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A corrosive lack of leadership on AIDS

December 22, 2009

There is no question that as this decade ends, significant progress can be seen in the battle against HIV/AIDS.

There’s vastly greater awareness and there’s more money; in the developed world AIDS has been transformed into a chronic disease and the hospital wards of the developing world are no longer fast-tracked to the cemetery.

It’s not that death is on vacation. Two million people died of AIDS-related illnesses last year, and AIDS is the primary cause of death among women, world-wide, in their reproductive years. Prevalence rates remain staggeringly high in a number of African countries, and from Washington, D.C., to the First Nations reserves in Canada, the grim reaper still haunts the landscape.

But progress there has been. I wouldn’t dispute it for a moment. However, as we enter the new decade, it’s fundamentally shocking to realize how far we have yet to go.

While there are now four million people in treatment, there are an additional six million people who require treatment today, immediately, and we’ll never be able to roll out the drugs quickly enough to get to them all in time to keep them alive.

For every two people we put into treatment, there are five new infections. Clearly, despite herculean efforts, we haven’t found the key to prevention — all we can claim are snippets of behaviour change here and there among various age groups in various countries.

In the vexing area of vertical transmission — transmission from an HIV-positive mother to child during the birthing process — progress is sabotaged by inaccurate statistical data coming from UN agencies, and even more severely compromised by a double standard of treatment between North and South. You can guess who reaps the benefit.

We have no vaccine, despite heroic efforts to discover one, nor do we have a microbicide. An excellent preventive technology such as male circumcision is only now haltingly in use because of the endless delays and prevarications to which UN agencies are addicted. They take forever to make up their minds when the obvious stares them in the face. One of the things that most vividly characterized the last decade was a corrosive absence of multilateral leadership.

There’s a desperate shortage of doctors, nurses, pharmacists and community health workers. The opportunity to export generic antiretroviral drugs from developed countries has gone nowhere — only Canada made the effort and with both Liberal and Conservative governments, that effort is on life support.

The high-risk groups of men who have sex with men, sex workers and injecting drug users are only beginning to get the attention they deserve. But the intolerance and punitive hatred directed at so-called vulnerable populations makes progress very difficult.

Sadly, we have monumental numbers of orphans languishing without adequate attention and nurture in country after country. If it wasn’t for the grandmothers of the world, God knows what would happen to the majority of these children (which, forgive the shameless self-promotion, is why the Grandmothers to Grandmothers campaign of the Stephen Lewis Foundation makes such sense).

And to top everything off, because of pervasive, unrelenting gender inequality, women are disproportionately vulnerable. The response to women infected by the virus has been the most disappointingly lamentable of all.

The year 2010 was supposed to be the year of “Universal Access” to treatment, prevention and care. We’ve missed by a huge margin. That’s why it’s tough to be sanguine about what the next decade will hold.

But the real and most formidable challenge is that of resources. We’re billions of dollars short of what we’ll need, year after year to keep millions of people alive, and to fight the virus on many fronts.

And surprisingly enough, the problem of dollars lies primarily with the Obama regime. Who would have thought it? On two counts, the Obama administration has put the entire struggle against the AIDS pandemic in peril; both involve money. It doesn’t augur well for the next decade.

First, President Barack Obama has flat-lined the budget for PEPFAR, the President’s Emergency Plan for AIDS Relief. This is a direct reversal of the increases he promised during the election campaign, and the policy reversal is in place despite the fact that the increases have been endorsed by Congress. The AIDS activist community is rightly up in arms, given the astronomic amounts spent on bail-outs and bonuses. It’s hard to be persuaded that the financial crisis is so great as to prejudice an additional three or four billion dollars a year for HIV/AIDS when hundreds of billions are tossed around in wanton corporate fashion.

Second, and even more ominous, the Obama administration seems to have bought into the idea that AIDS has been receiving too much money at the expense of other global health priorities.

This is a truly pernicious argument. It leads to the intellectual folly of suggesting that resources should actually be taken away from AIDS and transferred elsewhere — say, to maternal and child health for example. It’s just so nonsensical that it’s hard to take seriously, except that some self-aggrandizing academics, salivating in the publicity, have put it forward as a thesis and won the uncritical approval of some members of the Obama coterie.

It’s hard to imagine that Barack Obama would fall for that kind of guff. The answer of course is to enlarge the pie for global health so that HIV/AIDS, still struggling as the world’s most alarming communicable disease, isn’t compromised.

That’s the challenge for the coming decade.

What is lacking in all of this is global political leadership. Only Gordon Brown, Prime Minister of the United Kingdom, of all the G8/G20 leaders, has thus far shown an abiding and determined commitment to ridding the world of poverty, conflict and disease.

Certainly Canada’s Stephen Harper isn’t in that league.

