Africa's HIV Journey

HIV

Last week, thousands of delegates gathered in Washington for the 19 th International AIDS Conference. There are still daunting gaps between where we need to be and where we are on AIDS.

We are yet to reach the United Nations target of getting 15 million HIV patients on anti-retroviral drugs. There is still no HIV vaccine.

Many who are infected do not know their status—even in advanced countries like the United States. Central to the progress has been Africa.

Despite these and other gaps, there was a lot of optimism based on the progress made.

The optimism was based on the solid accomplishments of the last twenty years.

In 2010, over 6.5 million people received anti-retroviral drugs and millions were tested.

As former US President Bill Clinton told the conference, 'All of you have created the possibility that we could have an AIDS-free generation.'

Africa has been, in large part, the frontline of the fight against HIV. For a variety of reasons, it is home to a disproportionate number of HIV patients. Due to the cost of medications, HIV was virtually a death sentence in Africa. In 2003, barely 50 thousand Africans with HIV were on medications. Most of the world agonized about the cost of getting so many people on medications. The medical community, aside from cost, worried about whether uneducated Africans could adhere to complex drug regimens and about drug resistance that might emanate from non-compliance.

Then America—or more specifically—George Bush, stepped in with the President's Emergency Plan for AIDS Relief (PEPFAR). This plan committed 16 billion USD to the fight against HIV, Tuberculosis and Malaria. To date, about 46 billion USD has been spent in these efforts. The US effort has been in tandem with the Global Fund for AIDS.

The results have been spectacular. The 50 thousand on HIV drugs in 2003 grew to 2 million in 2005 and then about 4 million in 2008. Currently, it is estimated to be approaching 5 million. These investments have saved millions of lives across Africa. Every day, in my practice as a physician in Africa, I see patients who are alive because of resources made available through these programs.

To be fair, many have contributed to the progress made against HIV. Amongst these are scientists, African leaders like Uganda's Yoweri Museveni and thousands of dedicated Doctors working in the remotest corners of Africa.

Despite the contributions of all the others, the contribution of America to fighting the HIV pandemic has been exceptional. From the discovery of the disease, to the search for a cure, to the provision of resources, the Americans have led the world.

It is ironic that the President who addressed the HIV conference was Bill Clinton and not George Walker Bush. While Mr. Clinton's foundation has done some good work in the AIDS fight, the pride of place in the fight against AIDS should go to President Bush and his team, including Colin Powell, Condi Rice and Bill Frist.

Admittedly, many Americans have contributed to the fight against AIDS and all deserve thanks from Africa. However, our reluctance to acknowledge the contributions of Mr. Bush, which is strangely shared by many Americans, is baffling.

Part of this wilful neglect of the truth comes from the popular African perception that Republicans are anti-black and therefore not friendly to Africa. This belief endures despite significant evidence to the contrary. Here are a few facts that fly in the face of the myth of anti-black and anti-African Republicans.

First, the Republicans ended slavery through President Lincoln's emancipation proclamation.

Second, it was the Republican President, the elder George Bush who sent American forces to help stabilize Somalia in 1992.

The third, of course, is the role of President Bush in the HIV fight.

On the other side, despite the universal assumption that Democrats are our friends, there have been a few instances when Africa has come out on the short end when Democrats have been in power.

The obvious example was the Rwandan massacre when the Clinton administration stood by, while 800,000 Rwandans were killed by their countrymen in 1994.

With respect to President Bush, our ingratitude to him may also be fuelled by the unpopular Iraq war and the revulsion that the entire world felt at his indifference to world opinion in the lead-up to the war.

Interestingly, our reluctance to credit some of those who have been heroes in the fight against HIV may be matched by our reluctance to blame those who have contributed to the spread of the epidemic. Amongst these are the irresponsible promiscuity of African men who refuse to use condoms, the lack of empowerment of African women with respect to their reproductive rights, decades of under-spending by African governments on health infrastructure and the bigotry of those who should know better. For instance, recently in Ghana, I watched a priest and AIDS activist living with HIV recount how, after testing positive, he had told his supervising priest. The supervising priest, instead of offering support, had denounced this man to his church and had him ostracized.

Going forward, the best approach is for Africa to appreciate America and its generosity towards our continent, particularly in the fight against HIV.

We should respect and honour all Americans whose deeds show that they are truly Africa's friends, regardless of their party affiliation or their race.

While the world can afford to show ingratitude to those who have made lasting contributions, Africa cannot. We must encourage new friends to step forward by celebrating old friends.

As I write, spending on PEPFAR, the Bush programme that anchored the significant progress made in the fight against AIDS, is expected to decrease by 12% next year, according to the budget proposals of the Obama administration.

Thanking and celebrating President Bush will be a clear message to President Obama that we will remember and celebrate our friends.

Let us begin by having the Africa Union nominate President Bush for a Nobel Prize, in appreciation for his contributions to the fight against HIV.

Furthermore, let our governments make the necessary investments in our health through public education and improvement in our infrastructure. I fear that as the American money dries up, HIV will rebound with a vengeance and our people, once again, will die like flies.

Finally, let us attack the bigoted attitudes and ignorance that have become allies of this dreaded disease.

God bless Africa.
By Arthur Kobina Kennedy