THE UNITED STATES OF AMERICA AND THE ‘WAR’ AGAINST HIV/AIDS IN AFRICA

There is no doubt that the world has rapidly become more vulnerable to the eruption and the global spread of both old and new infectious diseases. Nothing symbolizes this new global vulnerability more than the AIDS pandemic. According to the United Nations Report for 2000, over 36million people were infected with HIV and another 22million have died from the effects of AIDS. Sub-Saharan Africa, with an estimated 29.4million infected has become the epicenter of the pandemic. In the year 2002, the epidemic claimed the lives of an estimated 2.4million Africans. To combat the spread of this disease, the UN and the developed economies of the world have been playing an important role. In particular, the U.S government has been in the forefront in the crusade against HIV/AIDS in Africa especially in this new millennium. American government’s involvement is characterized by the setting up of the AIDS Marshall Plan and the Global AIDS Trust Fund, among others. It is against this background that this paper appraises the efforts of the U.S government in fighting HIV/AIDS in Africa. It looks at the degree of success so far achieved, examines the challenges to the American efforts and offers suggestions on how the government could perform this role better in the 21^st century.

Introduction

These comments of James Wolfensohn and Stephen Lewis echo and aptly capture the concern of many about the AIDS situation generally in the world and particularly in sub- Saharan Africa. Twenty-three years after the first clinical evidence of Acquired Immunodeficiency Syndrome popularly known as AIDS was reported in the U.S., it has become “the most devastating pandemic humankind has ever witnessed”.^³ AIDS has killed almost 14 million people around the world, 11 million of who lived in Sub- Saharan Africa. In year 2000 alone, 2.4 million died from the effects of AIDS in Sub- Saharan Africa. This is 80 percent of the world’s total. Indeed, two-thirds of the 34 million people who are currently infected with AIDS live in Sub-Saharan African, including 1million children.^⁴ As noted by the World Watch Institute, the HIV epidemic raging across Sub- Saharan Africa is a tragedy of epic proportion.^⁵ It is not only a health but also a development crisis; one that is altering the region’s demographic future, reducing life expectancy, raising mortality, lowering fertility, creating an excess of men over women, and leaving millions of orphans in its wake.^⁶

At the end of 2000, 36 million people were living with HIV/AIDS worldwide. Of these, some 25 million (or 70percent) were living in sub-Saharan Africa, even though only a tenth of the world’s population lives in the region. South Africa has the highest number of infected people of any country in the World, estimated at 5.3 million. Here, no fewer than 5,000 babies are born HIV positive every month.^⁷

Almost everywhere in sub-Saharan Africa, AIDS is taking a terrible toll resulting in 1 in 10 children being orphaned to be looked after by grandparents if they are still alive.^⁸ Otherwise the eldest child has to become the breadwinner sacrificing his/her own future to bring up brothers and sisters. As orphans, these children undoubtedly have a high risk of malnutrition, suffer from the stress of seeing their parents die, become surrogate parents to their younger siblings or coerced into early sexual activities and probably never see the inside of a school.

The above describes the tragic situation that the AIDS pandemic has thrown Africa into. The international community has demonstrated a lot of concern for the African situation. A leading actor in this regard is the United States government. This paper discusses the efforts of the United States’ government at fighting HIV/AIDS in Africa. It highlights some of the problems militating against the efforts and makes some suggestions on how the government could perform this role better in the twenty first century.

Causes And Spread Of HIV/AIDS In Africa

A number of factors have been identified as responsible for its spread. In the first place, there is a high rate of sexually transmitted diseases (STDS) in the region. Untreated STDS destroy the body pathogens and make the individual carrier to be more vulnerable to HIV/AIDS.

