Stephen Lewis is a consummate speaker who rarely uses scripts or even notes. A politician earlier in life, he later served as Canada’s ambassador to the UN, and later still as the UN’s unofficial ambassador to combat the spread of HIV/Aids in Africa. He gave this speech to a citizens’ forum in Calgary during the Group of Eight meeting in July 2002, where world leaders were talking about a rescue plan for Africa.
Human side of ledger
I live two lives: one is speaking within Canada to a variety of groups; the other is the role of UN Envoy on AIDS in Africa. Inevitably the two roles intermingle, but tonight, of all nights, I want to retain at least twelve degrees of separation. Tonight I’m speaking in what diplomacy elegantly calls my personal capacity . . .
Let me proceed to deal with the issues. The New Partnership for African Development (NEPAD) is a document driven by the fashionable current tenets of liberalized trade, governance, democratization and anti-corruption. They all sound fine in themselves, but I happen to believe that that prescription is faulty; indeed it is reminiscent of many similar analyses of Africa which have gone before, and have come to naught . . .
There is only a pro forma sense of the social sectors, only modest references to the human side of the ledger. And in a fashion quite startling, in fact, disturbingly startling, NEPAD hardly mentions HIV/AIDS at all. But how can you talk about the future of sub-Saharan Africa without AIDS at the heart of the analysis? The failure to do so leads to a curious and disabling contradiction.
NEPAD has a number of stunning goals. They are essentially the Millenium Development Goals: an annual growth rate of 7 percent for fifteen years; cutting poverty in half by the year 2015; reduce infant mortality rates by two-thirds; reduce maternal mortality rates to three-quarters of what they were before; have every child enter school who is eligible, thereby re-enforcing the principle of gender equality. A more admirable agenda could not be imagined. But there’s a dreadful conundrum . . .
I cannot put the case too strongly. There will be no continuous 7 percent annual growth rate in the twenty-five countries where the prevalence rate of HIV is above 5 percent, considered to be the dangerous take-off point for the pandemic, unless the pandemic is defeated. In fact, it is virtually certain that several of those countries will experience a negative rate of growth year over year under present circumstances.
There will be no cutting poverty in half by the year 2015 unless the pandemic is defeated; poverty exacerbates the pandemic, but the reverse is equally true. When family income is gutted as wage earners die, as plots of land are left untended, as every penny goes to the care of the sick and the dying, it is preposterous to pretend that poverty will be halved. There will be no reduction in infant mortality by two-thirds, unless the pandemic is defeated. How can there be? Two thousand infants a day are currently infected, a certain death warrant, maintaining or elevating the already impossibly high infant mortality rates. There will be no reduction in maternal mortality rates unless the pandemic is defeated. How can there be? We’ve learned over the years that maternal mortality is one of the most intractable health problems throughout the developing world; in a situation where the health systems are under assault, where hospitals and community clinics can’t cope, there’s no chance of reducing maternal mortality by three-quarters. Seldom has the word pipe dream been more applicable.
And there is certainly no chance of putting every eligible child in school, especially the girls, unless the pandemic is defeated. UNESCO has very recently released a study showing that four out of every ten primary school age children are now not in school in sub-Saharan Africa. Young girls are regularly pulled out of classrooms to look after ailing parents. There are thirteen million orphans in Africa, the numbers rising inexorably, huge cohorts of them living on the streets, or attempting to survive in child-headed households after the extended family is gone and the grandmothers are dead. These kids have nothing; they certainly have no money to afford school fees, or books, or uniforms. And it’s not just the children, it’s the teachers . . .
Paper mache coffins
I remember visiting a little Catholic community centre in Windhoek, Namibia, in February. It was a place where people living with AIDS could network, find a support group, have a meal, try to earn some money through an income-generating project. What was the project in that instance? The Sister running the centre took me out back to show me. A group of men were making miniature paper mache coffins for infants, and as they affixed the silver handles, they said to me with a mixture of pride and anguish: “We can’t keep up with the demand.”
I guess that was, for me, the nadir of this last year of travelling through Africa. It’s simply self-evident truth that in country after country where the pandemic is grievously rooted, the development process has been dealt a mortal blow. The G8 Summit is, in a way, the last best chance for Africa. The G8 leaders, straightjacketed in the kind of denial that afflicted the African leaders for twenty years, must make a Herculean effort to break free and provide a binding commitment to the continent . . .
AIDS can be addressed
Let me be clear: while the situation feels apocalyptic, it can be addressed. AIDS has done and is doing terrible things to Africa, but we know how to defeat it. That’s what drives me crazy, we know how to defeat it. We know all about voluntary counselling and testing; we simply have to train more counsellors and get rapid testing kits into the hands of those who administer the tests. We know all about the prevention of mother-to-child transmission. We know about the wonder drug nevirapine; one tablet to the mother at the onset of labour, one tablet during the birthing process, one dose of liquid equivalent to the baby within hours of birth and transmission of the virus can be reduced by up to 53 percent. We know about antiretroviral treatment, the so-called drug cocktails that keep people alive.
Largely as a result of competition from generic manufacturers in India, Thailand and Brazil, the cost of “ARVs” has dropped dramatically, but no matter how dramatic, the drugs are still beyond the capacity of Africans to afford when people live on less than a dollar a day. But it could be afforded through external financing, and it is one of the gruesome iniquities of the present situation that people are dying, everywhere, in huge numbers, unnecessarily . . .
A personal note
Let me end on an intensely personal note. Over the last few days, people have told me — not unpleasantly — that I get very emotional about the subject of AIDS in Africa. Some of my good friends worry about my psychological equanimity. I guess, in part, men are supposed to be stoic and bravely unfeeling, or at least self-contained.
I make no apologies for the occasional emotional catharsis. I can’t help it. All my adult life, as a democratic socialist, along with countless colleagues, sometimes in partnership with people of other ideological beliefs, I’ve raged against injustice. But I’ve never seen anything like this. I don’t know how to get a grip on it. I don’t know how to make sense of it. Is the behaviour of the western world just appalling insensitivity, is it unacknowledged racism, is it sheer unbridled indifference, is it the comfortable assumption of hopelessness in order to avoid contributing money; is it possible that the political leadership is completely out of touch with the vast populations — like the people of Canada — over whom it holds sway? . . .
I carry around with me the images of young mothers, sitting on makeshift benches, in the shade under a tree, fifteen or twenty at a time, all of them exhibiting AIDS-related symptoms, and urgently, with great dignity, asking who will care for their soon-to-be-orphaned children, asking about medicines for straightforward opportunistic infections, asking about treatment, and so help me, I can’t give any answers. Somehow, this G8 Summit has to be a turning point.
In times of war, every apparatus of the state is conscripted into battle. In times of war, resources are somehow found that are thought not to exist — just think of the so-called war on terrorism, with scores of billions of dollars hurled into the fray overnight to avenge the horrendous deaths of three thousand people. So explain to me why we have to grovel to extract a few billion dollars to prevent the deaths of over two million people every year, year after year after year?
Why is the war against terrorism sacrosanct, and the war against AIDS equivocal?
In the answer to that question lies the challenge for NEPAD and the true test for the G8.
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