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in Zimbabwe: whose side is the government on?
December 02, 2005
article appeared on our blog yesterday to commemorate World Aids
Day (1st December). Links to all the sources mentioned are available
on our blog. Link to blog : http://www.sokwanele.com/thisiszimbabwe/archives/294
It’s World AIDS
day today, and Zimbabweans can enjoy a rare piece of encouraging
news. This year’s AIDS epidemic update report, released by the Joint
United Nations Programme on HIV/AIDS (UNAIDS) and the World Health
Organization (WHO), claims that there is evidence for the first
time that prevention programmes initiated are finally helping to
bring down HIV prevalence in some countries, and Zimbabwe is one
of the countries mentioned. Specifically, the report says this of
data from the national surveillance system show a decline in HIV
prevalence among pregnant women from 26% in 2002 to 21% in 2004.
Other data indicate that the decline had already started in 2000
(Ministry for Health and Child Welfare Zimbabwe, 2004 and 2005,
forthcoming). Findings from local studies reinforce the national
evidence. In Harare, HIV prevalence in women attending antenatal
or postnatal clinics fell from 35% in 1999 to 21% in 2004. In rural
eastern Zimbabwe, declines in HIV prevalence in pregnant women were
also reflected in declines among both men and women in the general
population (Mundandi et al., 2004). A significant decline in HIV
prevalence among pregnant young women (15–24 years)—which fell from
29% to 20% in 2000-2004—suggests that the rate of new HIV infections
(incidence) could be slowing, too (p.20).
A decline in
HIV prevalence among pregnant women from 26% in 2002 to 21% in 2004
is good news, but the figures have been received with some scepticism.
A reporter writing for the Mail and Guardian wondered how South
Africa, the economic powerhouse of Southern Africa could continue
to see "an escalating HIV epidemic, while economically crippled
Zimbabwe has apparently brought down levels of HIV infection among
its people". The article goes on to grimly say:
which measures the ongoing level of HIV infection, is not particularly
informative without knowing the incidence, or the rate at which
new infections are occurring. A falling prevalence rate may reflect
that the number of people dying because of the virus is outnumbering
those newly infected with it.
the economic and food security difficulties in Zimbabwe, high numbers
of deaths could be behind the apparent decline in HIV infections.
(Mail & Guardian, 29 Nov 2005)
The Women and
AIDS Support Network (WASN) is one Zimbabwean NGO that has taken
a gender based approach to their fight against the HIV/AIDS epidemic
(57 percent of infections and deaths in Zimbabwe are women). Their
efforts have included a campaign to get Nevirapine, an antiretroviral
drug that helps to reduce parent-to-child-transmission of HIV by
about 50 percent, into every health center in Zimbabwe. Their website
explains that "out of 600 000 Zimbabwean women who give birth
annually, 200 000 are HIV positive and 30 percent of them transmit
the virus to their babies. This means that about 60 000 babies are
infected at birth". A fifty percent reduction in transmission
would save 30 000 infant lives each year.
But only a couple
of weeks ago, the director of WASN and other activists and advocacy
specialists were criticising the government for its apparent failure
to take the distribution of life-saving antiretroviral drugs seriously.
A report in The Standard pointed out that the Global Fund scheme
should by now have ensured that 270 000 Zimbabweans were accessing
antiretrovirals. The government’s own figures claim that up to 700
000 people are in urgent need of antiretrovirals. However, to date,
only 12 000 Zimbabweans are receiving the drugs.
The deputy minister
of health’s response again raises the question of how an economically
crippled Zimbabwe could apparently bring down levels of HIV infection
among its people. He blamed the government’s failure to meet drug
targets on a "lack of foreign currency":
economy is not operating at 100 percent capacity and that means
some areas will be affected like fuel supply and the provision of
drugs. There is no doubt that there is need to increase the number
of people on ARVs but with insufficient funding, that will always
present challenges. " (The Standard, 13 Nov 2005)
manufacturing generic antiretrovirals face the same challenges that
other Zimbabwean businesses do and are struggling to meet the demand
due to critical shortages in foreign exchange. A recent report pointed
out that the cost of locally manufactured (generic) life-prolonging
anti-retroviral drugs (ARVs) had shot up by more than 100 percent
with manufacturers saying the increase was necessitated by the shortage
of foreign currency to import raw materials.
of antiretrovirals is so severe that the Network for HIV-positive
Women in Zimbabwe is advising people "not to start taking ARVs
because there is a risk of drug resistance if they take the drugs
and later stop because the drugs are no longer available" (AFP,
28 Nov 2005). The spokesperson for the organisation, Angeline Chiwatani,
said that "ARV treatment is supposed to be uninterrupted for
life". Health Minister David Parirenyatwa solution to the problem
appears to be to look outside the country. Yesterday he said, "I
am hoping that come next year, with the global fund money coming
through, we should have more people on treatment" (Reuters,
30 Nov 2005).
It is a simple
fact that the HIV/AIDS epidemic in Zimbabwe is a national disaster
that affects all of us without exception. Today we cautiously celebrate
the apparent gains made in the fight against HIV/AIDS, and full
credit goes to the hardworking Zimbabweans whose efforts have achieved
this. Their achievement is especially noteworthy given the Zimbabwean
context today. But in the face of Zimbabwe’s overwhelming economic,
social and political challenges that show no sign of abating, can
we hope to still be celebrating this time next year?