Stephen Lewis is former UN special envoy for HIV/AIDS in Africa.

– – –

The End of the 00s: A decade in review

The Citizen has asked prominent writers to assess human progress in a variety of fields over the last 10 years: economics, science and technology, culture, poverty alleviation, nuclear disarmament and more. Their responses will be run over the month of December.
© Copyright (c) The Ottawa Citizen

11 Comments leave one →
  1. Christine&Caitlin permalink
    May 3, 2010 9:29 AM

    In response to the Stephen Lewis Foundation the HIV/AIDS pandemic in Africa can be controlled and reduced by a variety of preventative measures that will inform, protect and better the entire HIV/AIDS community. First off, ensuring that both genders have access to the same education will increase gender equality giving women more control reproduction and above all themselves. Providing sex education at a young age will decrease the likelihood of contracting the disease as well as unplanned pregnancies. In combination, Antiretroviral Drugs should be available for everyone especially pregnant mothers so that they do not pass on the disease to the child. Considering the fact that nearly an entire generation of parents have passed away from HIV/AIDS and the grandmothers are having to take care of their grandchildren as well as orphans; money, food and emotional support should be provided at less of a cost for them if not free. Without the grandmothers to guide these children they would be unable to provide for themselves and most likely follow the same fate as their parents. To follow, making the Antiretroviral Drugs cheaper and more accessible for everyone who is affected by HIV/AIDS will allow them to live the fullest and longest life they could possibly have. The funds to support these solutions would come from annual fundraisers held by every school because children in Canada take for granted what they have and it is important that everyone that is able to help, should help or the problem will not be resolved. Researchers and pharmaceutical companies should donate at least half the drugs needed so that the citizens in Africa will not have to pay as much for them. Trips should be planned to Africa for those who would appreciate the experience to see not only where the money is going but how much more need to be done. The HIV/AIDS pandemic will not solve itself, contributions wherever possible and generosity from everyone is crucial for the country to increase their standards of living and hopefully one day be HIV/AIDS free.

  2. Kyle Bulstrode permalink
    May 3, 2010 9:29 AM

    As years pass cases of AIDS in Africa become more frequent, even though there are lots of opportunities for other countries to participate in relief projects to help out. Many other countries are very aware of this issue, yet they seem to ignore the obvious actions that they can take to resolve this issue. The Canadian Government is able to help out with problem by rather than constantly bailing out of government run AIDS programs, they should invest more into them. Another thing that the Canadian Government has the power to do in order support Africans with AIDS is they could apply a small service tax to each Canadian. This would be beneficial because all of the extra money collected from this tax could be directly saved and used towards anti-retroviral drugs, so that no more unnecessary deaths would occur in Africa. Canadian citizens need to become more engaged with local AIDS foundations within their community; these foundations tend to send the majority of the money donated to directly helping out suffering AIDS patients in Africa. Another thing that active Canadian citizens can do is participate in missions and trips over to Africa. Here they can really get a sense of the lifestyles of these children, and by doing this, upon returning from their trips they will become more motivated to spread the word in their community’s about the impoverished that most Africans live. Canadians should take this issue seriously because it is something is fixable now, but if not given attention to sooner than later, than the disease of AIDS will eventually make its way around the world, and become a leading killer in all countries. It is important that Canada becomes a leader in helping out with AIDS in Africa, because they will be looked upon as respected members of the global community. AIDS in Africa is a serious problem that needs to be given attention to immediately, the only way that this will be possible is if people start making a difference and influencing others to do the same.

  3. KRW permalink
    May 3, 2010 9:30 AM

    Of all the crises in Africa the AIDS pandemic is the worst. It kills millions of Africans each year and leaves thousands orphaned. Though there is no vaccine for AIDs, Anti-Retroviral drugs (ARVs) have proven to be the most effective counter-measure against AIDS. The trouble is prices can easily fluctuate making them unaffordable to many. Canada has ignored its commitment to aiding Africa in its plight. There are in fact two possible solutions. A dollar a day or 365 dollars a year from Canada alone could provide each person in Africa with ARV drugs. Another idea would be for the Canadian government to take an example from Brazil and make its own ARV drugs. These could then be given to Africa. Overall, solving the AIDS crisis could open the door for solving Africa’s other problems including famines, droughts, military coups, war, and genocide.

  4. Gertrude permalink
    May 3, 2010 9:30 AM

    AIDS in Africa is a very serious issue, which needs to have more awareness. Canadians and the Government of Canada could effectively address the issue by sending more doctors over to Africa to help. Also they could send more financial aid to the people of Africa and invest more money in developing a cure for AIDS. It is important to care about the issue of AIDS because it is a pandemic that could easily spread across the whole world and our population could die out. Also it is important for Canadians to become leaders in this issue because we are a well developed country that could easily assist the people of Africa and it could be an example that other countries could learn from. In conclusion, Canada can take action to help fight AIDS by giving their time and money to learn more about the disease and how it can be cured. If Canada helps it will be one country closer to finding a cure.

