Health Care in Africa: A Human Rights Catastrophe

The word Kurarama in Mozambique means to live. International Human Rights Day on December 10 is the perfect time to recognize one of the greatest obstacles to healthy lives for children in Africa -- AIDS. Everyday, about 6000 children lose one of their parents to AIDS worldwide, according to the United Nations Programme on HIV/AIDS. About 90 percent of these children are in Africa - leaving an estimated 12 million orphans on the continent. That figure is expected to rise to at least 20 million by 2010. And this crisis is further exacerbated by Africa's back-breaking debt burden. The continent spends up to $15 billion on debt repayments and only small fraction on health services - including AIDS drugs - for its people.

Most of Africa's debt - given by irresponsible lenders to corrupt African dictators - is illegitimate and odious. From a global perspective, canceling Africa's crippling debt to the International Monetary Fund (IMF), allowing the continent to use its own resources for health care and domestic purposes, is one way to take the first step to addressing the AIDS crisis. Africa spends three times more on repaying debts to rich Western countries and institutions than it does on providing health facilities and drugs for its sick and poor population. Severely indebted countries have higher rates of infant mortality, disease, illiteracy and malnutrition that other countries in the Global South.

Even the legitimacy of this debt is dubious. Africa was trapped into debt in the wake of rising oil prices and falling interest rates in the 1970s. During the Cold War, Africa was a hot battle ground for the former Soviet Union and the West, including the United States. Billions of dollars in debt were disbursed to any country that supported them, regardless of their politics. Many African countries have already paid their IMF debt several times over. For example sources say that Nigeria which initially borrowed $5 billion, has so far paid over $16 billion and still owes $32 on the same debt. If these African governments were allowed to invest in human development, rather than make usurious debt repayments, an estimated three million children would live beyond their fifth birthday.

The need for urgent international attention and involvement in alleviating the AIDS crisis in Africa cannot be underestimated. The tragic fact that Africa's most productive population is being decimated paints a gloomy picture for the future. It is the children, teachers, doctors, lawyers, and young energetic farmers and workers who are most affected. That means Africa's productive base - historically lean and inadequate - is being further diminished, resulting in the plunging of living standards and a more rapid descent. The American Friends Service Committee, with decades of work in Africa, is executing a comprehensive AIDS orphans project in the southern African country of Mozambique. In this former Portuguese colony that has suffered decades of civil war, an estimated 30% of the population is HIV-positive. About half of new HIV infections occur among young adults between the ages of 15-24. A growing number of households in the battered country are headed either by grandparents or by children as young as nine. The great majority of HIV-positive people in Mozambique have no access to AIDS drugs and continue to die in alarming numbers.

Unfortunately the stigma attached to adults with AIDS is passed on to their children, making their survival even more precarious. In accordance with the taboos attached to the disease, many African newspapers do not mention AIDS in obituary columns. Children orphaned by HIV/AIDS are more likely to suffer abuse and exploitation, and they are more likely to become infected themselves. Tragically, the UN has estimated that 37% of current 16-year olds in Manica will die of AIDS before reaching age 30. In addition to the struggle to acquire food, clothing, and shelter, children deal with intense trauma, suffer extreme stress, face dangerous threats and have few protections. In many cases, they end up as child soldiers, programmed at a young age to perpetrate violence and acts of terrorism. The tragic consequences of HIV/AIDS for communities in Mozambique and for numerous other nations in Sub-Saharan Africa will be felt for generations to come. Overall, the facts are startling: In 2002, 70% of people living with AIDS worldwide resided in Africa, home to only 10% of the world's population. Africa is the only continent where life expectancy has dropped below levels of the 1950s. Thousands of orphans in the country roam the streets trying to eke out an existence or live with extended family members who often are burdened already by severe poverty.

On this International Human Rights Day, urgent international attention and involvement is needed in alleviating the AIDS crisis in Africa. A concerted international response and firm commitment are required to organize food assistance, funds for clothing, medicines, shelter and educational opportunity to the lives of the children affected by HIV/AIDS.

Baba Jallow is national associate with the Africa Program of the American Friends Service Committee. Originally from the Gambia, he is a 2002 recipient of the Human Rights Watch's Hellman/Hammet Award for journalists.

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