Second is the issue of morality. As sexual contact is the primary means of HIV infection, a lack of clear moral standards evidently promotes the spread of the disease. Related to this is the issue of rape which, in South Africa, has been described as a national emergency. In that country, cases of rape have doubled in recent times and these acts are committed seemingly in perpetuation of the myth that an HIV carrier who rapes a virgin will be cured.^⁹ Related to this is the issue of prostitution. Prostitution helps the spread of AIDS. The practice of unprotected sex by those who see sexuality as a lucrative business venture promotes the spread of HIV/AIDS.

Thirdly, there is the issue of poverty. Many countries in Africa are battling poverty, and this creates a climate favourable to the spread of AIDS. Poverty is associated with weak endowments of human and financial resources, such as low levels of education and generally poor health status. An aspect of the poor health status of the poor is the existence among many Africans of undiagnosed and untreated STDS, which is recognized as a very significant factor in the transmission of HIV.

Related to the above is the fact that there is an increasing number of children infected with HIV through transmission (from mother to child). Mother–child transmission could be prevented through appropriate access to drugs (AZT) but most African women could hardly afford these drugs due largely to their poor status.

In addition to the above, there is the problem of ignorance. A large number of those infected with HIV in Africa are unaware of it. Indeed, many are ignorant of the disease and many more, including the elites do not believe in the existence of the disease.^¹⁰ Still, many do not want to be tested because of the stigma connected with the disease.

African culture has been identified as a factor in the spread of HIV/AIDS in the continent. In many parts of Sub- Saharan Africa, a number of cultural practices have been identified as having tendencies to facilitate the spread of AIDS. Among other practices, polygamy, levirate or wife inheritance and female circumcision are the most pronounced.

Finally, war has become a veritable instrument for the spread of HIV/AIDS. In the early stages of conflict situations, when a large number of refugees are on the move, their need for food and other basic necessities can be acute. Exchanging sex for money or food can, therefore, be commonplace. This is capable of promoting the spread of AIDS.

Implications Of HIV/AIDS For African Development

The devastating social, economic, security implications and human tragedy of AIDS have been most severe in the countries of Sub-Saharan Africa. With only 10 percent of the world’s population, Sub-Saharan Africa carries the burden of more than 80 percent of AIDS deaths worldwide, losing 5,500 men, women and children each day.^¹¹ Hard-won gains in life expectancy, child survival, education, and economic development are being eroded in many countries on the African continent.

The toll of HIV/AIDS on households is severe. Many families are losing their income earners. Many more are overwhelmed by the burden of caring for victims of the disease. Many of those dying have surviving partners who are themselves infected and in need of care. They leave behind children grieving and struggling to survive without a parent’s care. As noted by UNAIDS, there are approximately 8 million African AIDS orphans and 42 million children will lose one or both parents to AIDS in the next decade.^¹² Orphaned children often resort to prostitution for money to buy food. As a result, while many children are born HIV–negative, their struggle for survival puts them at a serious risk of becoming infected by the disease. In many cases, the presence of AIDS means that the household dissolves eventually, as the parents die and children are sent to relatives for care and upbringing.

In all affected countries, the HIV/AIDS is bringing additional pressure to bear on the health sector. As the epidemic matures, the demand for care for those living with HIV/AIDS rises, as does the toll among health workers. Already limited medical facilities have been overstretched even more as a result of AIDS.

In the education sector, the impact of AIDS, is also far-reaching. As parents continue to suffer from the scourge of HIV/AIDS, so also the children and their education. The sickness or death of family members or children themselves thins pupils out of school. Therefore, the demand for education is reduced as fewer children are born and most children infected at birth develop the disease and of course, die before reaching school age, thereby affecting initial school enrolment.

Economically, HIV/AIDS affects labour, setting back economic activity and social progress. The vast majority of people living with HIV/AIDS in Africa are between the ages of 15 and 49 – in the prime of their working lives. Employers, schools, factories and hospitals have to train other staff to replace those at workplace who become too ill to work as a result of the AIDS scourge. Through its impact on the labour force, households and enterprises, HIV/AIDS retards significantly economic growth and development.

