By almost any measure, the war on AIDS is more important than the war on terrorism. Yet Washington’s fixation with the latter—still loosely defined—campaign threatens to crowd out attention to Africa’s priorities. And those priorities, from obtaining support for international peacemaking and peacekeeping, to canceling illegitimate debts and arresting the growing disparities between rich and poor in the world, to defeating the AIDS pandemic, are all equally global priorities.
In 2001, African leaders, as well as African and international civil society, successfully promoted wider recognition of the urgency of responding to the HIV/AIDS pandemic. At the World Trade Organization’s summit held in Doha, Qatar in November 2001, developed countries were forced to acknowledge the principle that public health must take priority over rigid patent protections.
African leaders also formally launched the transformation of the Organization of African Unity into the African Union, which will hold its inaugural summit in South Africa in July 2002. They also reached agreement on the New Partnership for African Development (NEPAD), intended to serve as a common platform for economic planning and negotiating with international partners.
There was no major escalation in African conflicts during the year. Ceasefires remained in effect in the Democratic Republic of the Congo, in Sierra Leone, and on the Ethiopia-Eritrea border. However, warfare continued unabated in Sudan and Angola, while civilians were threatened by systematic violence in eastern Congo and by serious if less pervasive abuses in a number of other countries.
In 2002, with African economies battered by the global recession, the AIDS pandemic still unchecked, and the threat of new conflict in key countries such as Zimbabwe, Nigeria, and Kenya, the challenges for both African leaders and the “international community” will be enormous. The prospects are sobering, and the initial responses to the first high-profile tests of the year—in February a volcano eruption in already-devastated Goma in eastern Democratic Republic of the Congo, and an arms depot explosion in Lagos, Nigeria—are not encouraging. Nevertheless, the groundwork has been laid for the first large-scale effort to fight back against AIDS. And African resilience and creativity still take unexpected forms, as illustrated by the launching of two new Internet service providers in Somalia within months of the shutdown by U.S. financial sanctions of the one previous provider which Washington accused of having links to international terrorism.
Last year saw major advances on international AIDS policy: Activists joined in forcing multinational drug companies to withdraw a suit challenging South Africa’s right to obtain more affordable medicine, and developing countries at the World Trade Organization summit won acknowledgement of the primacy of public health over patents. African leaders held a summit on AIDS in Abuja, Nigeria in April, and the UN staged a special session of the General Assembly in June. The principle that treatment and prevention are both indispensable became the official consensus, despite footdragging in Washington. UN Secretary-General Kofi Annan’s global health fund had moved from idea to institutional reality by the end of the year.
Despite modest increases in availability of lower-priced drugs, however, a study by international health experts estimated that at the end of 2001 only 200,000 of more than 7.5 million HIV-positive people who could benefit from antiretrovirals were receiving treatment (http://www.africaaction.org/docs01/par0112.htm). The UN’s Global Fund estimated it would only have between $500 million and $700 million to spend in 2002, less than 10% of the estimated amount needed each year. And, despite stronger declarations on AIDS by African leaders in Abuja, New York, and increasingly at home, the test of matching speeches with action was still largely unmet.
The issues in 2002 in the war against AIDS will be both operational and political. At the operational level, key tests will be whether the resources allocated to the global fund begin to flow to those on the frontlines to be used both to save lives and to build local capacity. Many fear that contributors to the fund will cut resources for other urgent needs, as in President Bush’s budget proposal that reduces other international health funding by $95 million. The fund is also intended to provide resources for tuberculosis and malaria, and competition for funding will be intense. Activists will be watching closely to see whether treatment with antiretroviral drugs at the lowest cost gets significant resources, and whether the multilevel country mechanism facilitates funding or imposes additional delays. Opponents of public funding for global health will be looking for excuses to deny additional resources.
At the political level, the two greatest impediments to the fight against AIDS—disregard and denial—are epitomized by two leaders who ostentatiously failed to attend the special UN session on AIDS last year: George W. Bush of the United States and Thabo Mbeki of South Africa.
Mbeki’s denial and ambivalence is still crippling the South African response to AIDS. By opposing treatment for South Africans with HIV/AIDS, his government has come into conflict not only with AIDS activists but also with the medical community and much of its own political base. Unless Mbeki shifts course, this confrontation is certain to escalate.