Some of our
government’s policies do very little to support those in the frontline
in the fight against HIV/AIDS, and there seems to be little political
will to face hard truths and to take a more responsible role in
the fight against the disease. For example, we know that nutrition
is key to building immunity and helping people to fight off infections.
The HIV virus targets immune systems, and yet access to simple nutritious
affordable food continues to be a major crisis in our country. Incredibly,
the zanu-pf government even decided to withhold the distribution
of food aid to struggling communities until after the senate elections
had taken place. Robert Mugabe went even further by using food,
again, as a campaign gimmick in worst affected areas.
It is also true
that poverty and HIV/AIDS have a grim co-dependent relationship.
There is no question that economic mismanagement and failed government
policies have contributed to immense hardship for ordinary Zimbabweans.
But, in actions that can only be described as criminal, the government
also compounded the error of their ways by deliberately depriving
people of their homes and means to survive - Operation Murambatsvina.
in Zimbabwe exceeds 70% leaving the majority of people to scratch
out a meagre income through informal means. These people were the
target of the government’s crackdown on ‘illegal traders’ during
Operation Murambatsvina, people that Police Commissioner Augustine
Chihuri described as a "crawling mass of maggots bent on destroying
the economy". In actual fact, the ‘mass of maggots’ included
people like 23 year old Shamiso Makamba, the mother of three children
under the age of 5, who lost both her home and her livelihood under
the government’s onslaught:
lives have been destroyed. I was living in the Joburg Lines [in
Mbare] with my younger brothers and sister while I made a living
selling vegetables at the bus terminus. Now that they have destroyed
our houses and prohibited us from selling our wares from Mbare Musika,
we do not know what to do next" she said (Genocide Watch, 3
And what does
a 23 year old mother of three small hungry children do to survive
in a country dogged by unemployment and hyperinflation? The truth
is, her options are limited. Madeleine Bunting, writing for The
a country with high levels of poverty […] the deal offered by a
truck driver or street vendor with some Mozambican meticals in his
pocket can represent the best survival strategy for a woman. This
is a disease that is feeding off desperate poverty. If you’re worried
about where your child’s next meal is coming from, or how you are
going to avoid being thrown out of your shack for not paying rent,
longer-term risks such as dying of Aids carry little weight (The
Guardian, 28 Nov 2005).
And there are
regular reports coming out of Zimbabwe on how women are turning
to prostitution to survive. Like this one, for example, which comments
that in Beitbridge, business and sex go hand in hand: "As the
shortage of basic commodities worsens, women are forced to engage
in sex for preferential treatment in the purchase of restricted
goods" (WorldPress.org, 23 Sept 2004). Or this one, which describes
how Tracy Bunjwali, a university student, is forced into part-time
prostitution in an effort to support herself and her brothers and
sisters: "She has little choice, she says. Orphaned during
the last term of high school two years ago, the 23-year-old has
to support a brother and sister still at school after her parent
died of AIDS-related illnesses." (IRIN, 15 Nov 2005). And yet
another article tells how Operation Murambatsvina has forced as
many as ten families to share one house in Harare, and "Even
though HIV and Aids pandemic continues to be a major problem in
Zimbabwe, several women at the house are reported to have resorted
to prostitution for survival" (The Standard, 20 Nov 2005).
And still another from last year tells of how poverty is so severe
that there are a growing number of young women forced to turn to
prostitution to make ends meet - competition is fierce:
Hazvinei, 24, said girls as young as 15 and middle-aged married
women were turning up. ‘We are too many ladies looking for too few
men. I need to come earlier and earlier and stay longer to get business.’
(The Guardian, 17 Oct 2004)
sexual behaviour combined with extremely high HIV/AIDS statistics
paints a stark picture for the future, and the government has to
be forced to take some responsibility for ratcheting up the poverty
that brings the two together.
There are other
areas too where the government could play a role in the fight against
AIDS, and yet it seems unwilling to do so. We all know that education
is key to survival, and that access to information plays a critical
role in the fight against AIDS. A report released by the Panos Institute
in August this year noted that the Southern African media has played
a vital role in raising awareness about HIV/AIDS, but it goes on
to say that "in light of the immensity and complexity of the
epidemic, there is a great need for the media sector to not only
do much more, but to make a more comprehensive and positive contribution."