  5. Amy Kennedy permalink
    May 3, 2010 9:34 AM

    The lack of leadership specifically from Canada in this area is atrociuos. As a country we are known worldwide for our high standards of public health care. We should be taking a leadership role in this fight against AIDS to show the world a serious commitment to human rights and healthcare around the world. We should be contributing funds and efforts to lessening this awful disease’s impact on our fellow humans. The countries need antitretroviral drugs to be cheap and easy to distribute, education and prevention programs to help stop the spread, and most importantly female empowerment programs to alleviate the gender inequality. Also those orphans need someone to look after them!

  6. Kaylee Carscadden permalink
    May 3, 2010 9:36 AM

    Concerning the pandemic of AIDS, I believe change can only happen if wealthier countries lend a hand to such a country in need. It is crucial that both Canadians and the Canadian Government take a leadership role in effectively addressing the issue of AIDS in Africa over the coming decade through implementing an additional tax which would go towards providing healthcare for Africans, setting up a Canadian-run program in Africa to help improve the equality of women, and implementing a Grandmother to Grandmother’s group in each community in Canada to help raise funds and awareness. To begin with, the Government of Canada could charge annual taxes from each household, in the amount of a dollar per residence in that household. This relatively affordable expense would be enough to cover the healthcare needs of each AIDS infected citizen in Africa by supplying them with the necessary antiretroviral drugs. Sparing just a few dollars per household each year, could improve the lives of the people in Africa dramatically. Furthermore, perhaps the Stephen Lewis Foundation could send representatives to Africa to educate women about HIV/AIDS, and to promote women’s rights. More specifically, not only could these conferences be geared towards women, but also the men in Africa could undergo group counseling to learn to be more respectful of women and to learn more about equality. With enhanced equality and women being further educated about AIDS, African women will be able to make wiser choices in their future to help stop the spread of this horrifying disease. Finally, the Canadian Government could ensure that each community in Canada has a Grandmother to Grandmother’s group. In doing so, there would be increased awareness on the fact that Grandmothers in Africa are bearing all the responsibilities of raising the countless orphans with AIDS. These campaigns help provide African Grandmothers with all the resources they need to raise these orphans, including the basic essentials needed to survive. With so many Grandmother to Grandmother campaigns throughout Canada, each raising funds, there would be immediate improvements of overall health and quality of life in Africa. It is vital for Canada to take some initiative surrounding this issue as we are well- endowed with abundant resources that Africa is lacking, yet are in great need of, so it is our duty to assist them with this traumatic issue. As Canadians, we should be more caring because we have the ability to help out a nation in desperate need and they deserve to have the quality of life that we are so blessed to have here in Canada. If Canadians and the Canadian Government follow through with these ideas, I believe a world of differences can be made concerning the pandemic of AIDS in Africa.

  7. Raven&Heather permalink
    May 3, 2010 9:49 AM

    The Governenment and people of Canada can take a strong leadership role in addressing the issues of AIDS in Africa. It is heartbreaking to see a continent dying unnecessarily when as Canadians we have readily available treatment. We live in the lap of luxury and hardly stop to think of the global consequences and our ignorance. Action needs to start now and it should begin with us. Currently there are four million people taking retroviral medicine in Africa, yet six million more people funds and access to these life saving drugs. Our Canadian companies should begin to help immediately. Holistic treatments such as organic medicinal herbs can be grown in their own environments. Not only do these promote safe treatments but provide jobs and a means of self sustainability. The Global National Healthcare Trust is an African NGO that cares and treats several thousand patients annually. With this idea members in comminities could begin to start support groups. A good example of this would be the Go Go Grandmothers. This group was first started in Africa as a way to help the grandmothers who who were supporting their communities. In turn the grandmothers from towns across Canada gather to raise awarness and funds for HIV/AIDS in Africa. This is also an important thing to do in Africa to try and stop and prevent this disease from spreading. As an active member of the global community we should strive to help in any way we can. More social support groups of all ages should get involved to represent the massive age span that this pandemic affects. There are many options if actions they can accomplish through fundraising, and writing letters to people in power. Also, Canadian with our high livings standards and GDP should begin to learn that our time and money can be spent is efficient ways. From the orphans that need care to building new hospitals, the opportunity to help stop this pandemic is easier that one may think. We have become role models on the topic of humanitarian issues and healthcare within our own country. It is our duty as good citizens and Canadians to show that we care and can spread our knowledge and hearts to those who want to make a difference to Africa. How long will it be before everyone bands together to fight HIV/AIDS?