Bush, for his part, symbolizes outright disregard for the fate of those with AIDS. Despite congressional resolutions calling for contributions of up to $750 million, Bush’s budget proposal for the fiscal year beginning October 2002 included only $200 million for the Global Fund, the same meager level as the current fiscal year. There is momentum for mobilizing more resources on AIDS in 2002.
Unfortunately, the chances are much less for forcing a serious global debate on the fundamental economic obstacles that weaken African capacity to confront the pandemic. While European and Canadian leaders at least acknowledge the need for debate, the Bush administration has shown no signs of openness. The president’s State of the Union address at the end of January contained no mention of AIDS, global health, poverty, or any other global or African issue except terrorism.
In December 2001, the World Health Organization Commission on Macroeconomics and Health released the results of its two-year study showing that scaling up global investment in health would produce enormous economic gains. The report provides a wealth of supporting arguments in favor of investment in public goods such as health, education, and other infrastructure as essential prerequisites for development on all fronts. At the beginning of 2002, however, there were few signs that there would be breakthroughs in the continuing debates on trade, aid, and debt.
Meanwhile, the International Monetary Fund announced that estimates of the economic growth rate for the African continent in 2001, with the added impact of September 11 and the global recession, fell to 3.5% (just 3.1% in sub-Saharan Africa). Prospects for recovery in 2002 were not strong.
A multi-year UN effort to promote new thinking about global financing for development culminates in March 2002 in Monterrey, Mexico. The framework agreed for the conference contains many common elements with the New Economic Partnership for Africa’s Development (NEPAD) framework adopted by African leaders in 2001: new “ownership” of economic development plans by developing countries, mobilizing domestic resources, “untying” of aid in favor of support for agreed plans, regional cooperation, greater access to markets in developed countries, increases in both donor support and private capital flows, and debt reduction.
Behind the bland language of these compromise documents lie substantial disagreements on particular issues, such as trade, aid, and debt reduction.
Trade: Promise & Reality of Market Access
Washington and the international financial institutions continue to stress trade liberalization, along with other measures to attract foreign investment, as the high road to development. Yet while the pressure on developing countries for more liberalization continues unabated, opening rich country markets remains a pious wish. As IMF director Horst Koehler stressed in January, rich countries still spend hundreds of billions of dollars on subsidies “in areas where developing countries have a comparative advantage—as in agriculture, processed foods, textiles and clothing, and light manufactures.”
Meanwhile, African exports continue to be concentrated on vulnerable primary commodities. High-profile initiatives such as the U.S. Africa Growth and Opportunity Act have had little impact on this pattern. The second report on the act released in January by the U.S. International Trade Commission, for example, shows significant increases in U.S. imports from Africa in 2001, but these imports were overwhelmingly dominated by oil and other energy-related products.
Aid: How Much & Who Decides
European countries and the World Bank have joined UN agencies and African countries in calling for significant increases in official development assistance, arguing that such investments in health, education, and other sectors are indispensable requirements for economic advance and poverty alleviation.
UN Secretary-General Kofi Annan has won significant support from other “donors” for the goal of doubling official development assistance. U.S. Treasury Secretary Paul O’Neill has joined critics of the conventional development model in calling for a shift from loans to grants to finance development in the poorest countries. At the same time, however, O’Neill has seized every opportunity, including the World Economic Forum held in February 2002 in New York, to reiterate Washington’s hard-line refusal to accept even a rhetorical commitment to providing increased funds.
The Monterrey Consensus on “financing for development,” (http://www.un.org/esa/ffd/) which was agreed in advance of the March meeting in Mexico, notes “with concern current estimates of dramatic shortfalls in resources required to achieve the internationally agreed development goals.” Yet debate in Washington has remained largely mired in the stereotype of aid as optional and wasteful charity. Without a shift in paradigm (partially visible in the debate over the global health fund), public investment for global and African development is likely to face further setbacks rather than gains in Washington.
Debt Reduction: HIPC or More?
Despite claims of success by creditors for their Heavily Indebted Poor Countries (HIPC) initiative for debt reduction, the IMF estimated that Africa’s debt service payments would only go as low as 17.1% of export earnings in 2001 (down from 20.3% in 1999), before rising again to 18.4% in 2002. This is still a crippling economic burden, as African leaders as well as debt cancellation campaigners continue to stress. The overwhelming majority of the debt is owed to the World Bank and the IMF. But neither the international financial institutions nor the rich creditor countries gave any indication they were willing to consider more than marginal adjustments in the HIPC program.