The Politics Of HIV/AIDS In Africa

No issue in Africa seems to have witnessed and generated real politicking as the HIV/AIDS scourge. It is one serious issue that has succeeded in dividing the camp of Africa leaders into two viz: Conservatives and Liberals. Among the former group are Thambo Mbeki of South Africa and former President Chiluba of Zambia. They reportedly rejected the existence of the disease, maintaining that it forms a part of the grand-plan of the West to further tie the economies of the developing world particularly Africa to their apron strings. Thus, at the 13th International HIV/AIDS Conference in Durban, South Africa, in July 2000, Mbeki openly rejected AIDS. President Chiluba denied the reality of AIDS and threw obstacles in the way of those keen to confront it.^¹³ Consequently, for a very long time particularly in South Africa, the government prohibited the use of antiretroviral drugs in government owned hospitals.

The disease is seen as an agenda of the West to yet paint Africa as the “white man’s burden.” It is observed that the causes of the disease have always been part of human civilization. So, why was the disease now given a name in the 1980s? Why did it take the West so long a time to discover that such disease exists? These are questions that have defied credible answer.

Efforts are also being made to trace the genesis of the disease to Africa. This, the conservatives have also vehemently opposed, noting that it represents a part of the Hamitic hypothesis. The Hamitic hypothesis emphasized that the initiative for any change be it development or progress could not have been due to the effort of the Africans themselves, but must have derived from outside Africa. In short, that nothing good could come out of Africa. Hence, the assumption that Africa is the origin of the HIV/AIDS pandemic.

Meanwhile, no cure has been discovered for the disease but increasingly, preventive and treatment measures are developed. Condoms and antiretroviral drugs have most often been celebrated as prevention and treatment respectively for the pandemic. Again, this has come under severe criticism. The pharmaceutical companies where these items come from are based in the West and the drugs are beyond the reach of those in need because the prices at which they are sold are exorbitant even at government subsidized rates. The proceeds from this are injected back into the Western economies, while efforts in Africa at developing cure for the disease have for a long time been discredited. This, again, has been described as a new form of imperialism under the guise of humanitarianism.

Diametrically opposed to the views of the Conservatives is the position taken by the Liberals who believe in the reality of AIDS and the connection between HIV/AIDS and development. Presidents Obasanjo of Nigeria, Ibraheem Wade of Senegal and John Kufor of Ghana are among the African leaders who belong to this camp. AIDS is not only seen as an African disease, it is perceived as a disease of the world. The position of this school is that the severity and high prevalence of the disease in Africa are directly linked to the many problems of development. It is often asserted that no developed country has an AIDS epidemic approaching those of the under developed world. This says something glaringly obvious about the links between AIDS and development. Consequently, U.S involvement in the fight against the disease is not only welcomed but applauded as it represents a laudable effort at salvaging the continent from a serious crisis.

It is against this background that some of the problems faced by the U.S in its fight against HIV/AIDS in Africa are better understood. The question at this juncture, however, is what effort has Washington made towards fighting AIDS in sub-Saharan Africa?

The U.S. Efforts At Combating AIDS In Africa

While the various African governments continue to mount programmes against the AIDS pandemic, much of the effort against the disease has most often come from outside the continent. Donor nations like the United States and multilateral organizations like the United Nations are not only involved in the war against AIDS financially but continue to carry out research into the very nature of the disease and its impact particularly in sub-Saharan Africa. On its part, the U.S government has succeeded in launching itself into the mainstream of the fight against AIDS. Washington’s involvement in the war against the AIDS scourge is, no doubt, predicated upon Barbara Lee’s submission:

In the early days of the disease, in the 1990s to be precise, the U.S government through its Agency for International Development (USAID) was preoccupied with research and prevention, but the government has since extended its programme to include projects that care for AIDS victims, mother-to-child transmission, health infrastructure, and support for AIDS orphans. In addition, USAID is working with the Departments of Defense, Labour, Health and Human Services, and to attack the disease on all fronts.

