A letter from KAWI Director Prof. Ed Karanja, that appeared in several National Daily Newspapers on October 2, 2003.
The letter is concerned with the issue that ODI funding or international aid is not the only consideration in the fight against AIDS and is a response to a speech made by Stephen Lewis, UN Ambassador to Africa for the Secretary General.
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WHILE I have never met him, I have but absolute respect
for Mr. Stephen Lewis, the former Canadian Ambassador and the current
Ambassador to Africa for UN Secretary General Kofi Anan.. I have read numerous
speeches and publications on Aids pandemic by Ambassador Lewis and all these his
writings exude qualities of fearlessness, profound care, sincerity and deep
commitment to helping and assisting those within the African continent who are
infected and affected by the scourge. Indeed, the Secretary General Kofi Anan
could not have appointed a more dedicated individual.
His speech at Nairobi's ICASA (September 22---"Africa Can't Do It Alone..")
was
vintage Lewis.. the eloquent and vehement crusader against HIV/Aids. As he has
done so often before, he challenged the Western nations to demonstrate
greater concern to the HIV/Aids ravaged continent by giving Africa more money to
fight the epidemic. The logic behind his well-received speech was quite simple:
the more money the West gives Africa, the more affordable relevant drugs
shall be, the more VCT scan be set up.... and the more effective shall be the
campaign to control the pandemic. Naturally, the speech was received with a
thunderous applause. After all, a call for more money among the poor is music
to a lot of ears. There is absolutely no question about it, we need money,
lots of money to slow down, least stop the Aids pandemic.
However we should ask, is money the sine quo non, the absolute condition without which Aids war cannot be won as implicitly claimed in Lewis' speech? That is, Lewis seems to suggest that if the West donates lots of money, then the Africa war against Aids is likely to be won. But is this true, we must ask? I am inclined to think not.
Yes, I grant along with many that buying antiretrovirals and other relevant drugs is an expensive exercise. It is indeed so onerous that only a handful in Kenya and Africa have the wherewithal to afford the drugs. Indeed, many who could have been saved have died because they could not afford them. It seems to follow that we need money to buy this badly needed medicine. I concede moreover, that setting up voluntary counseling and testing centers (VCTs) is another critical strategy in our battle against Aids. I agree furthermore, that this is also another money-guzzling exercise and only with the donor financial support can we engage in such.
The array of Aids-related needs notwithstanding, pouring tons of money into a country , even if such were physically doable, is not in itself going to make an iota of difference in the war against Aids. Money ,and especially donors' money, is certainly not the panacea of the Aids problem. It is becoming exceedingly clear that the success of the war against Aids must rest as much on the domestic initiatives and policies as on the external assistance.
A critical concomitant strategy in the Aids war that Lewis must include in his exhortations is the war on corruption by the recipients of Aids money. Without strategies on how to fight corruption, advocating for more money to fight Aids will be ineffectual and is even potentially counterproductive. Kenya is unquestionably a case in point where availability of money has not translated into success story or even made a dent in the Aids scourge, theatrics notwithstanding.
Millions of shillings (most of it in loan form) have been spent in the war against Aids in the last couple of years but those involved in implementation of the relevant programmes would be hard pressed to point to any empirical evidence of success. We know moreover that millions of said money has gone into lining people's pockets while hundred have continued to die each day. Yet, those in the vanguard of the war have always told us that with more money, the war is winnable.
As the tide of skepticism has increased, it has been established that our National Aids Control Council (NACC) while under the directorship of Dr. Gachara lavishly spent over 80% of its donated money on emoluments, salaries and administration expenses and only a pittance in rendering services to those infected and affected with Aids. The former director shamelessly and obscenely hogged over 2 million shillings in monthly salary while the people she served died. Yet, while her behaviour would be deemed unconscionable and even criminal in some quarters she still had defenders, sympathizers and even admirers. Would more money then mean greater success in war against the scourge? I am highly skeptical.
Besides the essential war on corruption, we also urgently need a paradigm change in terms of our general strategy for the mobilization of resources for fighting Aids. We need to make a radical change from the view that money to fight Aids will come and must come from outside. We need to own the problem of Aids and transcend the whining and begging. We must strategize on how to generate money from within. Why, for instance, not institute a levy that would go towards fighting HIV/Aids? Why not annul some one or two holidays we have and the earnings from that day(s) work go into fighting Aids? After all, we have more holidays than rich countries from which we are begging for money. Won't such homegrown strategies force us to own the Aids problem and, as a result, make us more sensitive and more vigilant in punishing those who dare steal from our Aids kitty? I think we would more intolerant of the rogues we have hitherto put up with.
So, what then do we make of Lewis' vehemence and good-intentioned call for more money for Africa to fight the Aids virus? We support Lewis but we do so with a caveat. Lewis needs to couple his noble call with an equally vociferous demand that the recipients of Aids money be responsible, accountable and transparent. Moreover, he should request that before the donors dole out Aids funds, they must ensure that concrete mechanisms providing independent monitoring of funds have been put into place to ensure that funds go into where they are intended. Without such a precautionary step, we have no reason to be rationally convinced that a call for more money this year will make any difference to the infected and the affected than a call for more money last year.
Edward Karanja
KENYA AIDS WATCH INSTITUTE
(KAWI)