"It may have taken the death of an African president from AIDS for the leaders to take the disease seriously", said one delegate at the end of the Eleventh International Conference on AIDS and Sexually Transmitted Diseases in Africa (ICASA) convened in Lusaka, Zambia in Septermber, 1999. Many more delegates also publicly voiced grave concern over the no-show of African presidents to the meeting on the AIDS epidemic in Africa. Not one head of state or government, including the host president Fredrick Chiluba who had been scheduled to officially open it, bothered to attend ICASA. A presidents' pre-conference, which had been planned to precede the main meeting, had to be cancelled. To the thousands of delegates who converged in Lusaka this was a clear signal of the lack of seriousness and political will of African leaders in combating the disease which now poses the foremost threat to development in Africa.
It had been hoped that African leaders would come together to undertake a critical appraisal of the response to the epidemic and to stimulate the dialogue around the issues relating to current and future priorities in the fight against the deadly disease. Since the first ICASA conference in 1985, millions of Africans have died of AIDS. According to Peter Piot, Executive Director of UNAIDS, there is now a HIV prevalence of more than 30 per cent among women in some Eastern and Southern African cities. In Zambia, host country to the conference, the chance that a 15-year-old will die of AIDS is 60 per cent. In Botswana, Namibia, Swaziland, and Zimbabwe, more than one person in five, between the ages of 15 and 49, is estimated to live with HIV or AIDS.
"These numbers are so staggering that they challenge the limits of our comprehension," noted Calisto Madavo, vice-president of the World Bank, Africa Region. "The epidemic is not only claiming lives, it is changing the very nature of life in Africa." In more than a dozen countries, most of them in Southern and East Africa, life expectancy by early next century will be 17 years shorter because of AIDS - 47 instead of 64, Madavo said.
While African leaders have not been roused into determined action by these frightening figures - not a single Sub-Saharan country spends more than one per cent of its health budget on AIDS - the World Bank and UNAIDS announced a new programme called "International Partnership Against AIDS". It seeks to mobilise governments, civil societies, and the private sector worldwide to accelerate action to tackle the disease. The Africa Partnership will also focus greater attention on the emergency nature of the epidemic in many African countries.
According to Callisto Madavo, the International Development Association (IDA) will commit up to three billion dollars annually under the partnership. "The impact of AIDS in Africa is catastrophic, and the scenario will worsen unless global leaders work together to invest more, much more in prevention efforts and in programmes to address the multitude of social and economic problems that AIDS has wrought", said Peter Piot of UNAIDS. "Investments in health and social development are already eroding. We must act quickly and strategically so that these investments are not wholly obliterated," said Piot. "Effective measures to meet this emergency exist. However, the current allocation of resources to combat the epidemic is grossly inadequate," he said.
Although Africa is the continent hardest hit by AIDS, its own resources allocated to deal with the disease are insignificant. For example, out of the 150 million dollars spent in 1997, only 15 million came from African governments. But in the view of some of the African ministers present in Lusaka, this is due to the general underdevelopment in Africa. Zimbabwe's Health Minister, Timothy Stamps, lamented the fact that there was no reference during ICASA on how to address the huge disparities in trade and economic development between the developed world and Africa which have had an impact on Africa's capacity to fight HIV/AIDS. Reducing the divide would mean an improvement in the living standards of African people, he said. Zambian Health Minister Nkando Luo echoed this view. "Now we are being hindered by the high debt stock Africa owes to the West. My country, for example, is spending a lot of money in servicing this debt. We could have used this money to fight AIDS," he told the media.
Ironically, while the World Bank and UNAIDS are now prepared to allocate 3 billion dollars annually to fight AIDS, the Bank's structural adjustment programmes in many countries are seen by many Africans as having destroyed the development support structures needed to combat the disease. Spending on health has been drastically reduced at a time when HIV/AIDS is at its peak. While every HIV infected person would need to pay about US$ 12,000 every year on medicines alone, African countries cannot allocate more than 10 dollars to be spent on the health of each person.
But as the non-attendance of African presidents at the Lusaka conference has shown, an amazing degree of indifference towards AIDS still exists. "Governments lack the political will and commitment regarding this life-threatening disaster," said Moustapha Gueye, director of the African Council of AIDS Service Organisation (AfriCASO). "Governments in Africa do not listen. They are in power and want to remain in power, but they are doing nothing to seriously fight AIDS," said Gueye.
