AIDS: It’s Now up to Africa’s Leaders

Published April 1, 2003

As the U.S. edges closer to war with Saddam Hussein, its global popularity seems to be ever diminishing. President George W. Bush’s decision to act on the global HIV/AIDS crisis, announced in his State of the Union address, may improve his international image, but its success is far from certain.

HIV infection continues to rise in Africa, while mortality from AIDS-related illnesses is increasing alarmingly. Few African governments can be proud of their response to the epidemic. Yet some have faced this catastrophe admirably.

Ugandan President Yoweri Museveni showed bold political leadership years ago in his nation’s fight against AIDS. By tackling transmission of HIV and ensuring people had access to treatment, infection rates are down 50 percent since 1992.

African governments must end widespread corruption, so that drugs donated or bought cheaply go to those who require them and are not sold to the private sector.

Weak Infrastructure

Antiretroviral drugs are needed in Africa, and pilot projects have shown that in many instances they can be taken correctly and the regimens adhered to. But such efforts require enormous investment in health infrastructure and training.

While Bush’s $15 billion (of which $10 billion is new money) to fight AIDS is welcome, it will not be easy to reach the stated goal of 2 million people on antiretroviral treatment without improving infrastructure.

The few African success stories show one of the best ways of doing this is to work with the research drug firms that have developed the medicines. Nigeria recently experimented with generic antiretrovirals from India and this proved disastrous, with no more than 10 percent of those intended to get drugs actually receiving them.

Private Sector Needed

Generic suppliers rarely provide the necessary pharmacological back-up and advice that pharmaceutical companies offer. Despite the research pharmaceutical sector’s international unpopularity, it often does more for health care in Africa than most governments. Major research drug firms have donated billions of dollars to charitable programs and fund research on medicines for diseases like malaria and tuberculosis.

Humanitarian aid is important, but continued research into new drugs is most critical. Governments can help by guarding these firms’ investments through strong intellectual property rights.

Aid and humanitarian help is much needed, but decades of government-to-government aid have only left Africa poorer and more desperate than ever. To avoid misuse, the Bush plan should rely on nongovernmental and private-sector sources far more effective at delivering health care.

Colin Powell’s speech to the World Economic Forum offered more hope in the longer term. Powell was clear about the need to reduce trade barriers, increase economic growth, and ensure wealth creation in poor countries.

Africans are ill, unable to receive medical treatment and short of food because most African governments have kept people poor, frustrated trade, and interfered with markets. By allowing the private sector to thrive, Africa will be able to create the wealth that can build health infrastructure.

America’s billions are crucially important, but the only long-term sustainable solution is allowing Africans to get rich. And Africans won’t triumph over AIDS or poverty until their leaders make a true commitment to their people.

Richard Tren is a director of the South Africa-based health NGO called Africa Fighting Malaria. This article was distributed by the London-based International Policy Network and is reprinted here with permission. Tren’s email address is [email protected].