Global Policy Forum

The AIDS crisis has slipped off radar screens in the West thanks to heightened awareness on prevention and improved drugs to treat the disease. However the disease is laying waste to the continent of Africa, weakened by a decade-long debt crisis that has systematically undermined the health and education system. The combination of AIDS and Debt has been deadly - and has highlighted more than ever the scandal of the debt crisis which has extracted scarce resources from impoverished people.

Recent research by the United Nations AIDS programme in Geneva have shown that the world-wide total of people infected with HIV is 33.4 million, up from 27.6 million last year. There are 16,000 new HIV infections every day. 95 per cent of the infections have occurred in regions with the highest debt burdens in particular Africa., but also Asia and Eastern Europe.

The worst hit region is sub-Saharan Africa, where 70 per cent of all new infections and 80 per cent of deaths occur. UNAIDS estimates that there are 22.5 million people with HIV/AIDS in the region. Since the first AIDS deaths were recorded in the 1980s, 83 per cent of the world's AIDS deaths have been in sub-Saharan Africa, and 95 per cent of the world's AIDS orphans are African.

Carol Bellamy, executive director of the United Nations Children's Fund said that "the virus is already wiping out almost at a stroke, the substantial reductions in child mortality that were achieved in the 1980s and the first part of this decade. AIDS is well on its way to producing tens of millions of orphans."

In four countries – Zimbabwe, Botswana, Namibia and Swaziland - more than one in five adults are now infected with HIV. In Zimbabwe it is 26 per cent, in Botswana 25 per cent and in Namibia, Swaziland and Zambia 18 to 20 per cent. Uganda has the heartbreaking distinction of having the largest population of orphans in the world. 1.7 million children have lost their mother or both parents to AIDS.

Janat Mukwaya, Minister for Gender, Labour and Social Development in Uganda said: "Like a vast thresher, AIDS has churned through our fertile land with ruthless force, cutting down the young, the educated, so many of our people in the prime of their productive life." She stated that the human tragedy was compounded by a social welfare crisis -as people were forced to go without treatment for AIDS, because of the high cost of antiretroviral drugs that have kept patients in industrialised countries alive and healthy.

It is no coincidence that the AIDS crisis has exploded most dramatically in highly indebted countries. The impact of the debt over the last two decades in systematically diverting resources from health and education towards unproductive debt servicing has had devastating results. Many countries in Africa spend four times as much on servicing their debts as on health. Tanzania spends nine times more on servicing its debts than on basic health. The fall in expenditure in education and health has undermined the basic preventative measures needed to address the scale of the disease - such as health education, supplies of reliable condoms or ante-natal drugs treatment needed to prevent the spread of HIV. A fragile healthcare system has then been unable to cope with the ensuing spread of infection. The sudden influx of patients has brought many hospitals in indebted countries to the brink of collapse.

"The AIDS crisis thrives on poverty, social disruption and ignorance. Debt and structural adjustment have been instrumental in creating this situation through falling investments in health, the introduction of user fees for health and education and growth in unemployment," said Dr Dorothy Logie of Medact, an organisation of health professionals in the UK. "AIDS is also a marker of injustice and lack of human rights, especially women's. AIDS has spread dramatically as men have been forced to migrate to the cities in search of work - and have exploited women selling street sex in order to stay alive and feed the family."

Zambia is a typical example. Zambian GNP per capita is $390, but each Zambian owes $720 to foreign creditors. Each year the Zambian government spends $17 per person on health and $30 per person on debt service to western financial institutions. Contrast that with the nations of the G7 (the US, the UK, Canada, France, Italy, Germany and Japan) where governments spend $2,300 per person on health care.

Zambia's weak health service has been unable to cope with the rapid spread of AIDS. The treatment of AIDS is very costly. The average cost of treatment in the North amounts to about £10,000 per person each year. In Zambia 20% of the population is now HIV positive, and it is estimated that around 9% of Zambian children under 15 have lost a mother or both parents to AIDS. Yet the Zambian government has only $17 per person to spend on health. Life expectancy has now dropped to 43 years, and is expected to decline still further as AIDS continues to take its toll. Zambia is not alone. The expenditure on healthcare throughout Africa is pitiful. The astounding figures in Africa include: Kenya $8; Uganda $9; Cote D'Ivoire; $25; Burkina Faso, $54; Ethiopia $3.

Ann Pettifor, Director of Jubilee 2000 Coalition, said, "Continuing to demand debt payments above healthcare is a scandal - even more so in the context of this appalling AIDS epidemic. Creditors in the west must recognise that every dollar they take in debt service is another dollar that could be spent dealing with AIDS' deadly toll. While rich countries are beginning to cope with the AIDS crisis, the poorest countries are unable to afford simple measures that would limit the spread of the disease and care for those who are suffering."

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