In his state of the Union Address in 2004, President Bush noted that, research is key to removing the devastation caused by the disease. Thus, the American government continues to encourage and fund research to combat the deadly AIDS scourge. During the 13th International HIV/AIDS Conference in Durban, South Africa, in July 2000, the USAID released a ground-breaking study on AIDS and orphanhood, noting that, by 2010, one in seven children under 15 in sub-Saharan Africa would have lost a parent to AIDS. The significance of these research efforts lies in the fact that they produce statistics and data upon which concrete responses and treatment programmes for the disease are anchored. USAID supported research that helped slow the spread of the disease in target groups such as truck drivers, sex workers, and intravenous drug users.^¹⁵ To bolster these efforts, funding for the agency’s AIDS programme has increased from 117.5 million dollars per year in 1997 to 200 million dollars in 2000, and the programme has been expanded from 18 to 52 countries, 27 of which are in Africa.^¹⁶

Other U.S agencies are also involved in the war against AIDS in Africa. The United State Central Intelligence Agency’s (CIA) contribution in this respect has been most profound. As noted by Gellman:

The efforts of the U.S Congress in fighting against AIDS particularly in Africa cannot be overemphasized. In July 2000, members of the Congressional Black caucus, James Leach and Barbara Lee led a successful bipartisan campaign to pass and fund the Global AIDS and Tuberculosis Relief Act, H.R. 3519. This bill signed by President Clinton created the World Bank AIDS Trust Fund and provided 150 million dollars for two years to combat HIV/AIDS globally. Before the end of the year, 20 million dollars had already been allocated to fighting the disease. This Fund has remained till date one veritable avenue through which the U.S government fights AIDS in Africa.

In a similar vein, Maxine Waters introduced the Affordable Medicines for Poor Countries Act, H.R. 933 to address this problem. This bill codified into law a Clinton Executive Order allowing the importation and manufacturing of generic life saving AIDS drugs. The bill was a corollary of a lawsuit filed by thirty-nine pharmaceutical companies against the government of South Africa in order to block Medicines Act of 1997, a law that would allow the manufacture or importation of generic substitutes for patented life saving AIDS medicines. As a member of the Congressional Black Caucus (CBC), she said:

Also in July 2000, the U.S House of Representatives voted for additional funds for international HIV/AIDS programmes, thus increasing the white House 2001 budget request from 244 million dollars to 286 million dollars.^²¹ In taking the war a little further, the U.S President George Bush has increased funding for global HIV/AIDS, Tuberculosis and Malaria from 840 million dollars in 2001 to 2.8 billion dollars in 2005 which more than triples the investment since 2001.^²²

In his 2003 state of the Union Address, President Bush launched its President’s Emergency Programme for AIDS Relief (PEPFAR). The plan commits the US to a 5-year, $15billion effort to provide antiretroviral drugs for 2 million HIV-infected people; prevent 7 million new infections; care for 10 million individuals and orphans infected by the disease; and build the health system capacity in Africa and the Caribbean.^²³ On February 23, 2004, the day the programme was launched, the first 350 million dollars in funding for the focussed countries of the Emergency plan was made available. Fourteen (14) countries in Africa and the Caribbean are to benefit from this programme. Botswana, Cote d’ Ivoire, Ethiopia, Kenya, Mozambique, Namibia, Nigeria, Rwanda, South Africa, Tanzania, Uganda, Zambia, are to benefit alongside Haiti and Guyana in the Caribbean. The second distribution of funding (500 million dollars) will continue to build on prevention, treatment, and care efforts. In all, the Emergency Plan is spending 2.4 billion dollars on global AIDS in 2004.^²⁴

