The Human Immunodeficit Virus Crisis in Africa - Essay Example

217955The HIV/AIDS Crisis in Africa: The Political and Medical Truths It is a pandemic, a plague, that has spread across the African continent virtually unchecked, even though modern science and medicine and sociology has the technology and information with which to, if not cure it, at least contain it. When HIV/AIDS ripped through the social fabric of first world countries, the delay in at least bringing some measure of control to the situation rested with the fact that, at first, people did not want to know about it, much less engage in social discussion and debate about it. Still, in the labs of the CDC in America, and in the labs of France, research was being done that would, over time, lead to ways in which to bring the disease under control through education, and private research and drug manufacturing. If, however, in the first world countries, people struggled with the social implications of the disease, then it is perhaps not so difficult to imagine the struggle it has been for third world African nations, born of ancient civilizations that teeter on the brink between their ancient heritage and traditions, and those of the 21st century and, now, the new millennium. Efforts to educate Africans and to establish centers for HIV/AIDS treatment has been slow, and many allege that the disease has been allowed to rampage through the towns and villages of the continent because of political power games wherein the players have had a complete disregard for the humanity of those suffering the devastating affects of the disease in countries where life was often already a challenge. This study attempts to examine the politics and the science behind the African HIV/AIDS pandemic. What, if any, progress has been made in containing the spread of the disease over the last decade? Is the question that will be examined in order to understand more clearly why the third world countries of Africa, many of which are rich in minerals and natural resources; have lagged behind the rest of the world in containing the spread of the disease. An attempt will be made here to understand the sociological, political, and medical combination of events and actions that has brought the African continent to a place of near population annihilation because of the HIV/AIDS pandemic. The answer to the question that perhaps comes to the readers’ mind here, is, yes, there will be an attempt to place blame, because it is not acceptable that an entire continent of civilization stands on the brink of extinction because the world, and the leaders of the world, have failed to respond to the needs of their people. In the Beginning One of the changes that came abut with modernity was travel and communication. These two aspects of society alone connected the dots between nations, leaders, and world communities (Patton 2002 ix). These two events also occurred long before the next event that connected the global community; HIV/AIDS (Patton ix). Although governments and medical scientists recognized fairly immediately that something very unusual was occurring in that the outbreak of the newly identified disease was in several major locations occurring simultaneously around the globe, it did not immediately occur to them that it was the ability to travel overnight from one location to the next that was the carrier, via human incubator, of the disease that would be the link of commonality in the spread of the disease (Patton x). In other words, as scientists looked for the medical science of the simultaneous outbreak, it did not occur to them that they were looking at a sexually transmitted disease that was being spread by way of human movement and sexual promiscuity from one locale to the next (Patton x). The “global village” was “communicating” a new disease (Patton x). HIV/AIDS was the first “global” disease (Patton x). By the mid 1980s, the “communication” was interrupted as nations confronted with a new disease outbreak that could not be cured and, at that time, was not being contained; moved to apply border laws and restrictions that prohibited the free movement of people from one nation to next (Patton x). The intense panic and fear that the disease instilled in people resulted in setting back the progress made in religious, gender, and stereotypical prejudices and discrimination (Patton x). If mankind feared anything, it became apparent it was a nasty and deadly disease that circumvented his sexual freedom. There was a scramble to find ways to stop the spread of the disease. International organizations became involved: The World Health Organization, the United Nations, and global news conglomerates to spread the news about the disease and the progress, or, for many years, the lack thereof, in curing the deadly disease (Patton xi). “By the late 1980s, the WHO employed equally obfuscated ideas about risk behaviors to produce an epidemiological mapping of the world that continues to profoundly affect how we understand AIDS as a pandemic. The pattern of AIDS incidence associated with North America and Europe, where identified cases were originally predominantly found among homosexually active men and injecting drug users of both sexes, was called Pattern One. That of Africa, where cases were initially identified among heterosexually active but non-drug-injecting people, was called Pattern Two. Pattern Three was defined not by the demographics of its cases but by their location in a space-time framework: where “AIDS