Africa: Review 2000 
The year in which the fight against AIDS truly began... 

Several factors contributed to the new consciousness. The first was the International Aids Conference, held for the first time on African soil in Durban, South Africa. By holding it on the continent and in the developing world, the spotlight fell on the devastating path that the pandemic is wreaking. Other factors that contributed to the new consciousness included an international debate on Aids causation in Africa by South Africa's president Thabo Mbeki; world acclaim for the successful Aids prevention programmes of countries like Uganda and Senegal and a United Nations focus spearheaded by its agency, UNAIDS. 

The year ended with a positive pan-African response when leaders from across the continent committed themselves to action at a conference organised by the Economic Commission for Africa in Addis Ababa, Ethiopia. The world spotlight comes not a moment too soon and some may argue too late. Of the estimated 34.3-million people living with Aids in the world today, 25.3 million are inhabitants of sub-Saharan Africa. 

The rate of infection is highest in Africa, although the United Nations Aids programme, UNAIDS, revealed earlier this month that the continent registered 3.8-million new infections this year, down on last year's figure of four million new infections. Still, that is small comfort when the social, economic and political costs of Aids in Africa are weighed up. "By overwhelming the continent's health and social services, by creating millions of orphans, and by decimating health workers and teachers, Aids is causing social and economic crises which in turn threaten social stability," warned the UN secretary-general Kofi Annan warned early in the year. 

Another factor that placed the pandemic in full focus is South African President Thabo Mbeki's Aids debate. Mbeki assembled an international panel of scientists this year to consider the causes of the disease, aligning himself with the view that the HIV-virus alone was not responsible for the ravages of Aids in Africa. In addition, he began to investigate the view that Aids statistics in Africa are gathered in a ramshackle and unscientific way; that "poverty in sub-Saharan Africa is being medicalised" by the international HIV/Aids fraternity, according to the African Agenda magazine which devoted an issue to these ideas. Its contributors argued that the diseases of poverty (TB, malnutrition, cholera) are treated as if they are the cause of HIV/Aids alone, thereby excusing the developed world from funding effective development programmes. 

While Mbeki has been lambasted for siding with the so-called "dissident" Aids scientists who question the link between HIV and Aids, his debate has served to focus attention on the need for a pan-African response to the pandemic. Such a response is sorely necessary if one considers that HIV/Aids has come to surpass debt and structural adjustment policies as the key development challenge facing Africa. 

In fact, Aids threatens to roll back gains. Through the Eighties and Nineties, democracy had come to swathes of the continent; growth rates were up and the human development index was following in its wake. Access to education and healthcare was getting better and life expectancy was increasing. These increases have been curtailed as economists tally the existing and future Aids costs and estimate life expectancy downward to 45 years. Estimated economic growth rates are headed down too as gross domestic product has already come down by 0.7 percent a year and is expected to deepen to a loss of two percent a year as the disease peaks in the next two decades.

The reasons for the decline are not difficult to fathom. Countries are losing their productive workforces; companies are crumbling under the strain of increased absenteeism and spiralling training and healthcare budgets. In South Africa - which has one of the highest rates of HIV infection on the continent together with neighbouring Zimbabwe and Botswana - the epidemic could slash GDP by 17 percent by 2010. Botswana's national budget will be cut by an estimated 20 percent over the next budget as its strong economy succumbs to the pandemic over the next 10 years. 

The outlook is bleak, but the tide can be stemmed, according to world leaders. UNAIDS says that effective prevention and care programmes will cost an annual US$3-billion for the entire continent. Africa pays US$15-billiona year in debt repayments and the UN agency argues that savings from debt relief can effectively be channelled into Aids programmes. It will also be necessary for more aid from the G8 countries, argues that UNAIDS executive director Peter Piot. African leaders who met in Ethiopia in December have agreed that political leadership for a response against HIV/Aids needs to come from the continent. 

Instead of stressing the role of donors to reduce the destruction of Aids there was a greater need to emphasise leadership "here, first", said the ECA's executive secretary KY Amoako. It's a call endorsed by African leaders like Mbeki and actively carried out by those like Uganda's Yoweri Museveni. Uganda provides an example of successful best practice that can be emulated in other African countries. Based on effective testing, education and care programmes, the rate of infection is down. 

There are other examples of success stories including an education campaign in Senegal; private sector initiatives in Zimbabwe and South Africa; sex worker safe sex campaigns in Kenya are some examples. The good practice on show in every corner of the continent provides a basis of tradable skills that need to be harnessed, logged and sent around the continent so countries can learn from each other. 

Scientists are already working on a social vaccine for Africa and civil society is pressing for affordable access to Aids drugs. If anything, the2000 may be remembered as the beginning of the fight against HIV/Aids in Africa. 

By Farah Khan, IPS

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