As noted by Randall Tobias, the head of PEPFAR, U.S will spend about 5 billion dollars on existing bilateral HIV/AIDS programmes in about one hundred countries over the next five years and has committed a minimum of 200 million dollars annually to the Global HIV/AIDS Trust Fund.^²⁵ PEPFAR, therefore, represents some nine billion dollars in additional funding - an amount that, Randall has asserted is “more money than has ever been committed by any nation for any health care initiative”.^²⁶ A third of the funding (5billion dollars) will be spent to promote sexual abstinence. He noted further that, “the first installment of the new funding, 335 million dollars would underwrite ARV treatment for 137,000 people over the next five years”.^²⁷

In the area of anti-HIV/AIDS drugs production, the American government efforts have continued to be decisive. In the first instance, President Bush has continued to call on Congress to lift barriers to AIDS Vaccine development in the United States by providing liability protection to private vaccine developers and others involved in researching cures into the disease so that the hardest-hit nations can gain access to these drugs. Not long ago, former President Bill Clinton signed an agreement with some generics manufacturers to bring down to about 140 dollars a year - less than 40percent per day the price of antiretroviral.^²⁸

It should however, be noted that bilateral agreements are not the major features of the U.S efforts in its drive at fighting the AIDS scourge particularly in Africa. Washington has continued to fund multilateral organizations like the U.N and its affiliated agencies involved in the war against the AIDS pandemic. United States is the principal financier of the World Bank Trust Fund and the United Nations AIDS Programme (UNAIDS). The American government continues to use these institutions as veritable platforms for the ‘war’ against AIDS in sub-Saharan Africa. During its yearly rotational Chair of the U.N Security Council in 2001, the effort of the U.S government spurred the UNSC to organize a debate on the HIV/AIDS scourge in Africa, thus bringing the world searchlight on the disease. Other fora continued to be used by the U.S government. For instance, at the Group of Eight (G-8) Summit in early June 2004, President Bush announced a “global vaccine enterprise” to bring a strategic vision to global AIDS Vaccine efforts.

Problems Militating Against The U.S ‘War’ On AIDS In Africa

In spite of the efforts of the U.S in fighting the AIDS scourge in Africa, the continent remains yet the epicenter of the pandemic. Various problems continue to militate against Washington’s efforts.

Perhaps the biggest challenge to the efforts of the American government is the lack of political will on the part of most African leaders to translate global and regional plans into national policies and actions. In this regard, Omololu Falobi notes that:

African leaders usually are quick to sign treaties and agreement to achieve specific objectives, but most often, they do not take the necessary steps to ensure that these treaties or plans of action work effectively. What happened to the African Consensus and Plan of Action on HIV/AIDS adopted at the Abuja OAU summit on HIV/AIDS? The answer, apart from all else, lies in the lack of political vision and will of African leaders. A major part of the Plan of Action sees HIV/AIDS as a multi-dimensional problem of development and that it should be treated as such. But the situation in most African countries does not reflect this conceptualization as HIV/AIDS continues to be seen as a health problem.

Furthermore, for sometime there has been a denial of the existence of AIDS in many African countries. As we move into the 21^st century, AIDS remains yet one issue some people would rather not discuss obviously for fear of not being discriminated against. Ms. Charlotte Mjele, a 22-year old who is HIV positive told delegates at a conference organized by the African Development Forum in Addis Ababa in 2001 that:

This attitude, however, is not a peculiarity of HIV-infected people, government officials and politicians continue to cloud the issue by disputing the level of HIV infection or the link between HIV and AIDS. Some would still not admit the existence of the disease. As noted by Lewis, “former President Federick Chiluba of Zambia denied the reality of AIDS and threw obstacles in the way of those keen to confront it”.^³¹ Also, South African President, Thambo Mbeki once denied the existence of AIDS and for a very long time prevented the use of anti-retroviral drugs in most government hospitals. This attitude has also put a stumbling block in the way of the US effort at combating AIDS in Africa.

