HIV/AIDS IN AFRICA: THE GAINS OF THE DURBAN CONFERENCE
By Melvin Foote
and Chinua Akukwe
the curtains drew on the 13th International HIV/AIDS
conference in Durban, South
Africa, in July 2000, it became obvious that the AIDS landscape may
never be the same for many reasons. We will highlight the ten major
gains of this epoch Conference.
Conference may have broken the veil of silence about the disease in
Africa. According to print and electronic media reports, HIV/AIDS became
the major topic in many communities in South Africa. Citizens of South
Africa reportedly spoke openly about the hitherto taboo subject of sex
and its relationship to the spread of the virus. From now onwards, it is
unlikely that rational governments in Africa can ignore the urgent need
for national dialogue on HIV/AIDS.
A popular African government tasted the raw anger of its citizens. The
harsh criticism that reportedly heralded the keynote speech of the host
head of state, President Mbeki, during the Conference and swift,
widespread bitterness regarding the perceived lack of action by the
South Africa government on HIV/AIDS, should serve as a wake up call to
medical and development side effects of AIDS dominated the mainstream
media of Western capitals during the week-long Conference. During the
South Africa conference, the Washington Post published an extensive and
provocative three-part serial on HIV/AIDS in Africa. AIDS is now a
legitimate, mainstream news item.
one of the most significant outcomes of the Conference is the firm
consensus reached on the hitherto forbidden T alphabet
in HIV/AIDS advocacy: The treatment of
HIV/AIDS no matter the continent, country or community of origin. For
quite sometime, some experts considered it irrational, impractical,
or sheer fantasy to talk about the need for the
international community to provide life saving drugs to AIDS
patients in the hardest-hit countries. Now, the argument, is shifting to
When, Where, and, How, the international community can
deliver lifesaving drugs to all AIDS patients, especially in Africa.
multinational pharmaceutical companies are now falling over themselves
in their eagerness to provide cheap drugs for AIDS patients in
developing countries. Although this development is a culmination of a
long term campaign, the graphic stories of the destructive effects of
AIDS in Africa made it prudent for global pharmaceutical organizations
to now do the right thing.
scourge of HIV/AIDS is now recognized in all Western capitals as a
fundamental threat to globalization, and a tension-free world. The
Clinton Administration had in April 2000 declared HIV/AIDS a national
security threat, the first time in modern memory that a disease
warranted such a declaration. Shortly before the conference, the
President signed an executive order increasing the accessibility,
affordability, and procurement of cheaper anti-AIDS drugs. The U.S.
House of Representatives, in a major shift of emphasis, voted in July
this year to ante up the funding for international HIV/AIDS programs,
increasing the White House 2001 budget request from $244 million to $286
million. The recent signing of the U.S. Congress bill (sponsored by Representatives Barbara Lee and James Leach) to set up the
$500 million global trust fund for AIDS patients by President Clinton is
another significant milestone. Britain, France, and Germany are also
pledging additional resources to AIDS programs in developing countries.
international donor and relief agencies are now united in the global
fight against AIDS. For example, the UNICEF leadership chose the venue
of the conference to unveil its annual Progress of Nations report,
devoted to the global effects of AIDS on children and youth. On the eve
of the conference, the World Bank made a pledge of $500 million to fight
the epidemic in Africa. Juan Somavia, the Director-General of the
International Labor Organization (ILO) wrote a scathing commentary on
the plight of children in the UNICEF report and called for a global
moral imperative to assist them in this era of AIDS. In addition, the
United States Agency for International Development (USAID) released a
ground-breaking study on AIDS and orphanhood during the Conference.
growing numbers of AIDS orphans are now recognized as a major long-term
threat to the stability of hardest-hit nations. According to USAID, by
2010, one in seven children under 15 in Sub-Saharan Africa will have
lost a parent to AIDS. Other estimates project that during the same
period, AIDS will account for 40 million orphans, 95% of them in Africa.
The extended family system in Africa is under severe strain because of
the unprecedented numbers of orphans. Taking care of orphans in
institutional setting is out of the question in Africa because of the
hefty price tag of $2,000 a year for each child. These children are
likely to miss out of school, become surrogate parents to their younger
siblings or coerced into early sexual activities.
conference reestablished the primacy of clinical, biomedical, public
health, and qualitative research. Experts presented ground-breaking
studies in areas such as accelerated vaccine development, modified dose
therapy for developing countries, a relatively cheap, simple drug
treatment (using nevirapine) that significantly reduces maternal
transmission, and the economic implications of the disease. According to
studies presented during the Conference, health experts in Africa and
other developing regions face a major scientific dilemma on how to solve
the problem of breast feeding for HIV positive mothers. These mothers
can transmit the virus to their infants even after receiving nevirapine
at birth. However, bottle-feeding is impractical in poor countries, and
infants can easily die of dirt-induced diarrhoea diseases.
the greatest legacy of the Durban Conference is that the mobilization
against HIV/AIDS will be equal part science and development. The science
of AIDS will increasingly focus on the accelerated development of a
vaccine. The development agenda will shift toward
(a) ensuring access to lifesaving drugs, (b) strengthening the
health care infrastructure of developing countries, (c) implementing
comprehensive prevention programs, and (d) adopting multisectoral
approaches to AIDS programs at community levels, where, anti poverty
strategies, macroeconomic policies, democracy dividends, and social
justice programs will become as important as pills. An energized army of
activists will become as prominent as the star scientists and
researchers. Political careers in developing countries may soar or fail
depending on support for urgent remedial action on HIV/AIDS.
In the final analysis, the global community will likely deploy
formidable technical, financial, and human resources to stop the
destructive effects of AIDS. That may be the ultimate legacy of the
unprecedented gathering in Durban.
Foote is President
and CEO, Constituency for Africa (CFA), Washington, DC. The CFA is a
coalition of organizations and groups working to educate the American
public about Africa and African issues.
Akukwe is former Vice Chairman, National Council for
International Health (NCIH), Washington, DC.
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