. One thing I immediately noticed at the conference is that the ‘blacks’ were sitting next to one another and the ‘whites’ were sitting next to themselves. I hope that even we, the attendees of an ‘AIDS in Africa’ symposium, are taking the challenge of looking within to see how we continue to separate ourselves from others.

I am also reminded of a quote by a friend who spoke about nuclear disarmament. He stated that if you took all the weapons away from earth, humanity would find another way to kill themselves. If we took away poverty from the world, would we somehow recreate it because the greed that caused it in the first place still exists. Is true human transformation measured by how much economic stability there is in the world, and is there any other way to measure how much compassion exists in the world. It seems that if we do not change the mentality of human nature, then we are doomed to continue this struggle between the haves and the have nots.

The story of the Exxon Mobil CEO receiving $30M USD is more than a story of inequity. If greed was left to its own device, entire nations would continue to be crippled by the economic strength of the fortunate few. If we are unable to curb the mentality of the people, to alter our consumerism, to work through our addictions, then the work we do will be largely superficial. New governance models will be needed to ensure that greed does not recreate global poverty.

If we can somehow help people to realize that helping others is good for everyone, and that there is great reward in giving selflessly, then maybe we can create the world that we are all after. A world that is beyond global poverty and where there is equality of opportunity for all.

Sukh