A formidable challenge to the U.S efforts at combating AIDS in Africa lies in the poor state of hospitals and health centres where treatment and test for the disease are carried out. On this, Piot observes thus:

The American government continues to spend millions of dollars on treatment and precurement of anti-retroviral drugs. While not a cure, these drugs have succeeded in reducing the death rate of HIV sufferers, particularly in Africa. The drugs are expensive, however, and far beyond the means of most people even at government subsidized prices.

Similarly, the drugs are not easy to administer. Many pills must be taken daily, at specified times. If they are not taken correctly or if the medications routine is interrupted, this could lead to the development of drug-resistant strains of HIV. It is difficult to ensure adherence to correct dosages in African conditions where there may be little food, a low supply of clean drinking water, and few medical facilities.

Furthermore, those taking the drugs must be monitored. If resistance develops, their combination of drugs must be altered. Experienced medical staff are needed for this, and the tests are expensive.

Another major challenge to the U.S effort in its fight against AIDS in Africa lies in the nature of the American HIV/AIDS programmes. Generally, donor countries pick and choose, and most often, countries that desperately need funds are excluded. Under PEPFAR, some of the most heavily affected countries including Swaziland, Lesotho, Malawi and Zimbabwe, are excluded.

While the U.S government faces a formidable opposition overseas particularly in Africa for not doing much to help combat the AIDS pandemic as perceived in some quarters, it yet faces public outcry back at home against the disease for the enormous financial commitment particularly in an era of rising economic misfortunes. This is a fundamental challenge to Washington’s fight against the disease in sub-Saharan Africa.

Finally, the nature of the disease itself is a major challenge to U.S efforts. AIDS does not respect natural boundaries and its spreads across continent as people travel. Indeed, it is a transnational disease. Thus, the efforts of the U.S government in Africa will not yield the desired result if maximum attention is not given to the scourge in other parts of the world simultaneously.

Challenges To The US Efforts At Fighting HIV/AIDS In The 21^ST Century

Despite the problems highlighted above, much can still be achieved, as the problems are not insurmountable. Firstly, the leadership in Africa must be ready to supplement and complement Washington’s effort by developing the right attitude and political will towards fighting the disease. As observed by Lewis, “the high prevalence of the disease in sub-Saharan Africa is partly a reflection of the quality of leadership in the continent”.^³⁴ While Africa has found a formidable partner in the fight against the disease in the U.S, it need be said as noted by Nelson Mandela that “no one is going to save us from this crisis but ourselves. The leadership we need in Africa cannot come from outside, but rather must flow from within”.^³⁵ Today, there are promising signs that more governments are starting to respond and becoming involved. The examples of Uganda and Senegal with regards to prevention should be emulated and sustained.

Secondly, more AIDS related education is required especially in Africa’s rural and sub-urban areas. HIV/AIDS-related stigma and discrimination as noted above remains an enormous barrier to effectively fighting the AIDS epidemic in Africa. Thus, in fighting the disease effectively, more AIDS-related education is needed since no policy or law alone can combat AIDS-related discrimination. The fear and prejudice that surround the disease needs to be tackled at both community and national levels. Here the United States government possibly needs to release more money to non-governmental and government health institutions who would now embark on public enlightenment campaigns on the evil effects of AIDS in the rural, sub-urban and urban areas.

Thirdly, Washington needs to provide money for HIV/AIDS related prevention, care and treatment. In order to implement prevention, care and treatment programmes, a country’s health, education, communication and other infrastructures have to be well developed in order to deliver these interventions. While this paper does not submit that, in its fight against AIDS in Africa the U.S government should provide and help develop the needed facilities in the various Africa states, our position is that the development of these facilities should be a part of the U.S AIDS programmes for Africa. Thus, the fight against AIDS in Africa requires a multi-sectoral approach.

