For the United States and other wealthy countries, the worst of the Aids pandemic may be over, thanks to new powerful drugs.
For vast swaths of sub-Saharan Africa, however, a plague of proportions not seen since the Middle Ages is bringing death and misery and pushing entire nations toward the brink of collapse.
At the 14th International Aids Conference, the ”health gap” between rich and poor countries is stirring fierce passions among delegates.
Everyone agrees that vast financial aid is needed to bring the epidemic under control. But who is going to foot the bill of at least $10-billion a year?
Some say industrialised countries bear the moral burden to do so. Others that pharmaceutical companies should voluntarily give up patents to allow generic copies. Still others insist that African governments must dig further into their own pockets.
”Humanity demands that we as a global community respond to this crisis together,” said Godfrey Sikipa, a Zimbabwean with the UN program on HIV/Aids whose extended family is struck with a new HIV case ”almost on a monthly basis.”
The issue of funding erupted in the open on Tuesday as protesters took over a stage and prevented US Secretary of Health and Human Services Tommy Thompson from speaking.
”Shame! Shame!” the protesters shouted, calling America the ”stingiest and most miserly” contributor to Aids programs in poor countries. That’s despite that the administration of US President George W. Bush has pledged $500-million to prevent mother-to-child HIV transmission in Africa and the Caribbean.
More than 90% of the world’s 37,1-million HIV infected people live in developing countries. Sub-Saharan Africa accounts for 26-million – or 70% of the total, according to the US Agency for International Development.
A study released at the conference predicts that in less than a decade, many southern African countries will have average life expectancies of around 30 years. In Botswana, life expectancy will be 26,7 years.
”How can you create a future for a country when the life span is 27 years of age?” said Paul De Lay of the HIV/Aids office with the US Agency for International Development Conference chairman Peter Piot says $10-billion yearly would fund a combination of prevention programs and a supply of antiretroviral drugs to just five percent of those infected in the developing world.
Aids activists insist that the United States and other industrialised countries have exacerbated the problem in the developing world through economic exploitation.
Brook Baker, a law professor from Chicago’s Northwestern University who joined the hecklers, observed that international mining companies in South Africa, for example, require male migrant labourers to work far from home for extended periods of time.
”You can’t describe a more fertile breeding ground for
transmission of HIV/Aids,” he said. Protesters claimed that European countries contribute up to 25 times per capita more than the United States to the Global Fund to Fight Aids, Tuberculosis and Malaria. Economist Jeffrey Sachs from New York’s Columbia University, dismissed Thompson’s suggestion that the United States was doing its share.
”For everybody to be doing their share is not enough,” he told a news conference.
According to a study by the British charity Oxfam, many of the hardest hit countries are spending more on foreign debt repayments than on health care.
Kevin Watkins, author of the study, said $1,6-billion in debt relief would free up significant revenues that could be spent on Aids programs.
”That’s less than two days” of the $350-billion in subsidies that rich countries give to their farmers each year, he said. Past corruption in aid spending is no excuse not to give more money to developing countries, Watkins said, because ”you had creditors who knew full well this was going on.”
”There can’t be any doubt there is mismanagement,” said Rolf Korte of the German government aid agency GTZ.
However, he added: ”the aid money we are giving is being returned as debt. This doesn’t make sense.”
Pressure is also being put on pharmaceutical companies. Some have slashed prices on anti-Aids drugs but refuse to give up patents so that manufacturers in poor countries can churn out generic versions of the medicines.
Martin Sutton of GlaxoSmithKline, which produces antiretroviral drugs Retonivir and Epivir, said scrapping patents would eliminate the incentive for further research. He argued the challenge now is to get drugs to the people who need them with the proper follow-up care.
”Patents aren’t the issue,” he said. ”Obviously there’s more to do, but we are playing our part.” – Sapa-AP