Global Economics and the HIV/AIDS Crisis
Shirley Farlinger
August, 2006
ABSTRACT
This year, 2006, 25 years after AIDS was discovered, 3 million people will die of AIDS and 4 million will become infected. It is imperative that every effort be made to address this pandemic. Because Africa is the centre of this crisis at the moment there is a tendency to regard this as an African problem but this paper shows that it is a problem involving many factors and that Canada is not an innocent bystander. More funding is required for medical assistance, education, healthy food and water and immediate distribution of cheap or free antiretroviral drugs. Canada's Access to Medicines Regime has not so far resulted in any AIDS medicines reaching Africa. Canada's participation in policy making and funding for the International Monetary Fund and the World Bank also needs to be questioned. The global AIDS conference in Toronto and the first meeting of 30 Grannies-to-Grannies groups from Africa and 40 such groups in Canada gave rise to this analysis.
THE ROLE OF GLOBAL ECONOMICS IN THE AIDS CRISIS.
There has been great misunderstanding here and in Africa on what AIDS and HIV actually are. Acquired immunodeficiency syndrome is a set of symptoms that indicate a person has become infected with a virus that has seriously damaged the body's immune system. HIV stands for human immunodeficiency virus. A key symptom is the development of one or more of a range of `opportunistic' diseases from pneumonia to skin and digestive disorders. . People can only become infected if their blood comes in contact with the HIV. It is carried in some bodily fluids including blood, semen, vaginal secretions and breast milk. Most people get it in one of three ways: having unprotected sex with an infected person; injecting drugs with a needle that has been used by an infected person; or being born to a mother who is already infected. New drugs called antiretrovirals (ARVs) have enabled many people, especially in Canada, to control the virus and live more-or-less normal lives. However there are numerous side effects of ARVs and the remedies can be complicated and costly. (1) The immediate imperative of African countries dealing with the AIDS/HIV pandemic is to put in place the following steps:
1) Make AIDS drugs available to all
2 ) End the stigma of people living with AIDS
3 ) Free up enough funds
4) Promote peace
5 ) Reduce poverty
6) Support Education
7) Empower women
I will address each of these steps.
1-Make AIDS drugs available to all Most countries in Africa do not have a strong public healthcare system able to provide antiretroviral drugs and the medical professionals needed for diagnosis and treatment. This is partly the result of the economic policies of the International Monetary Fund and the World Bank. These organizations, set up in 1944 to respond to the needs of the people of Europe after the Second World War, have since imposed economic policies called structural adjustment programs (2,3). These programs are described as:
- rolling back regulations that benefited workers and protected public health, safety, and the environment but increased business costs; *eliminating restrictions on foreign imports, foreign ownership, crossborder financial flows, the export of natural resources, and the activities of foreign banks and financial houses so that global corporations could move goods and money cross their borders at will;
- privatizing public assets and services, including communications, power, and water by offering them for sale to private investors at bargain prices;
- slashing public expenditures for health and education to free funds for the repayment of foreign loans and
- providing special tax breaks and subsidies for foreign investors. (4) Not only are countries that need to borrow money from the WB and the IMF bound by these policies but also there are few other financial institutions willing to lend money to any country not abiding by these rules. After borrowing money and paying various rates of interest over many years, ways needed to be found for repayment. The SAPs were intended to do this. But countries have had to cut back on health, education, downsize government, privatize national enterprises often for low prices, and prevent the formation of unions which would demand higher wages. All of these policies have affected a government's ability to help the AIDS population. A few of the Highly Indebted Countries have had their debts cancelled but most are still paying interest on these unrepayable loans. I say unrepayable because many of Africa's 54 countries cannot earn enough income from their exports to repay the interest let alone the capital on their debt. African exporters are in stiff competition with each other so the prices they receive are low. In addition rich countries are refusing to lower the subsidies, tariffs and other barriers to trade they impose as they continue to subsidize their own farmers and to provide free irrigation. The World Trade Organization's last meeting did not resolve this impasse.