arrived late, ” that is, principally Asia (Patton xi).” By the time the politicians and medical science communities began making progress in towards containing the spread of the disease, it was determined – or decided, that the disease had originated in Africa (Patton xi). “Despite the fact that all signs pointed to a handful of major cities in the United States as the source of the disease, international media cloaked itself in scientific language and endlessly quoted the premature remarks of AIDS science luminaries, like Luc Montagne, who asserted that AIDS must have started in Africa (xi).” It didn’t matter where it started, at that point in time. The focus was on how to contain the spread the disease. What we know for sure about HIV/AIDS and Africa is that prior to the onset of international attention becoming focused on this pandemic, there exist very few reliable records on any healthcare issues, and especially not on sexually transmitted diseases in Africa (Setel, Lewis and Lyons 1999 3). So the fact that Africa was identified as the source of the disease is in and of itself difficult to understand since how that would be tracked to African people as the source of the disease when there were so few reliable records available. That, of course, no longer matters, because what is being discussed here is why the disease has not in the past decade come under control in Africa. Philip W. Setel, Milton Lewis and Maryinez Lyons say: “Of all the hallmark themes of the histories of STDs and AIDS in Africa, ambiguity is perhaps the most dogged and, from a health perspective, the most pernicious (3).” Perhaps not so pernicious as why efforts to contain the spread of disease did not occur or even begin before the 1990s, especially since it was during the mid 1980s that Africa was identified – rightly or wrongly – as the source of the outbreak of the disease. Organizations concerned with record keeping and tracking the HIV/AIDS related deaths began to concentrate on getting better data out of African nations. Reliable data on the disease and the spread of the disease only begin in 1995 (Setel, et al, 4); a decade after Africa was identified as the source of HIV/AIDS. The Politics Behind the Crisis In 2005, two decades since HIV/AIDS had been identified as originating in Africa; 29 million people are living infected with the virus in sub Saharan Africa (Seckinelgin 351). In 2002, more than two decades since HIV/AIDS was identified as originating in Africa, 3.5 million African people became newly infected with the virus (Seckinelgin 351). International policymakers say that the lack of funding is the greatest obstacle to bringing about education and drug regimen programs that can help contain the spread of the disease (Seckinelgin 351). Hakan Seckinelgin (2005) has identified the international policymakers as the “governance” of the H IV/AIDS pandemic in Africa (351). “This is done according to a particular domain of governance whereby people with the disease are constructed in a manner independent of their everyday lives, allowing them to be governed in a particular domain, that of international HIV/AIDS policy produced by certain languages and technologies. The overall analysis is based on the outcomes of my ongoing research on the impact of international policy on HIV/AIDS in sub-Saharan Africa conducted in the last three years in Uganda, Zambia, Botswana, and Rwanda. The article is a theoretical look at the issues; the empirical claims related to this debate are analyzed in depth elsewhere (351).” These international agencies are nongovernmental organizations (NGOs), Seckinelgin says (351). Agencies like the World Health Organization (WHO), the United Nations (UN) working as UNAIDS, and other agencies from around the world community (351). The problem, says Seckinelgin, is that the agencies are not granted the authority and funding they need to address the pandemic in a way that produces long term results (351). There is, Seckinelgin says, a disconnect within the hundreds of NGOs involved in prevention, support, and care projects, which thus far have proven inefficient in their work to bring about any significant containment of the spread of the disease, even though they have the funding of a multinational agencies behind them (351). The agencies Seckinelgin identifies as the NGOs are (351): * United Nations Childrens Fund (UNICEF) * World Food Programme (WFP) * United Nations Development Programme (UNDP) * United Nations Population Fund (UNFPA) * United Nations Educational, Scientific and Cultural Organization (UNESCO) * World Health Organization (WHO) * World Bank * United Nations Office on Drugs and Crime (UNODC) * International Labour Organization (ILO). “In the governance framework leading to interventions by NGOs at the international level, multilateral policymakers and experts take decisions within preexisting development parameters (that give direction for the recognition of relevant partners) and available aid structures (that decide what is feasible). (15) In this sense, the governance of HIV/AIDS is located within preexisting understandings among international actors. (16) One important nuance that needs to be clarified in this relationship is the link between a donor and a policymaker. It is clear that donors such as the World Bank, DFID, or even an international nongovernmental organization (INGO) such as OXFAM or foundations such as the Bill and Melinda Gates Foundation, are not merely funders but have comprehensive perspectives