operates under extremely oppressive press laws; ours is the only
country in the Southern African Development Community that requires
newspapers and journalists to register with a government-appointed
commission as a precondition for operation. The Media Institute
for Southern Africa (MISA) noted that, "with newspapers being
forced – by law and economy – to shut operations, the public is
left to the mercy of government media which, in most cases, seem
to have little regard for the principle of public interest"
(p.57 in the Panos report). The notorious Access to Information
and Protection of Privacy Act (AIPPA) has also created conditions
which make it very difficult for journalists to play a critical
role in the fight against HIV/AIDS. For example, accessing information
about HIV/AIDS from government sources is difficult, costly, and
slow, as the Media Monitoring Project of Zimbabwe (MMPZ) points
time limit for providing a document is 30 days – which is not very
quick – and that may be extended. If a member of the public makes
a request to the wrong body, then the request will be passed on
to the correct one and the time period will start all over again.
authorities will be able to charge a fee for the information that
they provide, including the services they provide, with no upper
limit set in the law.
for information must be made in writing, with detailed information
about the person or group requesting.
The MMPZ also
points out that AIPPA "creates a series of wide and vague offences
that can be committed by journalists, such as intentionally falsifying
or fabricating information and publishing a false statement. These
offences can attract severe penalties".
Laws like these
make it difficult, and risky, for journalists to pursue stories
that may expose failure in government polices or expose corruption
in the administration of funds, for example. But when dealing with
a disease like AIDS, stories like these could be the difference
between life and death for many people. The MMPZ says that the effect
of laws like these "can only be to discourage journalists from
exposing information that might be uncomfortable for the authorities;
for fear that they will lose their accreditation (and thus their
One NGO worker
summed up the position with the media as follows:
there is a weak interface between the local media and AIDS service
organisations. This has resulted in limited information and knowledge
among journalists on HIV/AIDS. Lack of ethics attached to HIV/AIDS
is also a major challenge. The media does not recognise HIV/AIDS
as a human rights issue and, as such, the media in its coverage
does not conform to ethics attached to covering human rights issues.
Another external challenge is the existence of restrictive policies
and legislation such as the Access to Information Protection and
Privacy Act. Internal challenges include lack of resources, general
lack of capacity and their personal attitudes which might lead to
stigma and discrimination of peers and their source of information
Even more challenges
- again, ones created by the government - potentially face the 260
NGO’s working in the HIV/AIDS sector. The NGO Bill gazetted in August
last year (now only waiting for Mugabe’s signature before it becomes
law) threatens to severely restrict their ability to do their work.
Sokwanele highlights some of the areas of concern:
drafts of the NGO Bill caused concern among NGOs because the proposed
Council to register NGOs would be entirely controlled by government,
with a majority of government members, and a minority of NGO members.
The NGO umbrella organisation NANGO proposed a Council controlled
by NANGO. But all lobbying attempts were ignored. Government knew
what it wanted, and was not going to be deterred.
real sting in the new Bill when it was finally gazetted was the
attack on the organisations concerned with human rights and governance.
The definition of an NGO is expanded by the addition of institutions
whose objects include "the promotion and protection of human
rights and good governance" and "the promotion and protection
of environmental rights and interests and sustainable development".
And, critically, it no longer exempts Trusts registered with the
High Court. Furthermore, a new section prohibits any local NGO from
receiving "foreign funding or donation to carry out activities
involving or including issues of governance" (13 December 2004).
NGOs have argued
strongly against the bill:
the work that NGOs do is human rights work whether its access to
water, land, information, education, treatment or promoting the
rights of people with disabilities or living with HIV and AIDS,"
[…] "Some of our members have already lost some of their funding
as a result of the Bill. This will result in the reduction in foreign
aid and foreign currency in-flows into the country.
is our conviction, as NGOs that given the current socio-economic
situation in the country, where 70-80 percent of the population
is surviving below the poverty datum line and unemployment hovering
between 60-80 percent, where over one million children are orphans
and where 25 percent of the population is infected by HIV/AIDS,
the NGO sector is a safety net" (The Standard, 3 April 2004).
in Zimbabwe was 69 when Mugabe came to power in 1980, but official
figures in Zimbabwe show the Aids pandemic has lowered average life
expectancy to 38 (News24, 21 Nov 2005). In the meanwhile, the government’s
struggle to control dissenting voices and political opposition has
resulted in a series of actions and laws that cultivate an environment
where HIV/AIDS thrives. Given the scale of the pandemic and the
catastrophic effect it has on people’s lives, these sort of decisions
taken by people in a position of authority should be considered
a crime against humanity.
And while we
are delighted to hear that there has been a decline in some of the
statistics in our country, we would be foolish to assume that these
figures would continue to fall - if they already have? There is
no sign that the economy will improve, little evidence that poverty
will improve or that conditions in our country will improve to such
an extent that NGOs in the fight against AIDS can work with the
full support of the government and unhindered by senseless laws.
government clearly intends to hang onto power at all costs, but
have they realised, or do they care, that that price might be an
entire nation? And given that stark fact, at what point will the
world’s leaders - and especially regional powers - start holding
the government accountable for the decisions it takes, decisions
which knowingly hinder and restrict efforts to fight HIV/AIDS? At
what point do we stop talking about this as a disease, and start
using the term genocide instead?
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