In 2002, there will be abundant opportunities to discuss these issues and the related fundamental economic inequalities: in Monterrey, Mexico at the financing for development summit in March; in Canada at the G-8 summit of rich countries; in South Africa at both the inaugural summit of the African Union in July and the World Summit on Social Development in August. Without major shifts in the political climate in rich countries, however, the prospects for change on these issues are slim.
At the end of 2001, in most African countries the structural violence of disease and economic injustice posed much larger threats to human security than the reality or risk of open conflict. While fragile, implementation of the peace processes in Sierra Leone and on the Ethiopia-Eritrea border advanced significantly during the year. The principal zone of instability and humanitarian need on the continent continued to be the region extending from Angola in west central Africa through the Democratic Republic of the Congo, Burundi, Rwanda, and portions of Uganda to Sudan in the northeast.
With the U.S. and other outside powers preoccupied with the threat from global terrorism following September 11, focus on resolving Africa’s internal conflicts may well rank even lower on the agenda of the “international community” than in 2001. Even if overt U.S. intervention, as speculation focusing on Somalia suggested early in the year, does not occur, the tendency to reinforce selected partners and ignore human rights abuses under the guise of fighting terrorism is certain to be powerful.
Agreed peace processes with very uncertain outcomes were under way with limited international support in the Democratic Republic of the Congo and Burundi. Progress toward greater security in 2002 would require significantly greater political will from both contending parties and outside mediators. Both countries remained among the most serious humanitarian emergencies in the world, together with Sudan and Angola.
Despite a limited ceasefire in the Nuba Mountains region in Sudan at the beginning of the year, and increased civil society pressure for peace in Angola, the prospects for a breakthrough to a genuine peace process in 2002 were not high in either country. Major outside powers seemed more likely to show interest in expanded oil production in both countries than in the search for peace. Implementation of sanctions against “conflict diamonds” remained inconsistent. Trade in diamonds, timber, and valuable minerals such as coltan continued to provide resources for conflict in Angola, central Africa, and the Mano River area in West Africa.
Elections in a number of African countries during 2001, including Benin, Chad, Gambia, Madagascar, Uganda, and Zambia, added to skepticism about manipulation of the process by incumbents, violence, and other barriers to democratic participation. In each case internal and external criticism was vocal, but the threat of open internal conflict was avoided.
With Zimbabwe due to hold elections in March, Kenya before the end of 2002, and Nigeria early in 2003, the danger is great that repression, manipulation, and other tensions leading up to elections could provoke escalated conflict. This would have enormous consequences not only for the countries themselves but also for their regions within the continent, and for Africa’s efforts to address continent-wide problems.
Europe and the United States are stepping up pressure on Zimbabwe President Robert Mugabe to allow free elections and reduce violence, but Zimbabweans themselves and their neighbors in southern Africa will be the ones who will largely determine what happens and who will bear the brunt of further deterioration in that country. So far, Mugabe shows little sign of heeding calls for restraint from any quarter.
In Nigeria, internal violence due to multiple causes is rising in this pre-election year. Instead of promoting security, the Nigerian military has contributed its own share of violence against civilians. Many question the capacity of President Olusegun Obasanjo’s government to maintain stability and deliver on the promises of democracy. Kenyans meanwhile fear a repetition of the last elections in 1997, when government-instigated violence and opposition disunity helped return incumbent President Daniel arap Moi to power.
Pro-democracy activists in these three countries and around the continent are profoundly skeptical of political elites as a substitute for democracy offer nationalist rhetoric, managed elections, and violence against opponents. But they are also skeptical of outside powers which have been inconsistent in their support for democracy and conflict resolution. To cite only a few examples, Western critiques in 2001 were almost inaudible with respect to the lack of democracy in Egypt (Washington’s favored aid partner) Sudan (being wooed as an oil-producer and security ally), and Zambia (with an election widely regarded as fraudulent).
In 2002, there are multiple threats to human security in Africa. To meet those threats, Africans and others must collaborate in a broad vision to prove that another Africa in a different world order is possible. Fortunately, there are hints of greater awareness by some among world elites of the threats to our common humanity. But the narrow visions of free-market fundamentalism and militaristic counterterrorism still hold sway among global policymakers.
The advances in the AIDS debate in 2001 demonstrated that small steps can lead policy in strategic new directions. In 2002, the challenge will be to continue the strategic advances.