By Oscar Okwaro Plato
Since the start of 21st century, HIV/Aids has increasingly become an “African disease”. The spectre of HIV/Aids, whenever mentioned, invariably points in the direction of Africa probably because of prohibitive, almost unbelievable statistics on the scourge.
According to UNAIDS, since the epidemic began, more than 60 million people have been infected. It is the fourth biggest killer worldwide with an estimated of 28.1 million infected people in Africa. If we believe these figures provided by UNAIDS, the impact on socio-economic development and poverty alleviation has got to be huge.
Africa entered the “HIV/Aids war” late but had nevertheless assumed control of proceedings by the end of the 20th century. The first AIDS cases were identified amongst homosexuals in the United States in 1981. It was thought of myopically as a ‘Western disease’; throughout the 1980’s Africa stayed relatively quiet and a mere spectator while the “HIV/Aids war” waged on. The epidemic took a U-turn in the 1990s when suddenly AIDS became a “clear and present danger” to a majority of African nations south of the Sahara. By the time the 11th International Conference on AIDS and STDs in Africa was launched in 1999, the damage AIDS had done was incalculable, according to World Bank.
The Joint United Nations Programme on AIDS (UNAIDS) has, as its “holy creed”, the imperative of strong political will backed by concerted multi-sectoral effort as representing a panacea for HIV prevention in Africa. However, the concern here has often been a stance of denial or alternatively, official acknowledgement of the need for an AIDS policy coupled with a persistent failure to accept the depth of the crisis, much less to follow through on constructing a comprehensive policy.
However, one cannot ignore the dynamics of political economy and poverty of this problem on this continent. Whilst there is no shortage of academic texts on the poverty of political will and democratic governance in Africa, the question is, does the failure of political will matter? The answer is yes and no. Yes, because it is governments who must formulate national plans, manage large-scale programmes and coordinate efforts of NGOs and CBOs to make responses to HIV effective.
There exists the need for governments to take charge of providing basic needs which ensures a decent living standard crucial for preventive campaigns. Yet, this has to be considered in context. Africa entered the 21st century financially indebted, technologically backward and poor. It was also the only continent experiencing negative economic growth. Under such a distressing climate and the already limited role of the state as a result of Structural Adjustment Policies imposed by the IMF/World Bank, it seems almost impossible to shoulder the onus of responsibility expected when it comes to HIV/Aids. Thus the validity and efficacy of such an approach is not without its critics.
Political will is but one part of a giant HIV jigsaw puzzle. Yet, to understand the problem, we cannot discount the importance that debt servicing and its attendant problems pose to our governments. The debt problems have a historical setting and are entrenched in global market forces unleashed by the so-called “Washington Consensus”. Political will is important but we must not forget that majority of countries faced with AIDS threats are ill equipped due to poor economies, poverty and malnutrition which are deeply embedded in the dynamics of the international political economy.
The hypocrisy of donors must be called into question given their articulation on the one hand of the huge gap in funding measures to combat the AIDS crisis compared to the relatively paucity of their own contributions, and the tendency for what is offered to be bound up in conditionalities which merely exacerbate the situation on the other. Our Debt servicing is close to 5 per cent of the GDP, and 15 per cent of export revenue. If 50 per cent of debt were cancelled, it would provide funds enough to mitigate the effects of HIV/Aids. Debt relief offers a window of hope to rehabilitate infrastructure for the delivery of both HIV/Aids prevention and mitigation in Africa where poverty creates conducive environment for its large scale spread.
There are many facets to the question of HIV in Africa. We must alienate ourselves from simple causalities and undertake a more in-depth structural analysis of economic and social arrangements that reinforce HIV risk behaviour. To defeat AIDS, all significant actors must become partners. The idea that, Africa must always be “talked to, about and not with”, on an equal platform, must be dismantled. There is an urgent need to transform the international political economy so that Africa can “participate” rather than “feed” on the global market.