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Politics shape war on HIV/AIDS
for War & Peace Reporting
(Africa Reports: Zimbabwe Elections No 02, 26-Jan-05)
By Sue Armstrong
crisis compounded by donor reluctance to channel aid funds through the
The 2005 Zimbabwe
parliamentary election will take place against the background of the worst
health crisis in the country’s history.
More than one in four
of Zimbabwe’s people aged 15 to 49 are HIV-positive and therefore vulnerable
to AIDS-related infections and possible death, unless a comprehensive
programme of complex anti-retroviral treatment can be rolled out.
Amid the current economic
and social chaos in Zimbabwe and the well documented decline in the country’s
health services, it is unlikely that anti-retrovirals – the drugs which
keep the virus in check but are not a cure – will become widely available
in the near future.
A bid last July by
Zimbabwe’s health ministry for a 516 million US dollar grant from the
Global Fund to Fight AIDS, TB and Malaria, with which it would have bought
anti-AIDS drugs, was rejected by fund officials for a series of reasons.
"It does not
help the people of Zimbabwe to pass money through channels which are not
well worked out," said Richard Feacham, executive director of the
Global Fund, which pools contributions from international donors and distributes
them apolitically. "Yes, the politics of a nation plays a role when
we determine that country’s application."
In other words, Zimbabwe’s
bid seems to have been turned down because the Global Fund did not trust
the Zimbabwe government to ensure competent and transparent distribution
of the money to non-government organisations, NGOs, designated by the
fund. This is a reasonable assumption, given that the government in Harare
has introduced legislation placing major restrictions on the activities
of NGOs and charities, including an end to their right to receive foreign
President Robert Mugabe
has described such foreign funding as the "conduits or instruments
of interference in our national affairs".
Concern that the money
would be misappropriated had already delayed release of another 10 million
dollar AIDS grant from the Global Fund that was approved nearly three
Before the new law
was implemented, Zimbabwe’s few remaining international donors of AIDS
drugs and medical support had tended to bypass the government by channeling
donations to locals NGOs or giving them directly to clinics or laboratories.
"It’s a Catch-22
situation that we find ourselves in," the coordinator of a Zimbabwean
home-care AIDS project told the Inter Press Service, a Rome-based news
agency dedicated to reporting civil society issues. "Because of the
new law, we cannot go behind the government and make independent applications.
Besides, to operate in Zimbabwe as an NGO or charity organisation, we
need to register, and we cannot afford to antagonise the government because
they will simply deregister us."
Zimbabwe’s minister of health and child welfare, said he had suspected
politics would become a factor when Global Fund officials helped his department
to process its earlier application. "The fund approved our first
round application in 2002 and to this day we have not received that money,"
he said. "They keep shifting the goalposts. By not including Zimbabwe
in the initiative, the Global Fund is depriving the world of benefiting
from Zimbabwean experiences."
In the absence of
massive international aid, Zimbabweans infected with HIV are doomed to
distressing and shortened lives. Relief workers quoted by New York Times
correspondent Sharon LaFraniere estimate that fewer than 1,000 Zimbabweans
receive anti-retroviral drugs free through government or charitable programmes.
And because of economic collapse and the law restricting independent foreign
donations there is little hope of expanding that number in the near future.
The staggeringly high
prevalence of HIV/AIDS, largely untreated, means that millions of Zimbabwean
voters will be unfit to give their full attention to issues in the election
and many will simply be too weak to get to polling stations.
The epidemic is killing
people at a rate unprecedented since the Black Death swept through 14th
century Europe. According to conservative estimates by the Geneva-based
Joint United Nations Programme on HIV/AIDS, UNAIDS, an estimated 170,000
Zimbabweans died from AIDS-related illnesses in 2003 alone, the most recent
period for which figures are available. That works out at 3,270 deaths
The epidemic has swept
away government ministers, members of parliament and countless civil servants.
By some estimates HIV may have infected up to 80 per cent of the country’s
But HIV/AIDS is unlikely
to become a much-debated topic in the election campaign because of the
stigma and taboo attached to the illness.
One of the very few
individuals who have publicly challenged the taboo is Zimbabwe’s top model
and businesswoman Tendai Westerhof, former wife of the country’s Dutch
ex-soccer coach Clemens Westerhof. She has disclosed her own HIV-positive
status, and in 2004 set up the Public Personalities Against AIDS Trust,
which promotes openness about HIV and AIDS.
Westerhof says she
has paid a price for disclosing her status, "The majority, most sections
of society, thought I was lying. It’s not possible. It’s not normal for
a person to disclose that they are HIV-positive. My business collapsed
overnight. No single person would come into my modelling agency. Some
of my models ran away. But I had to understand that it’s a process. I
had to give a chance to society to understand that if a person comes out
to say they are HIV-positive they need society’s help and they are also
trying to help society."
In this atmosphere
of silence, the virus is eating away at the fabric of society. By 2000,
Zimbabwe had already lost more than 10 per cent of its labour force to
AIDS. UNAIDS and the International Labour Organisation predict that by
2015, more than 40 per cent of the country’s workers will either have
died from AIDS or will be too sick to do their jobs.
which has maintained a small factory in Zimbabwe despite the political
and economic troubles, estimates that 25 per cent of its workers are HIV-positive.
The company has introduced a comprehensive treatment programme for HIV-positive
employees and their spouses, which includes the provision of anti-retroviral
The death of adults
inevitably leaves destitute children. In a population of 11.5 million,
there are now probably nearly 1.1 million "AIDS orphans" – that
is, children who have lost one or both parents to the disease. The figure
is based on a UNAIDS estimate that there were 980,000 AIDS orphans in
Zimbabwe by the end of 2003, with approximately 75,000 being added to
the total each year.
for ten or more of their orphaned grandchildren after the death of sons
and daughters are now commonplace in Zimbabwe. So too are child-headed
households. The United Nations Children's Fund, UNICEF, said in its annual
report published last month that children as young as nine years old are
caring for brothers and sisters or dying parents.
According to Festo
Kavishe, UNICEF’s representative in Harare, "Orphans are dropping
out of school, often with malnutrition, and are more likely to be involved
in hazardous forms of labour, including prostitution."
A decline in school
attendance is, in fact, one of the most visible effects of the epidemic.
According to the World Bank, the number of children in primary school
will have shrunk by 24 per cent by 2010 compared with 2000. The problem
is at least partly due to the loss of teachers to the epidemic. A study
in Manicaland, eastern Zimbabwe, found that 19 per cent of male teachers
and 29 per cent of female teachers were HIV-positive. The loss of teachers
can be especially damaging in rural communities where primary schools
depend heavily on just one or two members of staff.
To combat the epidemic
Zimbabwe needs a wholesale political, economic and social transformation,
but with Robert Mugabe’s ZANU PF government likely to take power for another
five years from March, the prospect of reversing the tragedy in the short
run is improbable.
is a freelance writer and broadcaster on science and health matters. She
has written extensively on the HIV/AIDS epidemic in Africa as a consultant
for the World Health Organisation and UNAIDS.
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