The South Africa Post (Oct. 20, 2003) is not the only news organization wondering why so little aid is being given to the poor and in need of medication for AIDS and HIV infections. Not only in the Congo, but throughout Central and Southern Africa. In the Congo, according to the article, one-tenth of the population is HIV infected. As many as 30 million have AIDS or are HIV+ in Africa. The 1,000 people in the Congo being helped with low cost medications are just a drop in a huge bucket. So, why aren’t more people, organizations, and nations doing more to stop this catastrophe?
People in the West, especially America, ask “why are we hated so much?” One answer can be found in the problems of supplying medicines to the poverty stricken in Africa, especially the millions who are either HIV+ or already in advanced stages of AIDS. There is no doubt that, until very recently, the problem lies with the pharmaceutical companies who manufacture AIDS medications. They have not made much of an effort to provide these medicines at a price poor Third World inhabitants can afford. True or not, the pharmaceutical manufacturers are often accused by politicians and the media of neglecting poor nations where their citizens cannot afford to pay. The African nations are a good example. High-priced AIDS drugs are simply not available to the AIDS sufferers because they cost more than they can afford. And, until recently, even African governments could not provide financial aid to buy medicines.
There are many who say it is all politics. A special kind of politics. KLuadey (1) calls it The Politics of AIDS. It means that only the wealthy and the well-connected in Africa can afford to pay for AIDS medication. “Few Africans can afford the drugs needed to fight AIDS, which can cost between $500 and $1,000 a month. Additionally, many African governments do not have the funds to import these drugs. The average African nation spends less than $10 per person each year on health care” (Kuadey 2002 2).
So, where are the UN and other humanitarian organizations? One problem, aside from the financial area, is attitude. Many in the West feel that providing medicines to the poorer nations is like providing humanitarian charity. This bothers many of the Africans, especially. And well it should. Here is one example: At the recent AIDS conference in South Africa, according to Hawa (1), South African President Thabo Mbeki said, quite plainly and agonizingly that when he heard this tale of human woe, he heard the name recur with frightening frequency- Africa, Africa, Africa. However, he pointed the finger at the real problem which goes well beyond disease when he concluded that the world’s biggest killer and the greatest cause of ill health and suffering across the glove is extreme poverty. Africans are quick (and right) to condemn the spread of the epidemic. Poverty may be a cause. But poverty should not be an excuse for not providing medicines. Hawa (2) quotes the late Jonathan Mann, a founder of the World Health Organizations program on AIDS as saying that discrimination isn’t just an effect, it’s actually a root cause of the epidemic itself.
Money is being spent. Supposedly it numbers in the hundreds of millions of dollars. But, there are people in the West who feel that the Third World should be doing more. Some feel that people should give more, but that should not keep the poor from contributing and spending what they can While no one dares put a price on human life, even so there needs to be an accounting of how public funds are spent. This is sad and frightening. There are many complaints that often health care in poor nations falls into the hands of the elite. These are wealthy people who prefer expensive, fancy metropolitan hospitals. They can afford them. But, what about the poor? They are left to visit rural clinics. These clinics have little medicines, and less money to buy any. Nevertheless, here is what this article means: the wealthy West wants the Third World to handle its own affairs. The West is telling poor nations to be a little bit more wise in how, and where, and on what, they spend their budgets. But, here is the sad part: the poor nations- especially in the sub-Saharan Africa- have little or no income to spend, no matter what it needs to be spent for- whether health care, roads, bridges, etc. For example, “The cost of ARV treatment in the Congo remains a major problem for most….the annual cost is about…$442 per year, roughly two-thirds of the average annual income” (IRIN News 1).
The rich West is unaware, or perhaps even uncaring about the plight of poor Africans. At least, one has to read the African media to learn more. Under the title “Humanitarian Bodies Fear Shortage of Medicine”, the story from the Central African Republic states that “the cost of immediate needs in vaccines is 90,000 dollars….A Health committee… announced that hospitals and health centers in the country’s most populous provinces are about to run out of medicines, and that supplies of anti-tuberculosis drugs had already finished” (No auth. 1). Even the bureaucratic UN, faced with this dilemma, seems unable to move quickly and efficiently enough to solve this problem.