Given that many problems arising from the epidemic are not specific to HIV/AIDS but are closely associated with wider challenges of development, such as poverty, food and livelihood, insecurity, gender inequality etc, U.S policy and programme responses need not be HIV/AIDS-specific but must address the root causes and consequences of wider challenges to development. In other words, a developmental rather than an AIDS-specific focus is critical to tackling the multi-sectoral complexity of the epidemic. Hence, the most effective response, or the best international ‘vaccine’ the U.S government should think of against AIDS in Africa and other parts of the world is sustained and equitable development.

Africa’s Initiatives In Fighting HIV/AIDS

In this final part of this paper, something needs to be said about the efforts of the various African governments themselves in fighting HIV/AIDS in Africa. Indeed, the African governments have not been complacent. They have been complementing the efforts of the US government. The various governments are actively engaged in the fight against the epidemic through several initiatives. Of these, the most important is preventive intervention. Here, the example of Nigeria will suffice. In Nigeria, like most other African states, preventive interventions are carried out through public enlightenment campaigns. The Federal government through the National Action Committee against AIDS (NACA), in collaboration with UNICEF has continued public enlightenment programmes to check the spread of AIDS. NACA in collaboration with the Society for Family Health with the support from USAID, has supported messages on radio and TV focusing on how to avoid HIV infection through abstinence, mutual fidelity and the use of condoms.^³⁶ Similarly, in Uganda, the government launched an extensive AIDS education campaign in the 1990s which cut HIV prevalence rates in that country from an estimated 14percent to approximately 8percent in 2000.^³⁷ The situation in Senegal is not different. The government’s efforts helped to maintain HIV prevalence rates below 1percent among the adult population.^³⁸/P>

On the issue of access to affordable antiretroviral drugs, the efforts of the various African governments have been most profound. At the 13th International AIDS Conference held in Durban, South Africa in July, 2000, the issue became dominant as there was intense negotiation between African Heads and pharmaceutical corporations midwived by UNAIDS. It is interesting to note that more African governments now offer antiretroviral drugs to infected people at subsidised rates. In South Africa, the Federal Government in its 2003 budget committed approximately R2bn (US & 233mn) to provide antiretroviral treatment for people living with HIV.^³⁹ The government has also since signed an agreement with the Global Fund for the purpose of making antiretroviral drugs accessible and affordable.

In addition to these, the various African states have been meeting at the continental and regional levels to map out concrete strategies to effectively combat the HIV/AIDS menace. For instance, the OAU organized a summit on HIV/AIDS in Abuja and came up with the African consensus and plan of Action on HIV/AIDS and emphasized the need for individual African states to factor the resolutions of the summit into their HIV/AIDS programmes to achieve better result.

As a follow up to that, a special summit of African Heads of States and governments on HIV/AIDS, Tuberculosis and other related infectious diseases was organized in April, 2001 in Abuja to develop institutional framework against HIV/AIDS and to mobilize political commitment and leadership at the highest level against the disease. The immediate aftermath of this summit is the establishment of the Africa Centre for HIV/AIDS Management in Abuja in collaboration with the United Nations. The focused of the Centre is to mobilise of nations and the society to reduce the impact of HIV/AIDS on individuals, communities and the nation. It is also to bring a fundamental change to how different communities and nations deal with the pandemic in a more holistic manner.

Notes and References

1 James Wolfensolin, World Bank President, made this assertion at the UN Security Council debate on the impact of AIDS on Peace and Security in Africa, 4086^th meeting. See also Press Release, SC/6781, 10 Jan., 2000.

2 Stephen Lewis, UN Special Envoy for HIV/AIDS in Africa made this assertion during the World Conference on HIV/AIDS held in Durban, South Africa.

3 Awake, Nov. 8, 2002, p.4. The same opinion was expressed at a meeting of AIDS experts in Switzerland in May 2001.

4 Benjamin Nelson, “The US and UN Response to The AIDS crisis in Africa”. Frank Columbus (ed.), Politics and Economics of Africa, Vol. 4, New York: NOVA Science Publishers Inc., 2003, p.4.

