29 September 2003

Africa: The Bush Aids Initiative: Unfinished Business


Washington, DC — CFA Roundtable examines the challenges facing the program in Africa

"While the world is finally responding to the global pandemic of HIV/AIDS, still much more needs to be done," according to former Congressman Ron Dellums. "The president's announcement of a $15 billion/five year commitment to fight AIDS in Africa and the Caribbean will help approximately one million of those estimated 4 million expected to die in Africa in 2004. What about the rest?"

With that provocative lead-in, the Constituency for Africa (CFA) presented a roundtable discussion at the Peace Corps headquarters, September 24 as part of its Ronald H. Brown African Affairs Series.

In introducing former congressman and current chairman of CFA, Ron Dellums as keynote speaker, Mel Foote, president of CFA remarked that, "Ron is the one primarily responsible for CFA's focus on the AIDS crisis in Africa. We had just finished our lobbying efforts on behalf of the African Trade Bill -- AGOA, and Ron remarked that if we don't do something about AIDS, there won't be anyone [in Africa] to trade with!"

Dellums, a veteran of three decades in the U.S. House of Representatives and a past chairman of the Congressional Black Caucus, gave an impassioned speech on the urgent necessity of implementing the provisions of the Bush AIDS Initiative.

"CFA needs to be on the front lines...to see that the funding is done right," he said. "We either are affected or infected. We are all in the circle of AIDS. And the notion that all you need to do is throw money at the problem is unrealistic. 15 billion dollars for 5 years is an unrealistic goal when millions continue to die each year."

He added that other issues additionally complicate the funding of AIDS programs and contribute to the spread of the pandemic in Africa: issues of orphan care, poverty, women's and children's rights -- all taxing social and medical infrastructures. "If we could translate HIVAIDS into the rhetoric of war; if we said that there is a war out there that is claiming 9,000 to 10,000 lives per day, I'm convinced that a global movement would emerge to stop this incredible tragedy."

The remaining portion of the program turned to an open-ended discussion with panelists fielding questions from CFA moderator Dr. Chinua Akukwe and from audience members.

Participating medical experts, representatives of Coca Cola and BASF International, an African ambassador, and an AIDS activist agreed that such funding was needed and appreciated, but may not be adequate and may not be dispensed in a timely enough manner to do much good.

In response to the problem of delivering needed AIDS medications and supplies to mostly rural Africa with transportation, political and geographic problems, Dellums said "these are problems that are not insurmountable. If the infrastructure is not there we can develop it; if the delivery system is not there we can develop it; if the system of accountability is not there we can develop it. These are questions...that can be overcome."

Panelist Robert Lindsay, vice president for Public Affairs at Coca Cola International, responded to the question concerning accessibility, saying that if it is possible to distribute soft drinks to remote villages in the African bush, then it is possible to do the same with AIDS medications and treatments. He further stated that what is needed is a corporate model, such as has been implemented in Coke factories in Africa where there is cooperation between management and employee and the host government in delivering healthcare programs.

"We have an opportunity to take this 15 billion dollars and do something and do it well enough to make a case. We need to build a model which is sustainable and can be replicated; and to build a model that will work, he said."

This was echoed by Marsha Martin, executive director of AIDSACTION, who added that "where there is Coke and CNN, there can be a response to AIDS. But for the Initiative to work, it must be a collaborative effort in partnership between government and community. It is a Marshall Plan for Africa."

For the work beginning at home, "We must define the jurisdictions and the authority; set up the infrastructure in the federal government, working with Health and Human Services, the State Department and USAID to allocate the funds and resources and properly distribute them. We must make sure that the beginnings are done correctly. Then international partnerships can be set up. That is the unfinished business."

Her Excellency Zambian Ambassador Dr. Inonge Mbikusita-Lewanka injected an African point of view by saying that the Bush AIDS Initiative was welcomed by her nation, adding that "in order to use this money most efficiently, it needs to get to the ground and working as quickly as possible. The more we get bogged down in discussions, you know that people are dying. We must make sure that at least 90% of that money gets to the targeted groups."

Comparing the state of affairs existing in Zambia to that of the developed world, she said, "Imagine if those infected people in the U.S. had no drinking water, no food, no telephones, no roads, no medications...like Zambia, which is the size of Texas, with 10 ½ million people, with one major university teaching hospital, with the nearest medical treatment centers hundreds of miles apart -- if this had happened in your country, then you would be wiped out. We are [also] a global village, and you can't close the door. HIV/AIDS is not only an African problem; it is an international problem."

Dr. Greg Pappas, Medical Director of the Futures Group and former senior officer on the President's HIV/AIDS Initiative, mentioned his concern with the limitations of the current funding, since the funding will target only 12 countries in sub-Saharan Africa, thus impacting only half of those Africans infected with AIDS. Within those 12 countries, most of the populations should be able to get some form of treatment, but "there is a huge unfinished agenda in making it happen."

Dr. Mohammed Akhter, Senior Associate Dean for Public and International Health, Howard University, stressed that it was not the 15 billion dollars that should be focused on, but [Africa's] future needs.

"Well done Mr. President; great first step, but it's just a down-payment. We need a long- term commitment for the next 20 years. We need to put this money up front where it is easily accessible and people can plan for the next 5 years. The people of Africa are looking for a long-term commitment so that they can slowly build their institutions that can serve the people. We should ask the African people what is their priority; let them make the decisions based on local needs and local input, and not let the bureaucrats do it for them. And the first need is nutrition. You can give the best health care possible, but if people don't have the food and are malnourished, treatment will not be effective."

Summarizing, Ron Dellums said that AIDS is a global problem for all: "All countries must be involved with funding, finding an AIDS vaccine, and ultimately a cure."

(The Washington File is a product of the Bureau of International Information Programs, U.S. Department of State. Web site: http://usinfo.state.gov)

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