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According to estimates by the U.S. National Intelligence Council, in general economies will decline when the HIV-infection rate reaches 5%. When it reaches 20% – the rate that South Africa presently faces – economic growth declines by over one percent of its annual gross domestic product. One percent is significant!
We must address poverty in order to combat AIDS
To describe the AIDS pandemic in Africa in this way certainly does not suggest, on the one hand, that AIDS is a tragedy because it has a negative economic impact; nor, on the other, that appropriate economic development and poverty alleviation “projects” will resolve the pandemic. What it does point us toward, however, is the reality that the African continent, bearing the brunt of the global pandemic and likely to remain at the epicenter of the pandemic for years to come, is the poorest and most vulnerable region in the world. It follows that, if we cannot be an effective partner in addressing poverty in Africa, avenues toward addressing AIDS will remain closed. In short, until people have something for which to hope, behavior is unlikely to change, and until causes of poverty are addressed in a comprehensive manner, AIDS will continue to ravage African societies.
U.S. funding for the global AIDS pandemic has advanced over the last several years, though it remains painfully inadequate for the task at hand. Estimates of funds needed from all donors to confront the pandemic are at $10 billion annually – not, we might add, a figure pulled out of a hat, but one reached through an analysis of health infrastructure needs and provision of broad access to anti-retroviral therapy for those who need it.
Of that $10 billion, a U.S. contribution would suitably be about $2.5 billion – a seemingly massive amount yet miniscule in terms of the federal budget. This reflects a common proportion of U.S. contributions to multilateral funding. It is also a figure we can afford. And yet we are only now creeping, reluctantly, toward $1 billion, and the shift in priorities since September 11th makes even that advance problematic.
These figures are for direct heath-related costs, not for broader economic development and poverty-reduction needs. The poverty issue takes us beyond funding simply and directly for AIDS education, prevention and treatment. It takes us into the realm of development assistance, where our own contribution is now the least among donor nations. It is crucial that we increase levels of non-military foreign assistance for poverty alleviation that would strengthen African nations to address the crises they face. We need development assistance that is truly capacity-building, as well as sustainable.
Unpayable debt aggravates the HIV/AIDS crisis
And then there is debt. The Jubilee 2000 campaign led to the reduction of the debt burden for some nations, but the fact remains that, even now, 22 countries which have been through the Heavily Indebted Poor Countries (HIPC) process are still paying more on debt service than they are spending on health care. The annual expenditure on healthcare throughout Africa is woefully inadequate. Ethiopia spends only $3 per person; Kenya, $8; Uganda, $9; and Cote d’Ivoire; $25.
Nearly two years ago Dr. Peter Piot, the Executive Director of UNAIDS, declared:
"It’s time to make the connection between debt relief and epidemic relief...If the international community relieves some of their external debt, these countries can reinvest the savings in poverty alleviation and AIDS prevention and care. If not, poverty will just continue to fan the flames of the epidemic."
It still needs to happen, addressing the connection between debt relief and epidemic relief. The burden of unpayable debt on Africa continues to aggravate the HIV/AIDS pandemic.
