South Africa

At The Boston Globe Michael Gerson has a column on AIDS in the developing world, focuding on Africa. Embracing neither foolish optimism nor outsized pessimism Gerson argues that a cobination of approaches will be required to stanch a disease that is still spreading at a faster rate than it can be prevented:

Treatment and prevention, in the end, cannot be separated. And the goal of universal access to treatment seems morally unavoidable. However expensive this commitment might be, there is also a cost to letting 40 million people or more die - a cost the world should not be willing to pay. But we also need to be realistic about the nature of this commitment. Defeating AIDS will require major new efforts on prevention. And moving toward universal treatment, according to the United Nations, will require between $32 billion and $51 billion by 2010. America has done much - and still we face an ocean of need.

It’s easy to caricature calls for more money for Africa. But AIDS is one of those issues that shows how aid money really can and does make a difference. The continent needs more financial support to help it to attain very reachable goals. The discussion should never be only about giving money, but such aid should continue be in the equation in light of the West’s persistent underdevelopment of Africa.

From a Medical Research Council report on children’s health issues in South Africa:

Every year almost 23,000 South African babies die in their first month of life, yet one in five of these deaths could be avoided with better education, and relatively inexpensive and easily implemented changes in healthcare, says a new study by the Medical Research Council (MRC).

“The bad news is that, according to the report, ‘one in five deaths could have been clearly avoided’, and inequalities are also highlighted, with avoidable deaths being twice as common in rural areas,” said Joy Lawn, Senior Policy and Research Advisor at Saving Newborn Lives, a programme run by Save the Children, an international non-governmental organisation for children’s rights, in the foreword to the report.

“The good news is that these deaths are not complex or expensive to prevent - improving the quality of care during childbirth is a top priority that would also save mothers’ lives and reduce long-term disabilities in children,” Lawn commented. 

This latter news, of course, is what South Africans must work to bring to fruition. These issues are tied in with questions of opportunity and access that South Africa also struggles to address.

Privation connected to poverty and vulnerability to climate change is wreaking havoc throughout the continent. Lesotho continues to suffer from drought-fueled food shortages. The droughts have also affected Swaziland and South Africa. The economic crisis in Swaziland has led to increased sex trafficking among children as well as women. Informal settlements in Namibia are embody hell on earth. Climate change is leading to an increase in malaria cases in Kenya.

 The news of the increased UN-African Union peacekeeping presence has raised hopes of humanitarian relief for the people of Darfur. Sudan claims that it will support the troop presence. We;ll see how long Khartoum’s conciliatory attitude lasts. Some Sudanese, meanwhile, are looking to South Africa for a blueprint for peace.

At Foreign Policy Stephan Faris worries that the boomlet that parts of Africa appear to be enjoying might be chimerical, with oil fueling another manifestation of the resource curse. The Council for Foreign Relations explores the process of ”hunting for elusive peace.” Despite these real concerns, there also is real progress on parts of the continent, as Kofi Annan argues in the Mail & Guardian.

At The New Republic Eliza Griswold analyzes the Somalia crisis as “the other failed invasion,” which is problematic inasmuch as viewing Africa through the prism of Iraq manages to be both too Western-centric while at the same time allowing Iraq to disproportionately warp our views of other issues.

In order to address the mindboggling inflation rate in Zimbabwe (is it really possible that it could reach 100,000% by the end of the year?) the government has issued  a Z$200,000 note worth $1 US. Meanwhile, add water shortages to the daily sufferings of the people of Zim.  

In this week’s New York Times Book Review, John Donnelly, who covers global health and the environment for The Boston Globe, has written a favorable review of Helen Epstein’s The Invisible Cure: Africa, the West, and the Fight Against AIDS. An important book on a vital topic, The Invisible Cure posits that the best solutions to the AIDS crisis in Africa will come from Africans, an argument put forth by many in the development community as well. Of course an Africa for Africans by Africans has been the cri de couer of the continent since independence. But the Pan African dream, the African Renaissance, a solution to the continent’s problems, will not come until good governance, transparency, and democratization are all priorities across the continent, and not just in a few scattered pockets.  

The International AIDS Society (IAS) conference, the biggest of its kind in the world, just closed in Australia. Its most significant conclusion is that the world must find a way to develop and deliver child-specific, side-effect-free (or limited) drugs to allow children with the disease to survive into adulthood (and perhaps to live to see a future in which the disease is eradicated).

Beyond hoary “children are the future” cliches, this proposal makes sense for a number of reasons. For one, call me a cynic, but the cliche is a great selling point. Finding a way to address in AIDS in children will inevitably capture hearts and imaginations in a way that simply addressing AIDS in Africa does not. But beyond the salesmanship, it seems logical to try to stanch the spread of a disease that has proven so fatal for children. Address the disease among its youngest victims while at the same time pushing for antiretroviral drugs geared toward adults and with side effects that can prove as dangerous to children as the disease they intend to attack. This is a strategy that seems both smart from a disease-combating perspective as well as from a marketing and political vantage point.

The United Nations Population Fund speculates that the urban population of Africa will more than double in the next quarter century. Obviously the ripple effects of this would be serious. It’s probably worth pointing out that dire population predictions have something of a mixed history, but the UNPF report indicates that 80% of the world’s population will live in the developing world by 2030 with huge ramificatioins for poerty, development, health, food supplies, and just about every other aspect of daily life.

On Tuesday Bill Clinton announced that his foundation has brokered a deal with Indian pharmaceutical companies to provide generic AIDS drugs in developing countries. Sub-Saharan Afria will obviously provide a huge market for these drugs.

There are perhaps a few of lessons to learn here. The first is that it is unlikely that these Indian companies, Cipla and Matrix, would be doing this were it not in the long run going to be profitable. Doing good and doing well do not have to be mutually exclusive concepts. The second lesson is that serious global leadership — from Clinton, from France — clearly played a significant, deciding role in brokering this deal. In an era when debates over the efficacy of development policies are strident and harsh, it is useful to see a clearcut example of policies that almost assuredly will have some direct positive effect in Africa and elsewhere. Finally, good for Bill Clinton. If this is the sort of thing that his foundation does, this might be a sign of a long and successful post-presidential career.

IRIN reports that there is yet another impediment to effective AIDS treatment in South Africa. Apparently rape survivors tend to get left out in prevention and treatment programs. In a normal society this might pass as a loose end left untied. but in a country beset by both AIDS and abominably high rape figures it goes down as a huge gap that, left unaddressed will leave a vulnerable segment of the population abandoned, hopeless, and staring at death.