Addis Ababa — The Commission for HIV/Aids and Governance in Africa holds its second commissioners' meeting Tuesday in the Mozambican capital, Maputo. Commission Chairman, K.Y. Amoako, argues that the pandemic is changing Africa fundamentally and forever and that we need to take notice.
We view the HIV/AIDS pandemic that is ravaging Africa as an emergency. After all, the death toll from AIDS far exceeds that of most wars. Urgent action is needed to keep the HIV-infected from getting ill and dying and those still healthy from being infected.
Yet, this focus on the obvious challenges may be distracting us from a different but equally pressing demand - the need to plan for the long term.
AIDS is changing Africa forever. It is transforming Africa's most fundamental systems - such as food production, education provision and labor supply. The pandemic impacts most harshly on the most active sectors of African economies, killing adults in the prime of their lives. Skills are lost and children left to grow up without the civic compass that should have come from their parents.
Few past assumptions about the potential for development continue to hold. Some African states risk being brought to the verge of destitution, unable to produce enough trained or educated citizens to replace those who are dying. Even Botswana's President Mogae, leader of one of Africa's strongest economic performers, has voiced the fear that his country could be 'annihilated' by the disease.
How are they to govern? How will they run services without trained personnel, maintain security, produce food or negotiate trade agreements?
We have barely begun to understand the profound socio-economic changes being foreshadowed in our societies, let alone to plan for them.
That is why UN Secretary General Kofi Annan last year asked me to establish the Commission on HIV/AIDS and Governance in Africa (CHGA) - to research and provide data and clarify the choices facing African governments today and for decades to come. We aim to help design the policies and programs that can contain the pandemic while supporting development and fostering good governance.
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The principal response to the epidemic over the past two decades has been to try and change individual behavior.
Yet while sexual behavior is obviously an important cause, it cannot alone explain why HIV prevalence is as high as 35 percent of the adult population in some southern African countries, less than 5% in others like Ghana, Madagascar and Senegal, and less than 1 percent in the developed world.
We need to consider other factors like poverty and wealth, disempowerment and disproportionate power, poor access to health services, deprivation and development - the very ways we as Africans live our lives.
One of the Commission's fundamental goals is to help build a shared understanding of the complex nature of the challenge facing Africa. A common framework, accepted and used by Africans and the international community alike, must be found.
Donor governments, multilateral institutions of global economic governance and African countries need to agree on policies so that the fight against HIV/AIDS does not become undermined by contradictory development strategies.
Without that, we will continue to have the situation in which an African government seeks to increase public spending, backed by donor support, as part of its HIV/AIDS containment policy, at the same time as international financial bodies demand that public spending be reduced.
Africa's governments must become more open to the need for partnership and coordination with HIV-affected individuals whose efforts lie at the heart of a sustainable response to this epidemic; they must also work even more closely with the NGOs and community groups at the sharp end of coping with the impact of HIV/AIDS.
Building this consensus should also persuade multilateral agencies (particularly in the UN system) to plan jointly and minimize duplication of effort while ensuring that available resources are better utilized.
Above all, our strategies should be sustainable. New programs of support, funded increasingly by the Global Fund, World Bank, private foundations, corporations, bilateral donors and national governments have transformed the opportunities for developing and implementing effective responses to the HIV pandemic in Africa.
But so far, funding is only a fraction of what is needed and it is doubtful whether its longer-term sustainability is assured. What, for example, will happen to the programs currently being funded by the Global Fund at the end of its five-year mandate?
Similarly, how will governments currently providing treatment and care for people living with HIV/AIDS be able to maintain these critical services once the available donor funds are used up?
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Funding the fight against HIV/AIDS is not an altruistic act, but an investment in a global public good. As should by now be clear, this challenge of HIV is not just one more African problem; it will transform and irreversibly damage the continent, with dangerous consequences for the wider world, if allowed to continue on the present path.
When CHGA's commissioners join me in Mozambique on Tuesday, they will be asking how best to maintain essential public services, keep economic development on track, maintain rural livelihoods, defend women suffering the worst consequences of the epidemic and ensure national security - in short, how best to govern a country, despite the distortions of HIV/AIDS.
The Commission on HIV/Aids and Governance in Africa was formed to help African governments understand the challenge that Aids poses to governing African countries. K.Y. Amoako chairs the Commission. He is also the Executive Secretary of the UN Economic Commission for Africa in Addis Ababa, Ethiopia. You can visit his weblog at http://amoako.typepad.com/.