So, where is the UN and other humanitarian organizations? This is a question that needs to be asked over and over. They are continuing to do “studies”. According to BBC commentary,
“The United Nations has launched an initiative to deal with the threat that HIV/Aids poses to African states, where 70% of the world’s HIV positive people live. The Commission on HIV Aids and Governance in Africa has begun discussions in the Ethiopian capital, Addis Ababa. Nearly 30 million people are living with HIV in Africa and their premature deaths rob the continent of vital skills” (BBC News, 1). But, talk is cheap. Action is what is needed. And there is immense frustration.
Many Africans are disappointed that some of these organizations seem to be moving at a snail’s pace. For instance, “African civil society groups packed their bags Wednesday to return home distressed that commitments made at this week’s UN General Assembly Special Session on HIV-AIDS would amount to mere rhetoric” (Machipisa 1). Here is a disturbing headline about AIDS activities from the UN: “As UN talks AIDS, Africa wants action: ‘Let’s finally see some deeds,’ says ailing Ugandan” (Salopek 2000 1). It is clear the ones afflicted with
AIDS, particularly in Africa, get little media attention.
The deeds can only happen when there is a truly united effort not for education but for affordable medicines for all whop have AIDS or are HIV+. Money for drug treatment, not just education, also is high on the wish list of Africans, whose countries have borne the brunt of the AIDS pandemic. 25 million HIV carriers–or fully two-thirds of the global total–live in Africa But experts say that fewer than 10,000 people there can afford the expensive cocktails of drugs that keep millions alive in the developed world. Controlling the disease won’t be cheap.
Salopek (3) writes about a recent article in the journal Science which estimates it will take annual investments of $9 billion to bring AIDS under control in the impoverished regions of the world where it is still exploding: Africa, Latin America and Southeast Asia. Annan, the UN chief, wants to create a $7 billion-to-$10 billion AIDS fund, splitting the cost almost equally between the countries most affected and the richer UN members. The author also interviewed a frustrated African doctor who had some problems with the fact that the UN should understand that another 1,000 billboards advertising condoms won’t do Africa’s AIDS patients much good.
So, where are those millions of dollars needed? Despite some economic downturns in America, surely the U.S. and other nations can contribute enough to make a difference in the Congo and elsewhere in Africa. “We have done about all we can possibly do alone,” said Dr. Samuel Luboga, a public health expert at Makerere University.
“Despite recent increases in spending to fight AIDS in Africa, the funding of such efforts by 2005 is projected to be about half of what will be needed by then, according to a new U.N. report released yesterday” (Weiss 1). This warning hasn’t increased available money. Instead, it has created more words. Words saying things are looking blacker than ever:
Various heads of the world’s major humanitarian agencies continue to call on the international community to respond appropriately to the human tragedy now unfolding in Southern Africa. This is the result of a combination of severe drought, the HIV/AIDS pandemic and growing poverty. The statement warns that all indications are that Southern Africa will suffer “nothing short of a decimation of populations in their most productive years, and the prospect of economic collapse and insecurity in the foreseeable future.” (ReliefWeb 1)
It is worth mentioning that the world’s nations are contributing some funds- but not nearly enough. For example, according to the online AIDS information center, including 2003 pledges, the U.S. has provided $1.5 billion; Japan, Italy and Britain, $200 million each; France and Germany, $131 million, Canada $100 million, the Netherlands $118 million. And, as individuals Mr. and Mrs. Bill Gates donated $100 million. So, where are the other nations of the world- including some of the wealthy African nations? Not heard from. Not interested. Afraid.