  8. Holmes permalink
    May 3, 2010 9:50 AM

    The Canadian effort on the issue of AIDS in Africa has been substantial in the last decade, however it is crucial that Canadians continue and expand our our efforts to relieve the beleaguered nations of the African continent. Some of the still prominent issues, the massive influx of orphans, the lack of medicine, and the lack of women’s rights all need to be addressed as paramount to resolving this issue. The massive, growing amount of orphaned children threatens the creation of a generation of children un-accustomed to authoritative figures. This unruly generation could be very rebellious and cause many problems for an already troubled African nation. Another of the most important issues is that of the lack of essential medicine, such as antiretroviral drugs, available to the people who need it most. It is quite possible to prevent the development of AIDS by fighting it in its early stages as HIV through this drug. In order to reduce the transmissions of AIDS among the populations of these nations, it is necessary to empower women, who have been disproportionately vulnerable to this disease due to their complete lack of control of their bodies. There are many ways Canadians and their government can aid in the resolution of these problems. One of the most significant contributions that can be made to the cause would be the donation of money to build the orphanages, provide the medicine, and empower women. This money collection can be done in ways like setting up charities or imposing small taxes on sales products. This issue is incredibly important to beat the spread of this pandemic. The developed world needs to act to help stabilize the affected African countries, or Africa could slowly descend into chaos. Not only this, but if left unchecked, AIDS could ravage not just Africa, but the rest of the world. This is why the world and Canada needs to rally behind Stephan Lewis and find a solution to the African AIDS crisis.

  9. Sam And Jessica permalink
    May 3, 2010 9:53 AM

    AIDS is a pandemic that has grown rapidly over the last 30 years, threatening the way of life for many people in Africa. Many children are losing both of their parents to this disease and being left orphaned. The long term effect of AIDS could have a huge impact on the population of many African nations. It is up to rich nations like Canada to help solve this problem considering the fact that we have the resources and access to publicizing the issue as something very important. One step the Canadian Government should take is exporting antiretroviral drugs to those in need. These drugs have the ability to extend lives by preventing HIV from spreading into AIDS. We have the technology to create these drugs, but many African countries do not. Exporting these drugs would help many people with HIV. As Canadian citizen, we cannot do these tasks along, but one thing we can do is raise awareness. Learning the facts of AIDS/HIV can really help in not only spreading awareness, but spreading it properly. Schools should start to implement an AIDS/HIV education program in order to inform children at a young age, therefore opening the acceptance to those who have been affected by it. It is in the best interest of our nation, and the world to help out in this issue when we can, in order to save the future population, generations and overall society.

  10. ben jolly permalink
    May 3, 2010 10:02 AM

    I aggree strongly to what is said here. What I don;t understand is why politics is such a lie. Can’t any leader do hwta htey say and actually try and move our world forward. Where is the care and the guts in our chosen leaders? A thing like this needs a leader, someone to provide everyone else with the means to making difference, and to show that defeating aids is not impossible. Imagine of everone through North America and europe were to take a small amount fo money to donate fro the cause. So little given can make the biggest difference.

  11. Harry Checchia & Eric Cardoso permalink
    May 3, 2010 10:11 AM

    The effect of HIV/AIDS on the continent of Africa as a whole is detrimental to their politics, economics, socio-economics, gender equality, workforce, livelihoods, and lifestyles in general. Although the disease is particularly devastating to middle-aged Africans, with the number of adults dwindling rapidly, this leaves orphans to fend for themselves while putting pressure on the elderly to care for them. Currently, there are over 18 million orphans throughout the continent, due mostly to the spread of HIV/AIDS. However, what is most alarming about the issue is the fact that we can actually stop it; all we’re missing is the political will. For example, America spends 8.3 billion in Iraq and Afghanistan monthly, while in ’05, America’s total donation to the fight against AIDS in Africa was 8.3 billion as well. Imagine if a country that is such an economic powerhouse were to pool their resources together to finally combat AIDS and stop it once and for all. Canada can do this. In order to prevent the spread of AIDS, gender equality must be sponsored and pushed for by the developed world, with Canada leading the charge. We have the fervor and ardor to lead developed nations in the battle, and we need only to convince Parliament that we do, and that we want to. We need to stop waiting for America and other powerful nations to make a move, and be the leaders that the world needs us to be, our reputation must proceed us. Antiretroviral drugs are not the only solution, but they are definitely necessary to cauterize the destruction of AIDS, and must be paid for and distributed throughout the countries that need them most. Adding to this, sexual education must be correctly taught for a more mature Africa to succeed not only in the fight against AIDS, but in the fight out of poverty. The secret to ending aids is to improve the total quality of life in Africa. Every minute we are not fighting for a better Africa, people are dying. We must take action now, and lead the world in doing so.

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