AIDS and the World Bank: Global Blackmail?

By Patricia Nell Warren, A&U Magazine. Posted June 27, 2000.

Earlier this year, South African president Thabo Mbeki, already known as an independent thinker, made world headlines when he sent hand-addressed letters about AIDS to President Clinton, and to U.N. Secretary-General Kofi Annan and other world leaders.

What grabbed the headlines was Mbeki's questioning whether Western approaches to AIDS theory and treatment were right for African countries. Mbeki defended his right to consult with AIDS dissenters. He asserted that it "would constitute a criminal betrayal of our responsibility to our own people" if his government did not explore all avenues of combating AIDS. According to the Washington Post, Mbeki "stepped up an emotional controversy over his country's response to AIDS, saying Africans should chart their own course on the disease."

Headlines also dwelled on Mbeki's invitation to several noted dissenters to participate in an AIDS advisory panel prior to the upcoming 13th International Conference on AIDS to be held in Durban, South Africa in July. His letter expressed concern about pressures on South Africa to treat pregnant HIV+ mothers and babies with some drugs. Mbeki said he had asked his government to investigate growing controversy about "the toxicity of certain drugs." According to a recent AP report, several deaths of South African mothers and children had been attributed to AZT poisoning.

South Africa's deputy president Jacob Zuma supported Mbeki. According to the Johannesburg Daily Mail & Guardian, Zuma, who is spearheading the government's anti-AIDS drive, said he believed "no scientists had a monopoly on all knowledge about AIDS ... The issues must be debated and all views are considered."

According to the Washington Post, the White House tried to cover up Mbeki's letter. After all, Mbeki was upsetting apple carts for U.S. officials trying to squelch AIDS dissent at home. The Post said: "The Clinton administration restricted distribution of the five-page letter, dated April 3, in an effort to prevent it from becoming public. Several Clinton administration officials and foreign diplomats expressed dismay at Mbeki's decision to intensify what they see as a diversionary dispute and to bring it to a potentially volatile international forum. One official made a copy of the letter available to the Washington Post, and South Africa's U.N. ambassador, Dumisani Kumalo, confirmed its authenticity."

Opposition parties in South Africa, as well as officials and AIDS activists in the U.S. countries, stirred up a firestorm of outrage at Mbeki's actions. As I write this article, Mbeki is under fierce pressure.

Amid the flap about dissent, the deeper message of Mbeki's simple heartfelt prose, and his deeper worry, was missed by many Americans. U.S. outrage at Mbeki's position reflects our comfortable insulation from developing nations' concerns. It also expresses that old missionary streak that is still strong in this country -- the idea that we know what's best for poorer nations, that they should be abysmally grateful for our help. It's time for us to take off the missionary hat and look carefully at how developing countries may see AIDS politics.

The fact is: Mbeki's letter followed a significant January 10 speech before the UN Security Council. This speech, by World Bank president James Wolfensohn, used some very strong re-positioning language. Wolfensohn said: "Many of us used to think of AIDS as a health issue. We were wrong. AIDS can no longer be confined to the health or social sector portfolios. AIDS is turning back the clock on development."

The World Bank, a group of international investment entities organized in 1944 to help rebuild the post-World War II world, is a major player in the AIDS debate. It is also a powerful economic driver in the world today. Americans who never gave a thought to the World Bank recently got their first look at its human faces on CSPAN. Wolfensohn and other WB officials tried to explain their position to the TV cameras, after anti-Bank student and labor demonstrations had jarred Washington D.C. for days and hundreds of arrests were made.

The Bank has now re-positioned AIDS as its "central development issue," even though malaria, tuberculosis and malnutrition still kill more people worldwide than AIDS. (By the Bank's own admission, malnutrition alone kills half the children in low-income countries.) The Bank is deeply involved in financing and implementing AIDS-linked investment, and singles out HIV+ women for global focus. And yes, it's true that the death from ANY cause of a woman of child-bearing age, with consequent loss of her income to her family, and nurturing to her children, is a direct blow to a nation's development.

Another big player in global AIDS policy is the United States. At the time of Mbeki's letter, the U.S. government was already the biggest contributor to international AIDS efforts. Following Mbeki's letter, President Clinton went to Congress asking to double our international AIDS funding. The White House is using its own dire re-positioning language -- World War II language -- by calling it our "Marshall Plan for AIDS." (The original Marshall Plan was used to rebuild bombed-out Europe after 1945.)

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