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Letter to African Finance Ministers at the IMF and WORLD BANK Spring
Meetings from Members of the Pan-African Treatment Access Movement
Pan African Treatment Access Movement (PATAM)
African Treatment Access Movement (PATAM)
April 22, 2004
to Press statement
to African Finance Ministers at the IMF and WORLD BANK Spring Meetings
from Members of the Pan-African Treatment Access Movement The
Pan African Treatment Access Movement (PATAM)
April 22, 2004
On 24 and 25
April, you will convene in Washington DC for the annual International
Monetary Fund (IMF) and World Bank Spring Meetings to review the
two institutions’ operations. As government representatives we understand
that your mandate is to ensure that the interests of all residents
in your countries are fully met. As you are well aware, the greatest
threat facing the African continent today is the HIV/AIDS epidemic.
We, the members of an Africa-wide movement advocating for access
to HIV/AIDS treatments and other essential medicines, encourage
you to consider the HIV/AIDS as an issue affecting all other critical
developmental issues and urge you to consider initiatives that will
help contain and reverse the steady march of the epidemic.
In particular, we ask that you enhance the current efforts by the
World Bank and IMF against HIV/AIDS but reject those initiatives
that hamper access to life-saving and affordable medicines for people
living with HIV/AIDS.
In the last
few years, as the costs of antiretroviral therapy have steadily
declined and some misconceptions most notably on the efficacy and
safety of the drugs have been proven unfounded. Treatment has become
recognised as a critical component in the response against HIV/AIDS.
At a conference of African activists held on March 3-5 in Harare,
we heard reports from representatives from countries across Southern
Africa that treatment rollout is either on the verge of starting,
or has already begun in most countries across the region.
these reports since they send many a ‘ray of hope’ to those infected
and affected by HIV. However, we were also told that despite the
increased willingness by all stakeholders, whether private or public,
to provide Antiretroviral Therapy (ART), many initiatives do not
have the financial resources to respond adequately. We write to
encourage you to consider state sponsored initiatives to fund programmes
to scale up Access to Treatment in your respective countries.
recognised that many government-led initiatives in Africa can only
meet a fraction of the treatment needs and therefore have to rely
on external support from donors and international initiatives such
as the Global Fund for HIV/AIDS, TB and Malaria (GFTAM). This is
an unsustainable situation with potentially very serious public
health consequences should the donors withdraw support. This is
not a new issue: African Heads of States meeting in Abuja, Nigeria
in April 2001 declaredthat "we recognise the need to establish
a sustainable source of income to fund HIV/AIDS program."
ask that urgent attention is paid towards building the internal
capacity of our countries to marshal their own resources against
HIV/AIDS. We see the Spring Meetings is such an opportunity
to raise the following issues with the IMF and World Bank.
While we have
witnessed some movement away from the view that markets function
perfectly and governments should interfere as little as possible,
this orthodoxy still influences policy decisions and priorities
taken by the IMF and World Bank. There are numerous examples that
you are very familiar with in which as a condition for receiving
loans or other grants from these institutions, you have been compelled
to give up state responsibility in the provision of some social
services. We highlight only one.
One of these
conditions that we have referred to is that you must ensure our
governments maintain fiscal discipline – in other words they do
not spend more than is budgeted for in a given financial cycle.
This is on the surface reasonable, however in practice there are
situations where it is necessary to borrow from the future to meet
the urgent needs of today and therefore spend beyond current revenue
sources. The HIV/AIDS epidemic is precisely such a case since if
we are not willing to borrow from the future, there simply will
be no future. This requirement becomes even more impractical and
ludicrous when you consider cases where you have had to contemplate
declining additional donated revenues for HIV/AIDS since it may
mean breaching that spending ceiling you have set. We ask you
to reject these kinds of conditions.
It has been
widely recognised that many countries on our continent shoulder
an enormous debt burden much of it granted by the IMF and World
Bank. Given the scale, much of this debt will never be fully repaid
and furthermore much of it is "odious" having been accumulated
by leaders who were largely unaccountable to us. While efforts such
as The Heavily Indebted Poor Countries (HIPC) initiative recognise
these simple truths and wish to offer relief, it is not enough to
cancel some of these debts especially when you still find yourselves
weighing whether or how much to spend in debt servicing over social
services. You should demand full debt cancellation.
the IMF and World Bank
Finally as you
yourselves recently noted at a meeting in Johannesburg, the largest
recipients of aid from these two bodies – you and other so-called
developing nations contributed very little to the decision-making
processes. This must change. We therefore fully support yours
and all other efforts to shed the light of transparency, accountability
and representation into these two institutions.
We firmly believe
that if these issues are sufficiently raised and implemented, they
will go a long way in freeing up our countries to respond much more
effectively and sustainably against HIV/AIDS. In the long run, we
must stop knocking at the doors of these institutions since though
we may win some gains, we are essentially beggars subject to the
goodwill of one who has more. Let us develop our own capacity.
We charge you
with this responsibility and remain ready to offer any support necessarily
but also reserve the right to use all tools available to us should
we feel that you do not represent the interests of all peoples in
our countries. Millions of lives are at stake!
Members of the Pan-African Treatment Access Movement.
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