Aside from shortages and financial woes, there is another problem: Ignorance. In a report, Fola Adekeye reports from Nigeria that there are some AIDS patients afraid to take drugs, fearing they will do more damage than good. Ignorance, or the inability of pharmaceutical companies to present information about side-effects is causing major problems. One doctor in Lagos said “the drugs had quickened the death of more than 270 HIV/AIDS patients. For once as a medical doctor, I am in a dilemma. My duty is to save lives but these drugs present terrible side-effects” (Adekeye 1). The fact that there seems to be a lack of information or knowledge about the potential dangers and side-effects of some of the medicines provided by Western companies is wreaking havoc. In fact, according to Akedeye (2), no AIDS patients who had taken antiretroviral drugs for unbroken three years are still living. It is easy to shift blame, of course, but somehow, the Western companies seem to have been remiss to do a thorough training and information job that might have saved at least some of those lives. So, it is encouraging not only to read about help for at least 1,000 AIDS sufferers in the Congo, but also some good news from Uganda. The New Vision website (1) points out that Uganda has an estimated 100,000 people living with AIDS, who are in urgent need of anti-retrovirals (ARVs). While they now cannot afford them, according to a Ugandan company planning to produce the drugs, they could soon have access to locally produced ARVs at a cost of less than 50 US cents per day, Some progress is slowly being made as governments in the Third World, especially in Africa, are implementing plans to get and distribute low-cost medicines from Western manufacturers. For one, “the government of Kenya has announced its intention to implement a law that would allow it to obtain cheap life-saving medicines” (James 1). International organizations, including the IMF and the WHO and agencies of the UN and national political entities are now literally obligated to develop a system for manufacturing, distributing, and overseeing the use of, low-cost, life-saving medicines.
At last, there is some action: The World Health now is planning to disclose the first details of a global AIDS strategy to bring low-cost drugs to 3 million people in poor countries, a plan that top officials said will eventually include endorsement of pills that combine three HIV drugs in a single tablet. But, the Washington Post reported that “the endorsement of the three-in-one pills is expected to be controversial because they could violate a variety of patents, the report said. Only about 300,000 people are receiving AIDS medicine in the regions targeted by WHO, according to the Post” (Dow Jones News 1).
The strategy is also expected to call for treating patients at the first sign of symptoms, rather than waiting for tests to confirm infection by HIV, the virus that causes AIDS, and to allow nurses and community organizations to dispense the medicines, the report said.
There is another serious problem: crime. Theft. Detouring some of the badly needed medicines intended for Africa. The media also reports about those in the West who have been taking advantage of the largesse- that is, providing medicines at a far lower cost- to Africans. Dyer (1) writes that the pharmaceutical industry’s efforts to send HIV/AIDS drugs to Africa at more preferential prices has been undermined by unscrupulous traders who re-import the cheap drugs to Europe for sale at full price. According to Dyer (1) these drugs were supposed to go to Senegal, the Ivory Coast, the Republic of Congo, Guinea-Bissau and Togo but never got there, or were somehow intercepted. With the high price and rarity of these medicines, it is logical that some thieves and corrupt people, including officials, would steal; and re-sell them at enormous profit.
The high cost of imported AIDS drugs has even created a political situation. “Cuban President Fidel Castro and South African President Thabo Mbeki have signed an agreement to cooperate in the manufacture of low-cost AIDS drugs while ignoring multinational drug companies’ patents” (Predrag 1). Of course, this is politics. But, why haven’t the West’s drug companies done Castro one better and supplied their drugs? AIDS, whether in Africa or elsewhere, should not be addressed under a cloud of politics, especially when Communist Cuba’s Castro can get favorable African headlines from his move.
There is one thought that pesters one. Is the reluctance of many in the rich Western world to pay to eradicate or help ease AIDS suffering due to the fact that it is AIDS, and not some other more “comfortable” disease. We have done wonders to help eradicate smallpox and malaria, even tuberculosis. But, those diseases were not caused by bad blood transfusions, or sexual transmission. Is the stigma of AIDS to blame here? Hopefully, not. This brings on another serious question. Is some of the slow response from white countries in the West due to the fact that this disease began and is spreading among BLACK Africans? There is no doubt that in some areas, there is prejudice. But, this sort of prejudice against black people cannot be condoned. Still, there is no one in the UN or in America or anyplace in Europe who is brave enough to bring this point to the public. One point that not enough people are aware of concerns the pharmaceutical companies in the West. “In March, 2001, 39 foreign drug companies went to court to challenge a South Africa law that would allow the country to buy cheap, generic substitutes for patented AIDS drugs” (Kuadey 2). Maybe Fidel Castro was more compassionate than, say, Eli Lilly! Nevertheless, it is heartening to report that, due to the publicity by activists, the companies withdrew that suit three months later.
