Death By Denial

It is difficult to overstate the trauma and hardship that AIDS has brought upon children in Zimbabwe. According to UNICEF, one in five children in Zimbabwe is an AIDS orphan; and one child dies of AIDS every 15 minutes. Yet these statistics underestimate the gravity of the problems bedeviling Zimbabwe.

Across Zimbabwe, over a million children are being denied a basic family life and lack love, attention and affection. They are pressed into caring for ill and dying parents, removed from school to help with the household or pressed into sex for survival to pay for necessities. They have less access to health care services. They are often treated harshly or abused by foster or step-parents and society at large. Relatives and neighbors charged with caring for the children frequently take their inheritances, leaving the children vulnerable to mortality, illness and exploitation. These problems are occurring in a society where children are already undernourished and impoverished.

How does the World Bank, the International Monetary Fund and the Global Fund to Fight HIV/AIDS, TB and Malaria explain a per capita spending on HIV/AIDS of $4 per head per annum in Zimbabwe compared to $187 per head in neighboring Zambia where both prevalence and incidence rates are lower?

The health care system in Zimbabwe has long since collapsed and Zimbabwe's internal efforts to fight AIDS have been thwarted and undermined by the international community. I was one of the first people to concur that the Zimbabwean government's proposals to the Global Fund had serious technical weaknesses, but the suggested actions put together by experts were never implemented. Furthermore, there is no logical explanation as to why Zimbabwe was not included in President Bush's Emergency Plan for HIV/ AIDS Relief (PEPFAR) when Zimbabwe's surrounding neighbors, including South Africa, Zambia, Botswana and Mozambique, are focus countries receiving funding from the $15 billion pledge.

"There are only two possible responses to suffering on this scale. We can turn our eyes away in resignation and despair, or we can take decisive, historic action to turn the tide against this disease," President George W. Bush said, demonstrating his global leadership in fighting AIDS. On AIDS in Zimbabwe, however, the United States has led the donor and international community in not just choosing to "turn away in resignation and despair" but in punishing Zimbabweans for the sins of their government and political leaders.

Over 160,000 people living with AIDS will die this year alone in Zimbabwe. This will undoubtedly result in increased instability, crime and other social problems and human rights abuses. HIV-infection levels are likely to increase significantly as people in desperate circumstances have to concentrate on immediate survival needs, not on protecting themselves from long-term health problems. Lack of sufficient care now is a recipe for the increased spread of HIV infection and social insecurity.

No terrorist attack or war has ever threatened the lives of more than 40 million people globally at one time. The institutional response to AIDS internationally has tended to mirror personal responses including initial denial, blame, repression and ultimately a varied degree of acceptance. However for Zimbabwe the primary limitations are inadequate international and local funding, weak political response exasperated by donor fatigue and a desire by the international community to punish President Mugabe and his government for alleged human rights abuses, flawed electoral laws and an unpalatable land reform and redistributing program.

Zimbabwe is experiencing the most severe HIV/AIDS epidemic in the world today, a long-term development disaster for the region on a scale never witnessed before; yet the major limitations of the response to AIDS have been the failure of others to act effectively.

This is a time for decisive leadership and action, and a time to put aside political demagoguery. We need to re-focus and channel resources to rebuild and strengthen Zimbabwe's health care and response mechanism. There remains a question of accountability on the part of the Zimbabwe government, but there are surely ways to go around that threat. For example, the AIDS response funds could be channeled through the U.N. Theme Group on HIV/AIDS, the World Health Organization or directly to NGOs.

Zimbabwe's children are a generation in peril. It is time to show that the international community will stand by those who are most vulnerable and weak in their time of need.

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