Hoping against hell

By Gamal Nkrumah
"Drugs are the scandal of Africa," John le Carré writes in his latest novel The Constant Gardener, which is set against the backdrop of an apocalyptic Africa that has fallen from grace and become a hellish pharmaceutical laboratory serving Western interests. The novel tells of the brutal rape and murder of a white woman on the shores of Lake Turkana, Kenya, in the heart of Africa's Great Rift Valley, which renowned paleontologist Richard Leakey named the Garden of Eden. The woman, it transpires, had compiled a dossier that threatened to expose the corrupt practices of transnational corporations in Africa. Predictably, Whitehall shelved the report, deeming it counter-productive to British commercial interests in the region.
Le Carré sets out to demonstrate that the mindset behind crimes against humanity is not only that of strongmen such as Slobodan Milosevic or Saddam Hussein, but the West's transnational corporations' profit motive -- and by extension globalisation. The Constant Gardener, reminiscent of le Carré's critique of Zionism and Zionist apologists in The Little Drummer Girl, exposes a raw nerve.
Health matters, linked to rampant poverty and underdevelopment, are Africa's most pressing problems. Increased demand for health care is taxing overstretched health services. The business of doctoring Acquired Immune Deficiency Syndrome (AIDS) patients is a very large and lucrative one. However, millions of people in Africa are denied access to new "miracle" drugs, increasingly administered to AIDS patients in the industrially advanced countries of the North, because the high cost of patented drugs and the protectionist policies of the North.
The patent laws instituted by the World Trade Organisation at the behest of Western nations prevents drugs from reaching people living with HIV/AIDS in Africa. The North insists that the WTO-stipulated international trade agreements should refuse permission for poor countries to produce generic drugs, even though they cannot afford the patented versions.
Two million Africans are estimated to have died of AIDS in 2000. Yet, the North does not have the moral courage to condemn pharmaceutical companies for lining their pockets at the expense of such carnage.
While the epidemic of HIV, the virus that causes AIDS, has largely been contained in the West thanks to educational campaigns and expensive therapy with antiretroviral drugs, HIV prevalence rates are rapidly rising in several southern African countries. Zambia lost an estimated 1,500 teachers to AIDS in the first ten months of last year. Agriculture has been seriously disrupted. Simple arithmetic says that the continent will be depopulated in two decades if deaths at such high rates continue.
In Botswana, South Africa and Zimbabwe, where a quarter of the adult population is infected, AIDS has seriously altered demographic balances and reversed years of declining death rates. The cause is the rise in mortality among young adults -- the most economically productive segments of the population. If this demographic impact becomes long-term, it will have devastating economic and social consequences.
"The AIDS toll in hard-hit countries is altering the economic and social fabric of society. We need to respond to this crisis on a massively larger scale to what has been done so far," warned Peter Piot, the executive director of the UN's AIDS programme UNAIDS.
"Because of AIDS, poverty is getting worse, just as the need for more resources to curb the spread of AIDS and alleviate the epidemic's impact on development is growing. It's time to make the connection between debt relief and epidemic relief," Piot adds.
AIDS, in other words, cannot be seen in isolation from the continent's debt crisis.
"African governments are paying out four times more in debt service than they now spend on health and education. If the international community relieves some of their external debt, these countries can reinvest the savings in poverty alleviation and AIDS prevention. If this does not happen, poverty will continue to fan the flames of the epidemic," Piot explains.
Hit by tidal waves of bad news, there is growing evidence that the countries of Africa are getting their act together. In Mozambique, social indicators record substantial improvements, in spite of the devastating floods that swept the country last year. Rising school enrollment and falling infant mortality were accompanied by improved household food security. Annual inflation fell to 2 per cent, from 47 per cent. Miraculously, the prevalence of AIDS/HIV sufferers among Ugandans has also declined, from 15 per cent two decades ago to less than 8 per cent today.
Even in some of the worst hit countries, such as Zambia, the infection rate among 15-to-19 year-olds has fallen dramatically. In Uganda, poverty has been reduced to 44 per cent, from 56 per cent a decade ago. Primary school enrollment rose from 56 per cent in 1995-96 to 94 per cent last year.
Research by UNAIDS and the World Health Organisation (WHO) in 2000 presented new data showing that Africa is not helpless in the face of the epidemic. Countries like Uganda, which fought the epidemic with logical strategies a decade ago, are now reaping the rewards in the form of falling rates of HIV infection and deaths from AIDS. Uganda's rate of HIV prevalence has now fallen to just over 8 per cent, from a peak of close to 14 per cent in the early 1990s.
In Zambia, new surveillance data from the capital Lusaka compiled by UNAIDS and the WHO show that the proportion of pregnant girls aged 15-19 infected with the AIDS virus has dropped by almost half over the past six years. This holds out hope that Zambia might follow the course charted by Uganda, where a decline in infection rates in young urban women heralded the turnaround in the epidemic.