2-End the stigma of people living with AIDS AIDS was first identified in Uganda in 1982. The local people initially believed the new disease was caused by witchcraft. Yet Uganda was able to overcome the stigma of AIDS and in 1992 it was the first African country to announce a fall in the HIV infection rate. This was sometimes done by AIDS victims themselves educating others by singing, dancing and acting out dramas in villages. Because there is often no social welfare system, such as old age pensions, it has been difficult. But religious and political leaders have helped to make the victims more acceptable. Education is just one important aspect of this problem and again a good public education system, which does not charge for uniforms and books and can educate the children, especially the girls, is important. In Canada AIDS victims have also known discrimination from employers, family, religions and the public. This is partly because the first victims were homosexuals. Now there is a greater acceptance, the provision of hostels and a big Pride Day Parade to help overcome the stigma of homosexuality. In Africa the victims are not mainly homosexuals but still face discrimination.
3-Free up the Funds The establishment of the Stephen Lewis Foundation will add to the initiatives to supply funding to end the AIDS crisis. Private donations from large donors such as the Melinda and Bill Gates Foundation will also help. Pharmaceutical companies can make or break the issue by allowing local manufacture in Africa of generic drugs or by supplying free drugs to victims. Bill Gates is connected to several pharmaceutical companies and could influence them. The Grannies-to-Grannies organizations will raise funds to be sent to the Stephen Lewis Foundation and this will be a substantial boost. The aid will be targeted to those most in need, especially to women. Governments at all levels can also help. However governments must be careful not to hinder progress in ways outlined in this paper. When you inquire about the reasons for Africa not being able to provide the necessary funding to address the AIDS crisis you get a picture of a continent that has been plundered for hundreds of years, from colonial days until today, for its resources and people. Africa is rich in gold, diamonds, oil, agricultural products and people. If they had been given a just portion of the riches other countries have removed from Africa it would probably be a rich continent today. Canada must take greater action on the conduct of Canadian corporations operating in Africa in order to give Africans a fair share of the profits and make resource extraction corporations clean up after themselves. Globalization is operating on the principle that companies can make deals anywhere to extract resources. Any resource that has been public is to be sold off to the highest bidder. Once privatized it has proven difficult to restore a resource to the public good. Controlling your own markets has been labeled "protectionism" Some economists are now arguing that developing countries would be better off protecting their domestic markets than pursuing trade liberalization under the existing framework. In Africa local markets are being flooded with mass-produced Western exports. Domestic farmers cannot compete let alone export their produce. Experience has taught Africans that life was better before globalization, trade deals do more harm than good and Western governments can't be trusted. When companies are insolvent they can declare bankruptcy, pay a portion of their debts and get a fresh start. No such arrangement has been made for countries even when repayment is obviously impossible. The privatization of water in South Africa is one example of globalization gone wrong. How are the poor to pay for water? Clean water and good food are essential to the care of AIDS patients and the general health of the population. One policy that seems to benefit the poor is microcredit. There are many such schemes that lend small sums to people on condition that the money is repaid out of profits and returned to the system.
4-Promote Peace This topic is not usually considered part of the AIDS crisis but it belongs in the discussion for several reasons. The diversion of funds into military expenditure often exceeds the budgets for health and education. Soldiers and private armies, sometimes to guard the activities of transnationals, especially in mining, attract young Africans to a life where guns are admired and rape is accepted as a tool of war. Rape is a primary way in which AIDS is spread. When civilian jobs are scarce it is no wonder that young Africans join the military. There is a plentiful supply of cheap small arms and light weapons which African child soldiers have been using. The United Nations tried to address this trade at a recent conference. The peaceful UN-supervised election in the Democratic Republic of the Congo will allow the government to turn its attention and money to the AIDS crisis. There are many ways in which Canada is involved both in peacekeeping and in working at the United Nations. However Canada is a leading manufacturer of weapons with no end use certificate. In other words we don't know where all our military goods will appear in future conflicts. They could end up in Africa. Africa became a nuclear-weapons-free zone when South Africa, under Nelson Mandela, gave up its nuclear weapons. Although Canada does not have nuclear weapons the government has not declared Canada a NWFZ..