on what the problems are and how they should be tackled (351). Literally hundreds of NGOs are working on prevention, Seckineglin says (351). It is a matter of policymaking, and policy application that is inconsistent (351). What needs to be done, is to draw these energies together and to bind them under a common and consistent policy. However, there are dynamics of organizational politics that come into play and prevent this common and consistent policymaking from occurring (351). Distributing prevention posters and condoms is not effective when the efforts are dispersed through the hundreds of NGOs, and when there is a lack of follow-up in the social and economic and especially the political change processes within the nations where the NGOs are working (351). Seckineglin says the problems are identified as (351): * organizational "set up" * leadership and human resources * managing external relationships with "primary stakeholders" * mobilizing funds (of a "quality" to allow the NGO to pursue its work properly) * "managing through achievement" Looking at the programs managed the NGOs is necessary. For instance, in Zimbabwe, funds are actually being spent on training journalists in that country to embrace a different thinking on the epidemic. “Aulora Stally describes how one of the Panos Institute partners in Zimbabwe, SAfAIDS, is assisting media personnel in Southern Africa to ensure responsible coverage and accurate communication about HIV/AIDS. This involves: changing journalists attitudes (e.g., AIDS is hopeless); helping them give AIDS a human face (e.g., reporting that helps reduce stigmatization of PHAs); challenging them to inform and motivate, rather than try to impress their readers (e.g., through sensationalistic stories); and providing them with background information so that their reports can alleviate confusion about AIDS among the public. SAfAIDS Media Unit serves as a resource base for training journalists, creating information packs and management of an e-mail forum through which media workers can share views, ask questions, etc. (Stanton 2004 3).” In African countries, HIV/AIDS is a disease of poverty, and if the African news media does not have a “human face,” on the epidemic in their country, then no amount of financial investment in educating journalists is going to change that perspective. There is an awareness of the epidemic, and there is a social and moral responsibility to the people who are infected with the disease. If journalists in Zimbabwe do not have the human face of the person suffering the disease, no amount of educating them will help them to develop an image in their minds. In fact, to say that they do not have the image of the humanity involved in the pandemic is misleading, because it is indicative of a greater problem. In Zimbabwe, of course, a country rife with political upheaval and inflation, it is a reluctant, if not refusing government within that country that is responsible for the spread of HIV/AIDS. If the country has no money, it is not going to devote funds to the sick population. These are hard facts that need to be acknowledged so that the appropriate international response and action can be addressed and taken. Through the United Nations and other organizations having the financial power to influence the political leadership of the African countries where the spread of the disease is the most prevalent, that political power and pressure can be brought to bear on those governments to provide a greater level of security within the country for the NGOs to operate safely, and to provide the NGOs a diplomatic immunity with which to move across borders and throughout regions, including those regions where there is civil war, and to have carte blanche over the administering of the policy with regard to HIV/AIDS. This is the only solution, and that means taking the infected populations in countries with the greatest proliferation of the disease out of the control of the sovereign government and putting those populations under the control of the international NGOs; but only after the NGOs develop an internal structure amongst them that can facilitate the authority and power being granted them within the sovereign nations. The science, medical technology and the sociological techniques by which to successfully implement treatment, care and prevention exist. There is no acceptable excuse for increased new cases of infection to occur such as was reported in 2005. This is a radical proposition, but it should be noted that the current political of these sub Saharan African countries are thwart with crime, violence and corruption on a scale where the political infrastructures have been described as temporary, exploiting the country for personal wealth before the leader then goes into exile elsewhere – with the money that has been pilfered. It is nearly impossible for the NGOs to have an impact in training and educating medical personnel in the sub Saharan countries on how to combine drug regimens in a way that does not put the patient at risk, or what literature they need to read to keep abreast of the myths that new, and those old ones that continue to exist that have been found to impact the populations of those nations such that they do not adhere the drug treatment programs or comply with the prevention standards (Stanton 2004 53). If those NGOs are not able to move about freely, under the protection of multinational policy and support and protection in their efforts to bring about a halt to