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The Scourge of AIDS in Africa

ISSUE:  Winter 2006

In August 2001, I was strapped into the passenger seat, speeding along the highway between Johannesburg and Pretoria, the capital of South Africa. On the edge of every shantytown and encampment, we passed two invariable landmarks: shacks with men selling stacks of tires and large billboards with slogans like “Condoms make it safer” and “Be wise, condomise.” I asked Naas, our guide and driver, about the tires. “Patched and retread from blowouts,” he explained. “For the taxis.” The taxis were really minivans, crowded tight, mostly with women, headed for service jobs in either of the two cities. Their drivers cover hundreds of miles each day—always speeding, always on treads worn so thin that they are in constant danger of high-speed blowouts.

It’s hard not to read such things as emblematic of larger ills in Africa. The entire continent is threadbare, hurtling forward, and constantly on the brink of catastrophe. Of course, that brink is frequently breached—whether by genocide, as in Sudan, or by natural disaster, such as the recent drought in Niger. Americans have always been vaguely aware of such problems and always made good-faith, if misguided, efforts to help. I remember too well plinking away on a cheap Casio keyboard, while the chorus of my classmates earnestly belted out “We Are the World” in the bleak auditorium of my middle school in Pittsburgh, all in an effort to raise money for the starving in Ethiopia. That was 1985, when we still thought such things—Band-Aid, Live Aid—were all it would take to save Africa.

Then came the era of AIDS—an era shrouded in the silence of our government’s unwillingness to discuss publicly a sexually transmitted disease, an era clouded by our own lack of moral clarity toward peoples of different races and different cultures with different sexual mores. Were that not enough, in 2001, within a month of my return to the United States, everything changed—as we’ve grown accustomed to saying. Our well of sympathy for those struggling on foreign soil went dry overnight, and there was little to refill the fount, as rumors swirled first in 2001 that Osama bin Laden had fled to Somalia and later in 2003 that Niger had supplied yellowcake uranium to Saddam Hussein. Though neither claim proved true, we now live in times where the shadow of doubt stretches wider and lingers longer than ever before.

To say we have forgotten the problems of Africa in the last four years would be an understatement. Our government has suspended many of the programs that allow for resettlement of political refugees. We have turned away from enforcing UN demands on African dictators. Worst of all, the Bush administration has made promises for political gain, then broken them for political expediency. In March 2002, for example, President Bush proposed the Millennium Challenge Account, a program by which the United States would increase aid by 50% over the next three years, resulting in an annual increase of $5 billion by fiscal year 2006. Yet, in January 2005, as FY06 approached, Bush requested only $3 billion to fund Millennium Challenge, and Congress cut that amount to $1.75 billion without a struggle from the White House—leaving barely a third of what was originally promised. Little notice has been paid to this broken promise or what it means for Africa.

Let’s be clear. The result of our inaction is not simply that programs for AIDS go “underfunded.” We cannot accept such bureaucratic language any longer. The real result of our inaction is that 7,000 people die in Africa every day. Rockstar-turned-activist Bono has rightly taken to describing this number as “two 9/11s per day.” The tragedy of September 11, 2001, is in no way to be minimized, but as Jann Turner points out later in this issue, the most painful images of that day were the photographs of people hanging from the burning towers, knowing, as we did, the certainty of their deaths. But why then are we not moved by the deaths of so many in Africa? Should they not be that much more painful to us, knowing that they are avoidable deaths? And they are avoidable. Indeed, with the aid of antiretroviral drugs, people living with HIV and AIDS experience what is known as a “Lazarus effect,” where the near-dead rise from their sickbeds like Lazarus risen from the grave to walk again among us. Yet only 3% of the 4 million Africans in immediate need of such drugs have access to them. Many of these drugs cost only a dollar a day, but most Africans can’t afford this. For less than $1.5 billion annually, we could supply antiretrovirals to the entire continent.

However, it is not merely a matter of treating those already HIV-positive; it is also important to stop the spread of the disease. UNICEF, which recently launched its campaign “Unite for Children, Unite Against AIDS,” estimates that 1,400 children die of AIDS-related illnesses every day, but even more alarmingly an additional 1,800 children under the age of fifteen become newly HIV-positive in that same twenty-four hour period. Of these, the Africa aid organization DATA (Debt, AIDS, Trade, Africa) estimates that 1,400 are infected during childbirth. According to AVERT, an international AIDS charity, inexpensive drugs are already available that reduce the chances of a mother transmitting HIV to her child during birth from 40% to 2%—but the United States does not currently fund aid for these medications. As a result, in the next twelve months alone, nearly half a million children, who could have been born healthy, instead will be born HIV-positive in Africa. Most will not live to adulthood. Any way you look at it, millions of children will die from an avoidable infection and a treatable disease.

There is a lot of talk in the halls of Washington these days about morality, about reestablishing America’s moral authority, about returning to our country’s Christian values. How can any moral American—much less any self-
proclaimed Christian—turn away from this challenge? These are the poor. These are the meek, who shall inherit the earth. Before we rush to hang the Ten Commandments in every courthouse, let us first enshrine in our hearts and minds the wisdom of the historical Jesus as set forth in the Beatitudes and the Sermon on the Mount. One need not be churchgoing to share reverence for such teachings. For once in this country, let us remember that the first shall be last, and the last shall be first.

But, if our consciences are not enough, can we at least act in our own enlightened self-interest? Who do we imagine the millions of AIDS orphans, those who avoid infection, will grow up to be? If, as it appears, al Quaeda has gained a foothold in eastern Africa—Somalia, Kenya, Ethiopia, Rwanda, Sudan—then we must do everything in our power to show America’s right, and not only its might. If we fail to act now, if we fail to show our compassion, then Africa could easily lapse into the same extremism that consumes the Middle East. If we really mean to make our world safer, then we must work to make allies of our potential enemies. We must befriend now or defend later. This is the choice we face—and what a luxury we enjoy to have such options before us.

Africa has no such choices. The vast majority of the continent shares a common fate without any say in their future. Like those crowded minivans, rushing from the countryside toward Pretoria and Johannesburg, they are merely passengers at the mercy of an unknown driver. I think of them—and the fate of their nation and continent—every time I recall passing yet another tire stand, piled high with repaired radials and whitewalls.

“Are they safe to drive on?” I asked Naas, who answered instead with his own question, “Would you drive on them?”


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