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Note: This document is from the archive of the Africa Policy E-Journal, published by the Africa Policy Information Center (APIC) from 1995 to 2001 and by Africa Action from 2001 to 2003. APIC was merged into Africa Action in 2001. Please note that many outdated links in this archived document may not work.

Africa: HIV/AIDS Updates

Africa: HIV/AIDS Updates
Date posted (ymd): 990618
Document reposted by APIC

+++++++++++++++++++++Document Profile+++++++++++++++++++++

Region: Continent-Wide
Issue Areas: +economy/development+
Summary Contents:
This posting contains a speech by UNAIDS Executive Director Peter Piot to the May Meeting of African Ministers of Finance and Ministers of Economic Development and Planning, hosted by the Economic Commission for Africa. It also contains a recent posting from the HIVNET forum on recent protests by AIDS activists against U.S. Vice-President Gore, for his involvement in U.S. pressures on South Africa over policies on imports of AIDS drugs.

+++++++++++++++++end profile++++++++++++++++++++++++++++++

[Debt Update: Eurodad, a coalition of European nongovernmental organizations, has produced a new series of background briefings on debt prior to the Cologne G7 summit taking place this weekend. Although it is not yet available on their website at,you can obtain copies of the briefs by writing to The briefings document the inadequacy of the terms likely to be agreed by creditor nations at the summit.]

Economic Commission for Africa

[For more information visit the ECA web site at]

Meeting of Ministers of Finance and Ministers of Economic Development and Planning

Addis Ababa, Ethiopia, 7 May 1999

By Peter Piot, Executive Director, UNAIDS

On behalf of all cosponsoring organizations of UNAIDS, I welcome the opportunity you have given me to speak about a subject that concerns me very much in a continent where I have strong ties of friendship and work, I am talking about AIDS.

It is encouraging to hear in this meeting that overall economic growth rates are up in Africa over the past couple of years - but a continuation of this improvement will be seriously jeopardized by the AIDS epidemic. I feel that it is no means an exaggeration to state that, along with armed conflict, the AIDS epidemic has become the greatest threat to development in much of sub-Saharan Africa.

In this presentation, I would like to raise four issues: 1. The Situation Today

AIDS now affects every country in the world, but it is sub-Saharan Africa that today is the most affected.

By one conservative estimate one-quarter of the population of Africa, 150 million people, has been personally affected by the epidemic. The nine most heavily affected countries in the world are all in Africa.

Let me give you just five shocking figures:

  1. At least 9 million Africans have already died of AIDS, and AIDS is now the first cause of death - last year alone, 2 million died.
  2. Over 22 million Africans are currently living with HIV or AIDS.
  3. There are almost 8 million African children under the age of 14 who have lost their mother or both parents to the AIDS epidemic. Today in many communities, there is not a family that has not lost someone because of AIDS. ...
2. The Impact of AIDS in Africa

Unfortunately, many in Africa and elsewhere still view AIDS purely as a health problem - and of course it is a disease. But in fact, it is much more than this. AIDS is at the heart of the development agenda for Africa. Let me explain why.

First: impact on Households. Those who suffer the consequences first are families. There is, of course, the emotional impact of seeing a loved one die. At the same time families must cope with significant economic loss.

For example, surveys show that one-third of rural households affected by AIDS experienced a 50% reduction in agricultural output.

Income loss like this leads to painful choices. Education can become a luxury. One study, in Cote d'Ivoire, showed that in families where someone had died of AIDS school expenditures went down by half. That means that one-half of the children left behind when someone dies of AIDS cannot realize their full potential.

Second: impact on Economic Sectors. These cruel effects on families are also cruel to countries' economies. As income declines so does purchasing power. Unschooled children mean growing social problems and a loss of competitiveness in a global economy increasingly dependent on knowledge. Food that is not grown must be imported or cuts down on that which can be exported.

In Zimbabwe today half of the in-patients in hospitals are there because of AIDS-related illness. Models show that by 2005, basic AIDS treatments costs will be over 60% of the Ministry of Health Budget -- and this does not even include the very expensive therapies used in high income countries. Zimbabwe is not alone. In Kenya by 2005 AIDS treatment costs will be over 50% of the Ministry's budget.

Studies show that in some countries, the military is two to five times more likely to be infected by HIV than the general population. What are the implications for national security? Teachers are dying of AIDS - for example, one teacher a day in Cote d'Ivoire, not even the most affected country. What are the implications for the education of your youth and for the future of your children? How will these teachers be replaced?

Third: impact on the Private Sector. Several recent studies in Africa show that company profits decreased by up to 20 percent as a direct result of AIDS.

What are some of those costs? HIV and AIDS absenteeism make up 52% of the costs. Recruitment and training of replacement employees made up another 17%. Add to this the hidden impact -- of children not educated because their parents have died and therefore of a reduced pool of skilled labor to replace those lost, and it is easy to see that the costs to the economy will be high.

Projections for South Africa suggest that employee benefits, as a percent of salary, will rise from seven percent to nineteen percent by 2005 because of AIDS. These extra costs and the loss of skilled labor have obvious implications for the efforts to attract high-quality foreign investment.