5-Reduce poverty With the majority of Africans surviving on one or two dollars a day it is no surprise that poverty is a major factor in the AIDS crisis. Women are sometimes driven into prostitution and this spreads AIDS. Land ownership is crucial to addressing poverty but women are often barred from owning or inheriting land and large agribusiness companies are adept at buying up land for more mechanized, more `modern' farming. Large families have meant the splitting up of farms into smaller tracts and the exodus of children to the city. Urbanization has increased as people search for jobs no longer available in the country. This has led to an increase in AIDS in the cities and the transfer of the disease when husbands return home. Population is also driven by the fact that few African countries can afford Old Age Security pensions and so sons are considered the best way to assure support in old age. Increased poverty in the future is also a problem. The devastation is so great in many African countries that the whole middle class will be wiped out and the economy transformed with only very young and very old workers left. Physicians and educators will be in short supply for a generation. Our immigration policies also add to the brain drain of professionals from Africa. Some countries may take advantage of this situation by buying up Africa's resources from cash-strapped governments. Instead the international community could extend a helping hand. Africa needs special treatment, not business as usual. Which direction the rich nations take will be a measure of our morality. Those who can think constructively about the future will realize that a failed continent will not improve life on Earth for anyone. Canada must commit now to the 0.7 percent of Gross National Product proposed by Prime Minister Lester Pearson for development aid.
6-Support Education In the AIDS crisis it is very important that children, especially girls, be educated. Marriage should not be a death sentence. Partners must know if they have AIDS and take treatment. In addition to antiretrovirals there are female condoms and biocides which can be used without the husband's knowledge. Treatment can also be effective in lessening the mother-to-fetus transmission. Sex education can save lives. Schools must provide this in free schools. Often it is necessary now for parents to pay fees and provide uniforms for students. So girls usually receive less education at a time when their empo:verment is crucial.
7-Empower Women I have left this to the last because I believe it is the overriding requisite for ending the AIDS crisis. So does Stephen Lewis as he noted at the close of the XVI International AIDS Conference. "Gender inequality is driving the pandemic and we will never subdue the gruesome force of AIDS until the rights of women become paramount in the struggle." Women must have the power in their own lives to name those with AIDS so they can be treated and to end rape or forced intercourse in or out of marriage. This will transform the patriarchal culture that has kept women in subservience for too long. Once gaining influence in their own households women must start influencing government policies. They must demand a voice in all government budgets because that is where the decisions are made. And the same is true in Canada where women must take a stand on the way in which our policies have contributed to the poverty and lack of means for women in Africa to end the AIDS crisis. This means opposing the policies of the World Bank and International Monetary Fund. The tax dollars of Canadian women are supporting these institutions. It is a question whether these institutions can be reformed or must be removed and new, fairer, bodies set up. They are part of the United Nations although they do not live up to United Nations' treaties and should therefore be replaced by order of the Secretary General and the General Assembly. Women have met in many UN World Conferences, the largest being in Beijing in 1995 with 50,000 women agreeing on a Platform for Action. Later the United Nations in the Security Council on Oct. 31, 2000, passed by consensus Resolution 1325, which mandates the inclusion of women in all decision-making. (5). This may have led to the Solemn Declaration on Gender Equality in Africa (SDGEA) which will be submitted to the African Union in January, 2007. Perhaps Canada could do the same. Armed conflicts are actually on the decline in the world and some claim this is caused partly by the rise of women in governments. The more women in positions of authority the less the chance of war. (6)
There are so many problems women face that are especially crucial to their well-being that a special agency has been proposed. Stephen Lewis has suggested that a separate agency modeled on UNICEF (United Nations International Children's Emergency Fund) be set up now. This is a great idea and women must ensure that it happens. It is only as women gain power in Africa and Canada that we can look forward to a peaceful, healthy world free of abject poverty, disease and conflict.
Bibliography
1-The New Internationalist Issue 346.May 2002 "How to Crush AIDS" and Issue 365 March 2004 "More World, Less Bank"
2-Lewis, Stephen. "Race Against Time" House of Anansi Press Inc. 2005 pp. 5,6.
3-Stiglitz, Joseph E. "Globalization and Its Discontents" W. W. Norton & Company. 2002 Pp.ll-15.
4-Korten, David C. "The Great Turning: From Empire to Earth Community" BK and Kumarian Press 2006 p. 137.
5-Lynes, Krista and Torry, Gina Ed. "From Local to Global: Making Peace Work for Women " NGO Working Group on Women, Peace and Security. 2005 pp.125-8. www.womenpeacesecuri , .org Security Council Resolution 1325 on Women, Peace and Security - Five Years On Report.
6-Ashford, Mary-Wynne and Dauncey, Guy. "Enough Blood Shed: 101 Solutions to Violence, Terror and War". New Society Publishers. 2006 p.33.