It is also important to stress one other fact: African leaders are not doing enough, either. Ayitley (1) makes this crystal clear when he writes that there is only so much that the international community can do. Without a strong political commitment on the part of African leaders, well-intentioned initiatives are doomed to fail. His article goes on to report that not one African head of state bothered to attend the annual conference on AIDS last year. “Notably absent was the president of the host country, Zambia, Frederick Chiluba, whose office was just minutes away and whose own minister of local government and housing….died of AIDS on the eve of the conference” Ayitley 2).
As one can see from this brief overview of quotes and media reports from the 1st and the 3rd world, there is disappointment and distress on the part of the Africans. There is also a desire by some African leaders to look the other way when it comes to AIDS. Many are busy with vario0us tribal and regional warfare to worry about the health of their people. There is a feeling in the West that people would like the whole thing to just go away. In reading these positive and negative citations and points of view, the biblical injunction of being one’s brother’s keeper comes to mind. The wealthy West should do more, care more, and accomplish more in saving 3rd world lives. This AIDS crisis is not merely a health problem and an economic problem, but it is a problem that will affect the lives of future generations in Africa. Too many young people are dying. Or will Africa remain a lesser continent? Will AIDS in Africa be seen by the West as a sign of lower standards of living.
WORKS CITED::
Ayiltey, G.B.N.: “Time for a Blunt Message to Africa” CNN.com Oct. 27, 2003
Adekeye, F.: Dilemma of Aids Patients” Lagos, Nigeria: Newswatch, February 25, 2002
BBC News: “UN Studies Impact of AIDS in Africa” Sept 17, 2003
Dyer, O.: “Cost price drugs for developing countries are found in Belgium” London UK: British Medical Journal, v.325, i. 7368, October 23, 2002
Hawa, R. S. : “Africa, poverty and the AIDS Virus” watchAfrica.com 2002 also on www.drugdonations.org/link.html
IRIN News: “Congo: UN to provide ARVs for 1,000 HIV positive people” www.SouthAfricapost.com October 20, 2003
James, J. S. Access to Medicines for AIDS Patients in the Third World” AIDS Treatment News, March 30, 2001
Kuadey, K.: “The Politics of AIDS Drugs in Africa”
News Monitor, Sept. 27, 2003 www.time.com/time/2001/aidsinafrica/
Machipasa, L.: “African groups disappointed by UN AIDS declaration” watchAfrica.com June 27, 2002 also located at URL:
www.drugdonations.org/links.html
Predrag, S. Cuba’s Castro offers Low-Cost AIDS Drugs to South Africa” Bay Area Reporter, April 6, 2001
Salopek, P. “Africa Wants Some Action” Chicago Tribune, June 25, 2000)
Weiss, R.: AIDS Funding Is Still Insufficient, UN Says” Washington Post, Sept. 22, 2003
No author listed: “Local Company to produce AIDS drugs” Kampala Uganda: New Vision, Nov. 10, 2003
No author listed: “Cheap cures, health care in poor countries” London UK: The Economist, August 17, 2002, p. 5
No author listed: “Humanitarian Bodies Fear Shortage of Medicines” UN Regional Information Networks, November 20, 2002
No author listed: Report on AIDS Funding” Inter-AgencyStanding Committee, UN, ReliefWeb, Jan. 21, 2003
No author listed: “WHO To Reveal Global Low Cost AIDS Drug Plan” Dow Jones Business News, Sept. 22, 2003