Fourth and finally: macroeconomic Impact. While we are still working to capture in our models the full effects of the AIDS epidemic on macroeconomic performance, there is no doubt that AIDS is having a significant negative impact in the most severely affected African countries. The keynote paper prepared for this meeting suggests that to meet the goal of reducing poverty by half by the year 2015, Africa needs growth rates of 7 percent per annum. The World Bank has conservatively estimated that countries with high HIV prevalence will lose one percent of GDP growth per capita annually. The cumulative expected loss in Kenya, for example, is expected to be 15% over the next decade. Broader measures of human welfare, such as the UNDP's Human Development Index, are also projected to decline dramatically in the Southern Africa countries because of AIDS.

3. What Can Be Done? The Answers Lie in Africa

I do not want to leave you with the idea that nothing can be done. I would not even be here if I did not believe we can turn the tide of the epidemic. We are not powerless. Much can be done, and some of the answers are already present within Africa. We have growing evidence from at least two African countries - Senegal and Uganda - that a combination of strong political support, broad institutional participation, and carefully selected program interventions can actually lead to declines in the number of new HIV infections and improved care for those who are ill.

This experience shows us that no amount of dollars can make a difference if there is not concerted leadership, at all levels from the head of state to the district level, involving government, in partnership with non-governmental organizations, communities, and the private sector. I see a growing momentum of such political commitment in the region, as evidenced by an increasing number of heads of state speaking up.

There must be openness about the disease and how it is spread. AIDS cannot remain "the disease with no name". People are dying because of ignorance and because of the stigma, humiliation, and fear of retribution that surrounds AIDS. Let's not forget that people lose their job, are out of school, are even killed - only because they have HIV.

We now have many of the essential tools for a successful national AIDS programme - scaling up investing in what we know that works.

One of the most important lessons is that national success in the fight against HIV/AIDS depends on people like you -- Ministers of Finance and Planning - getting centrally and personally involved. Allow me to suggest seven things I believe we can do:

First, to speak out strongly and publicly about the threat that HIV poses to your countries' futures. Such outspokenness will help to mobilize political support and human and financial resources in the struggle against AIDS, your voice on HIV/AIDS will send a powerful message to others.

Second, to help to mobilize more resources for AIDS prevention, treatment, and mitigation activities. A recent study found that in 1997, only $150 million a year was spent in African countries on AIDS prevention. We are currently estimating that well over a billion dollars needs to be devoted to AIDS programs in Africa now, if we are to come to grips with the epidemic.

Where will such a sixfold increase in spending come from? It will come in part from committing a larger share of domestic public funds to AIDS. The study mentioned above found that only a tenth of the reported spending on AIDS prevention in Africa in 1997 came from governments, an average of $0.03 per capita in the countries included in the study. If governments increased their spending on AIDS activities to an average of $0.35 per capita - less than one tenth of one percent of GDP.

Another source can come from redirecting to AIDS existing project resources that are not currently going into fighting the epidemic. There are billions of dollars programmed for upcoming social funds, education and health projects, infrastructure, and rural development, that could be channeled into AIDS activities to support those sectors. This is fully justified, as the AIDS epidemic is undermining the very goals of these other investments.

Third, to shape the resources going to AIDS by indicating to the bilateral and multilateral partners that this is a top priority and a key element in successful development and poverty alleviation. They need to hear this from you. Unfortunately, these same partners are telling us that in their programming discussions, many governments are indicating that they assign AIDS a low priority.

Fourth, to also insist that all sector ministries plan and budget for meaningful AIDS activities. Experience demonstrates clearly that in successful national AIDS programs, education ministries send powerful AIDS messages to pupils and teachers; youth and sports ministries help organize AIDS clubs and counseling centers; transport and construction ministries mount prevent services aimed at truck drivers, migrant construction workers, and others at highest risk of being infected with HIV; the defense and interior ministries actively offer testing and counseling services to those in the armed forces; and so on.

Fifth, to assess impact of economic and social policies as they may increase or decrease the societal vulnerability to HIV.

Sixth, to bring in new partners - NGOs, religious, PWAs, companies - yesterday, in South Africa, 100 million dollars were initiated by the Secretary General of the UN.

Seventh and finally, you are uniquely placed to support the development of a single, powerful national AIDS plan that involves a wide range of government departments, NGOs, the commercial sector, and the international development community. Without this plan, the efforts of the many partners against AIDS in your country will be fragmented, and their impact in halting the epidemic will be lower.

The "bottom line" is that AIDS is a development challenge and must be treated as one. It is as important than any of the other challenges outlined in the keynote paper presented to you for this meeting. And increasingly, we have the tools to meet this challenge.

My last point:

4. International Partnership Against HIV/AIDS in Africa

Acting upon a resolution of the OAU at its summit in Ouagadougou last year, the debates at TICAD II in Tokyo, and many bilateral discussions in recent months, UNAIDS and its seven Cosponsors - the World Bank, UNICEF, WHO, UNESCO, UNDP, UNFPA, and UNDCP - have recently come together in an International Partnership against HIV/AIDS in Africa. All have pledged to work harder, in a more coordinated fashion, with each other and with you, to combat AIDS in Africa.