the spreading of the disease amongst the populations of sub Saharan Africa. Seckinelgin says: “International policymakers need to understand the contexts in which they are targeting people, the projects for which social and economic resources are provided, and the constraints on people for action. By targeting only the sick and the HIV-positive individual, the interventions are not only creating stigma, but they are also making redundant the capacity of existing coping mechanisms available to people. Therefore, agency for change needs to be articulated beyond interventions based on tools that are, externally, deemed appropriate and feasible. Change will be possible only by considering sociocultural contexts and by providing actors that can influence and sustain change in such contexts. At the moment, neither the short-term relief-based vision implicit in many NGOs in the region nor the governance system supporting this vision, which is based on perceived common sense among the major development actors, is providing the agency for such change (3510.” Cindy Patton (2002) says that the pandemic in Africa is not about economics, because it is a condition of poverty, and that understanding prevention and treatment is an elitist entitlement (31). “Economic analysis cannot help us recognize that AIDS in Africa is a symptom of black peoples history of exclusion from global prosperity and economic dependency enforced by lack of control over either local or global resources. Grotesque comparisons of the sort I just outlined between the United States and Zaire reveal what global health activists already know: No matter how one looks at it, life—or rather, losing it—is cheap for all but the most privileged (31).” If it is a matter of economics in the country, as would certainly be the case of Zimbabwe; then it is up to the international community to respond not to the economic demise of the country as a whole, but to the affect that economic deterioration is having on the already impoverished populations within that country. If taking strong steps to enforce an international conscience are required, then those steps must be identified at the international level, and taken. “Much of Europe has now banded together in order to act collectively in their relations to the vast colonial territories of Africa that several nations once differentially administered and that still have the names— or at least the borders—that intra-European competition produced as trophies. In the context of the AIDS epidemic, and corresponding in time to the move toward an economically united Europe, the European group has been the region most effective at developing HIV-related antidiscrimination policy. Using the emerging European Communitys governing bodies, which partially map the space the WHO defines as a health region, countries have brought pressure to bear on one another to promote more humanitarian care for people with AIDS, to support local organizing, and to develop cooperative projects in the Third World, especially with African countries. In the face of a disease that so poignantly defies nationality, European countries invocation of human rights enables them to relinquish some control over national health policy, muting the political effects of national borders without challenging formal national sovereignty. Nevertheless, their collective relationship to their former client states in Africa has reinscribed a more general Eurocentrism in the face of an Other who is more different from Europeans than Europeans are from each other (53).” As we can see from Patton’s remarks, the international community, at least the European international community, is already acting to move towards at least taking under their control the infected populations and even the national health programs within the former colonial nations. While there is no support for overthrowing a democratically elected government, there is great support of annexing the national health care and prevention programs of those countries for the purposes of bringing about a halt to the spread HIV/AIDS within those countries. The problem of HIV/AIDS in sub Saharan African nations is one of politics, not economics. There is enough directed funding through the international communities, and through private philanthropy to bring about significant progress in at least the prevention of acquiring new cases of HIV/AIDS in the count of millions. The problem of politics must be resolved, and done quickly. The international community must annex the healthcare as regards HIV/AIDS in Africa, and confront the opposition to that move in order to bring about a halt to the continued spread of the disease on the African continent. No one leader, no one government, no one disease should be the demise of the African people. The time to act is now, and the action must be aggressive and must involve the support of the multinational community. Works Cited Patton, Cindy. Globalizing AIDS. Minneapolis: University of Minnesota Press, 2002. Questia. 21 Apr. 2008 . Seckinelgin, Hakan. "A Global Disease and Its Governance: HIV/AIDS in Sub-Saharan Africa and the Agency of NGOs." Global Governance 11.3 (2005): 351+. Questia. 21 Apr. 2008 . Setel, Philip W., Milton Lewis, and Maryinez Lyons, eds. Histories of Sexually Transmitted Diseases and Hiv/Aids in Sub-Saharan Africa. Westport, CT: Greenwood Press, 1999. Questia. 21 Apr. 2008 . Stanton, Theresa, ed. HIV/AIDS and Information. London: ASLIB-IMI, 2004. Questia. 21 Apr. 2008 . Read More