AIDS: Africa's State of Emergency
by Lynne Gildensoph, WAMM
As I sit writing this article, the number of people infected with the human immunodeficiency virus (HIV) in Africa stands close to 27 million. This number increases by one about every 25 seconds.
Last year, in sub-Saharan Africa, approximately 2.4 million people died of complications due to Acquired Immunodeficiency Disease (AIDS). The total number of people who died last year from AIDS complications worldwide stands at about three million (20,000 in the U.S.). What this means is that 80 percent of the people who died from AIDS last year lived in Africa. In South Africa, approximately nineteen percent of the population is infected (more than four million people). According to Salih Booker and William Minter (The Nation, July 9, 2001) the causes of such disparities are related to what they term "global apartheid." They define this term as:
". . . an international system of minority rule whose attributes include: differential access to basic human rights; wealth and power structured by race and place; structural racism, embedded in global economic processes, political institutions, and cultural assumptions; and the international practice of double standards that assume inferior rights to be appropriate for certain 'others,' defined by location, origin, race or gender."
Poverty, malnutrition, lack of access to basic medical care, and unequal power relations between men and women contribute to the devastation that HIV/AIDS has wrought in Africa. In a complex equation, colonialism, slavery, and global economic policies have all contributed to the increased infection rates and lack of access to health care and medications taking place in Africa.
Along with the physical sickness of AIDS comes the stigma of being HIV positive. In addition, large communities of children whose parents have both died of AIDS are now becoming common in sub-Saharan Africa. In fact, many of these children are also infected and will die unless medical intervention takes place. Women--especially young women--are the fastest-growing population of those infected.
Exacerbating the death rate is the fact that very few people in Africa are able to receive the same drug "cocktails" to which many of those (with health insurance) in wealthy nations have access. According to Barton Gellman (Washington Post, Dec. 27, 2000):
". . . in Africa . . . one-tenth of one percent receive the therapy that could avert their deaths. At current levels of intervention, the number of Africans dead of AIDS in ten years will probably surpass the population of France."
The price of the drugs that can help infected people survive HIV infection is very high--more than $10,000 per year, and this is only part of the equation. It is also expensive to access health professionals and hospital care. In regions where annual income is counted in hundreds of dollars, these costs are prohibitive. The cost gap of fighting AIDS is astounding (Washington Post, Dec. 28, 2000). In Switzerland, a wealthy country, the potential treatment cost for all infected people, as a percent of gross national product (GNP), is 0.06 percent (a cost of $144 million). Contrast this with Ivory Coast, where this same number is 84 percent ($8.4 billion cost), Uganda at 172 percent ($11.2 billion), and Zimbabwe at 265 percent ($18 billion).
In the past year, AIDS drug prices have caused a global debate. Last year, South Africa declared that it would seek to purchase generic drugs at much lower prices. Generic drugs that cost a fraction of what the name-brand versions cost are now being produced in India and Brazil. According to Johanna McGeary, writing for Time (2001), the same antiviral drug cocktail that costs $10,000 to $15,000 per year in the U.S. is available for $3,000 in Brazil and less than $1,000 in India. (Brazil is providing these drugs free to all Brazilians who need them.)
Multinational pharmaceutical companies immediately threatened to sue South Africa for breach of international patent agreements. In response to global outrage, this suit was withdrawn in the spring of this year. In addition, a number of drug companies announced that they will participate in a program to offer these medications to countries in need at reduced fees. This move has been criticized by some as being too little, too late. Each country needs to negotiate their own rates, and it appears as if, even with the reduced costs, few people who have AIDS will receive these drugs, since they will still cost more than is affordable.
Clearly, AIDS is taking a dramatic toll in Africa. At the UN, Secretary General Kofi Annan has asked wealthy nations to participate in a fund ($7 to $10 billion per year) to address AIDS and other infectious diseases in developing countries. In June of 2001, a special session of the UN General Assembly adopted a Declaration of Commitment on HIV/AIDS that seeks to address the ravages of this disease. With regard to Africa, the declaration notes that sub-Saharan Africa "is considered as a state of emergency, which threatens development, social cohesion, political stability, food security, and life expectancy and imposes a devastating economic burden, and that the dramatic situation on the continent needs urgent and exceptional national, regional, and international action." The declaration, which was approved by consensus, calls mostly for prevention measures, but also targets care, support, and treatment. The following points are made in the document:
The success of these aims remains to be seen. Non-government organizations (NGOs) such as Oxfam and Doctors Without Borders insist that success will not occur unless wealthy nations commit to providing financial support. According to Raymond C. Offenheiser, President of Oxfam America, "As the country that has benefited most from the world economy, the United States has a special responsibility to raise its contribution to the $2 billion level needed to leverage $8 billion from other donors" (DeYoung, Washington Post, June 28, 2001).
Hopefully the U.S. government will fully support this effort and will work with the UN and the various NGOs working on global HIV/AIDS issues. Our job will be to keep an eye on what is happening and to join in with others to urge action by our government and by pharmaceutical corporations to end this tragedy.