The vision of such a Partnership would be to ensure that within the next five years, the majority of African countries are implementing large-scale AIDS programs that reduce dramatically the number of new infections, provide care for those already infected, and help to mitigate the impact of the epidemic on individuals, families, communities and nations as a whole.

What are the key features of such a partnership? (1) actions to raise high level political support for intensified national AIDS programs; (2) develop strong national action plans; (3) mobilize greatly increased financial resources for these plans; and (4) develop strong country-based and regional technical platforms to assist program design and implementation.

To be effective, such an international partnership against HIV/AIDS needs to go beyond African governments and UN agencies, to include the NGOs, the private sector, and the international donor community.

Much work needs to be done in the coming months to further develop the partnership and the ownership. But without strong action on the part of everybody in this room, the partnership cannot succeed. As the paper prepared for this meeting says, it is you who must set the agenda for African development. And that agenda must prominently include AIDS.

International development organizations have told us that they, too are ready to be part of the Partnership against HIV/AIDS in Africa.

I am not standing here today to make promises about what we can achieve in fighting the terrible AIDS epidemic.

What I am committing today is to working with you as key partners against HIV/AIDS. Mr Chairperson, Ladies and Gentlemen, AIDS is not just another new problem that the world, including Africa, is facing. It is severely undermining development, with millions of lives in the balance. It is becoming a true "development emergency" for Africa. The time for action to confront this emergency is now. AIDS must become everybody's business. We need a broad coalition if we are to succeed. We are ready to join this coalition with you. Let us begin immediately so we can win this fight.

Thank you.

Excerpt from a posting to
To read previous postings from the forum visit:

Hivnet also hosts other forums on HIV/AIDS, including AF-AIDS (

For an extended background article on the issue, see John B. Judis, K St. Gore, in The American Prospect for July-August 1999 (

AIDS Activists confront VP on African drug policy
Thursday June 17, 1999 , Manchester NH

AIDS activists took over Vice President Al Gore's second campaign stop this morning in Manchester, New Hampshire. The activists were protesting Gore's instrumental role in preventing AIDS medications from reaching people in developing countries, including South Africa and Thailand.

Five protesters, organized by the local chapter of AIDS Drugs for Africa, disrupted Gore's campaign speech with noisemakers, chants and banners reading "GORE'S GREED KILLS: AFRICA NEEDS AIDS DRUGS." They were seated directly behind Gore in the audience of 300 in the Hesser College Gym.

"After our protest, Gore said AIDS drugs for Africa are very important. Yet, he is personally standing in the way of cheap, life-saving treatment for Africans with HIV", said Moshe Mizrahi, a protester. "I guess Gore does have strong family values after all; he has family ties to the pharmaceutical lobby and he's killing people on their behalf."

Gore's domestic policy advisor, David Beier, is the former head lobbyist for Genetech, a major U.S. pharmaceutical company. Tony Podesta, top Gore advisor and brother of Clinton's chief of staff, is currently the contracted lobbyist for PhARMA (Pharmaceutical Manufacturer's Association) and most other U.S. drug interests. Tom Downey, close Gore associate and former congressman, lobbies for Merck pharmaceuticals. Gore fundraiser Peter Knight is a former Schering-Plough lobbyist.

Gore has vehemently opposed the practice of "compulsory licensing", which allows local companies to produce cheap, generic AIDS drugs. He has threatened sanctions against the South African government unless President Thabo Mbeki calls a halt to generic drug production. Compulsory licensing is legal under current international trade agreements, and provides royalties to patent owners. AIDS medications would be available at 10% of their American price.

Currently, 22.5 million Africans are HIV-positive, including up to 26% of young adults, and totaling 67% of the world's HIV+ population. Virtually all are poor and unable to afford treatment at American prices. Most AIDS deaths in developing countries result from lack of access to drugs for treatable infections. Average income in South Africa is $2,600/year, and name-brand AIDS drugs cost around $12,000/year.

Pharmaceutical companies based in the U.S., long under attack for price-gouging at the expense of human lives, have claimed that the high cost of treatment reflects their production expenses. These companies stand to lose credibility as generic drug licensing exposes the true low cost of AIDS drug production; which may prevent them from continuing to drastically overcharge in first-world markets.

"Gore's abuse of power is a campaign issue," said Anna Janssen, a local AIDS activist. "He's taken a position, for the sake of earning points with lobbyists, that absolutely guarantees millions of deaths. Now he wants us to place our fate in his hands as President. Personally, I don't dare."

Local chapters of AIDS Drugs For Africa have vowed to confront Gore at every campaign stop.

Contacts : John Riley Email:

This material is being reposted for wider distribution by the Africa Policy Information Center (APIC). APIC's primary objective is to widen the policy debate in the United States around African issues and the U.S. role in Africa, by concentrating on providing accessible policy-relevant information and analysis usable by a wide range of groups and individuals.

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