So there are signs of hope. However, other social difficulties, when viewed alongside with the AIDS epidemic, still make it seem as though success is a long way off.
The African brain drain, for instance, is no less economically devastating than AIDS. There is one scientist for every 10,000 people in Africa, compared to five scientists for every 1,000 people in the US. African scientists and professionals are leaving the continent in droves. Money, too, is flowing out. At a conference on the challenge of financing development in Africa convened in Addis Ababa in May, it was revealed that capital held by Africans overseas is equivalent to 40 per cent of GDP, compared to 6 per cent for Asia. Participants at the conference organised by the Addis Ababa-based UN Economic Commission for Africa (UNECA) were told that the capital flight debt represents 94.5 per cent of total debt in Nigeria, 94.3 per cent in Rwanda, 74.4 per cent in Kenya and 60.5 per cent in Sudan. In relation to GDP, capital flight was put at 133 per cent for Nigeria, 102 per cent for Sudan and 58 per cent for Kenya.
African poverty is uniquely pervasive, a predicament that was the overriding theme of the UN's millennium celebrations in October. But the powers that be are not seriously interested in lending Africa a helping hand.
"By redirecting $70 billion to $80 billion a year in a global economy that is more than $30 trillion, the world could ensure access to the basics for everyone," states a report on the state of the world's children produced by the United Nations Children's Fund (UNICEF) published last year.
In face of these social and economic repercussions from AIDS, Africans realised that they can literally no longer afford to sit tight. The beginnings were, in retrospect, ominous. World powers feigned concern in 2000 about the continent's challenges in a sickening replay of the classic colonial "white man's burden." US President Bill Clinton kick-started the year with an unprecedented speech at the UN headquarters in New York in January, which focused almost exclusively on Africa. It was, alas, hollow and empty.
The only US president to tour Africa twice during his tenure in office, Clinton initiated the notorious Africa Growth and Opportunity Act (AGOA) that claims to provide preferential trade benefits to poor and debt-ridden African countries, but in reality stipulates that they adopt IMF prescriptions piecemeal and institute market-based economic deregulation and privatisation policies. This is the rhetoric employed by wealthy nations' leaders. The bottom line is that Africa's debts are not going to be written off.
For Africa, two conferences on the HIV/AIDS pandemic were the defining events of 2000. In July, the 13th International AIDS Conference was convened in the Indian Ocean port of Durban, South Africa. It transpired at the Durban AIDS conference that a war against women is running in tandem with the AIDS epidemic. Enough women are raped every day in South Africa to fill four jumbo jets, the conference was told.
Then, in the first week of December, over 1,500 African delegates converged on the Ethiopian capital Addis Ababa to tackle AIDS head on from an African perspective.
"As Africans, we have to deal with this uniquely African catastrophe," insisted South African President Thabo Mbeki. His unconventional views on AIDS has outraged many Western governments and institutions.
The question of the origins of AIDS is a highly contentious one in Africa. Many are increasingly convinced that Western-engineered eugenics played a decisive part in the creation of the virus. No disease has appeared so suddenly and spread so rapidly among specific population groups. Is HIV/AIDS indeed a genetically modified virus? There is growing belief in German-based scientist Jacob Segal's theory that the AIDS virus was created in US military biological warfare research laboratories. Similar views were voiced by Briton John Seale and American Robert Strecker.
The AIDS virus HTLV3 was in fact first identified at the US National Cancer Institute, Fort Detrick, Maryland, which also happens to be a major US Army biological warfare research facility. At a US House Appropriations hearing in 1969 the US Defence Department's Biological Warfare division requested funds to develop a synthetic AIDS-like virus through genetic splicing, a disease that would destroy a victim's immune system.
Some believe AIDS is ethno-selective. Are Africans more predisposed to suffer from AIDS? Is there a massive cover up?
What is even more confounding is that there is no consensus on what precisely AIDS is. Africa is wrestling with a formidable, but invisible enemy. According to Professor Peter Duesberg of the University of California, Berkeley, there is no single proper definition of AIDS on which discourse or statistics can be reliably based. Duesberg happens to be one of Mbeki's chief health consultants.
The deeper point made by Mbeki himself is that grinding poverty and underdevelopment are the killers, not the AIDS virus. Africa does not want its people permanently dependent on handouts by well-meaning Westerners. Such benevolence needs to go hand-in-hand with an attempt to eradicate poverty. Donor agencies are increasingly looking at AIDS-related care as a good investment, giving direct benefits for people with AIDS.
Research in Uganda demonstrates that small-scale credit schemes succeed in communities with high incidence of AIDS. These schemes, which grant small loans to individuals who want to start up a small business, played a pivotal role in alleviating poverty and assuaging the economic downturn exacerbated by AIDS.
Mbeki, like le Carré, is expressing outrage at the clouding of obvious truths.
Related stories:
Identifying the killer 6 - 12 July 2000
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