As the world will be celebrating World Aids day on December 1, it is prudent to review the fight on the scourge. Since the start of 21st century, HIV and Aids have increasingly been labelled an “African disease”. The specter of HIV/Aids, whenever mentioned these days, invariably points in the direction of Africa, probably because of prohibitive, almost unbelievable statistics on HIV/Aids. According to UNAIDS, since the epidemic began, over 60 million people have been infected.
It is the fourth biggest killer worldwide with estimates of 28.1 million infected souls in Africa. If we believe these figures provided by UNAIDS, the UN organisation that has assumed a hegemonic role with regards to HIV/Aids, then the scourge will impact significantly on our socio-economic development and poverty alleviation. The epidemic feeds on existing economic and social problems and unleashes untold misery on millions of lives.
Africa entered the “HIV/Aids war” late, but has 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 and it was thought of, myopically, as a “Western disease” and throughout the 1980s Africa stayed relatively quiet and a mere spectator.
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 World Bank was already claiming that the damage AIDS had done was incalculable but mostly blamed on lack of political will on the part of African governments. Briefly put, Africa’s response to the HIV/Aids pandemic has been phlegmatic.
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.
Under such 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. This can be likened to the analogy of “the soul is willing but the body is weak”. Thus the validity and efficacy of such an approach is not without its critics.
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 a 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 international political economy.
Therefore, 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 that merely exacerbate the situation. Debt is a drain on the ability of countries to direct resources to health needs.
The increasing financial insecurity and vulnerability that poverty breeds and exists in many female-headed households makes “transactional” sex a “rational” means of making ends meet. Women entrenched in poverty are limited in their ability to make healthy choices when it comes to adopting prevention methods.
While most prevention campaigns are premised on an equal distribution of power in sexual relationships, the reality on the ground is that low economic and social status of women in most parts of Africa implies that even when women have the intention and self-efficacy to adopt the use of condoms in sexual activities for instance, they cannot because in the final analysis it is men who hold the power, be it economic and/or social as to where, when and in what context sexual activity takes place.
Poverty breeds dependency and when it comes to concerns regarding food, shelter and caring for their children, many women in Africa place a higher priority on meeting these daily needs of their children than worrying over the long-term consequences of HIV. Thus there are many facets to the question of HIV in Africa. We must therefore alienate ourselves from simple causalities and undertake a more in-depth structural analysis of economic and social arrangements that reinforce HIV risk behaviour. The way forward in the fight against AIDS is that 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 entire international political economy so that terms can favour Africa to “participate” rather than “feed” the global market.
Okwaro Oscar Plato is an analyst with Gravio Africa. The views are his own.