5 WorldWatch Institute, WorldWatch Issue Alert, 31 October 2000, p. 1. See: http://www.worldwatch.org/chairman/issue/01031.html (No 14. 2000).

6 These words of Koffi Annan, UN Secretary General were read at the Security Council debate on the impact of AIDS on Peace and Security in Africa, 4086^th meeting, Press Release, Sc/6781, 10 Jan., 2000.

7 Awake, p.3.

8 This was part of the outcome of a ground-breaking study on AIDS and orphanhood released by US AID during the Durban conference.

9 Ibid., p.5.

10 The AIDS pandemic has become a controversial issue in Africa as it has succeeded in dividing the camp of African leaders. In spite of its enormous negative impact on the continent, so many people still hold the view that it does not exist.

11 AIDS Epidemic Update, December 2000, UNAIDS and World Health Organisation Report.

12 AIDS Epidemic Update, December 2000.

13 Quoted in Africa Recovery, Vol. 14, No. 1, April 2000.

14 Barbara Lee, U.S Congresswoman chairs the Congressional Black Caucus Task Force on HIV/AIDS and represents Califonia’s Nineth Congressional District. She made this assertion in a paper presented to the Black Caucus entitled: “HIV/AIDS: Africa, A Continent in Peril”.

15 B. Nelson, The US and UN Response

17 B. Gellman, “The Belated Global Response to AIDS in Africa”, The Washington Post, 5 July 2000.

18 Barbara. Lee expressed this view in her paper presented to the Black Caucus,.

19 Maxine Waters, a Congress woman, is also a member of the Congressional Black Caucus Task Force on HIV/AIDS said this in one of the meetings of the Black Caucus.

20 Ibid., p.31.

21 UN Department of Public Information, Africa Recovery, Vol. 18, No. 1, April 2004, p.7.

22 Ibid., p. 7. The PEPFAR is also known as the AIDS Marshall Plan.

23 Ibid., p. 7.

24 Ibid., p. 7.

25 Ibid., p. 8.

26 Ibid., p. 9.

27 Ibid., p. 8.

28 Quoted in the Africa Recovery, Vol. 14, No.4, January 2001, p.21.

29 Omololu Falobi, The Project Coordinator of Journalists Against AIDS in Nigeria said this in an interview with a “Special” Correspondent of the African Recovery. (See Vol. 14, No. 4, January 2001, p. 2).

30 Mjele, associated with the Hope Worldwide Jabavu Clinic in Soweto, South Africa, tasked African leaders to take up the leadership challenge just as she had done at the African Development Forum Conference in Addis Ababa in 2001.

31 This statement is credited to Stephen Lewis, UN Envoy for HIV/AIDS in Africa in Africa Recovery, Vol. 14, January 2001, p. 20.

32 Dr. Peter Piot, Executive Secretary of UNAIDS, made this assertion in an interview with a “Special” Correspondent of Africa Recovery (See Vol. 14, No. 4, Jan. 2001, 21).

34 Quoted in Africa Recovery, Vol. 14, No. 4, Jan. 2001, p. 23.

35 Nelson Mandela, former South African President, made this assertion in his Keynote Address to the delegates at the Durban Conference on HIV/AIDS.

36 Jerome Mafeni and Oluwole Fajemisin, “HIV/AIDS in Nigeria: Situation, Response and Prospects”, Policy Project, October 2003, p.2.

37 Awake, “When Will AIDS End?” November 22, 2004, p. 9.

39 John Nyamu, “Famine and AIDS: A Lethal Mixture”, Africa Recovery, Vol. 17, No. 1, May 2003.

O. O. Olubomehin and W. A. Balogun. “The United States of America and the ‘War’ Against HIV/AIDS in Africa,” West Africa Review: Issue 8, 2005.

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