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Death by denial: A case for Zimbabwe
Dr. Frenk Guni
March 30, 2005

It is difficult to overstate the trauma and hardships that the increase in AIDS related morbidity and mortality has brought upon children in Zimbabwe. According to Unicef, one in five children in Zimbabwe is an orphan and a child dies of AIDS every 15 minutes. These statistics are not just accurate but an underestimation of the gravity of the problems bedeviling Zimbabwe.

Children are being denied a basic family life, they lack love, attention and affection, and they're similar to children living in war-ravaged countries. 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 these children frequently take the children's inheritance leaving them more 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, the Global Fund to Fight AIDS, Tuberculosis and Malaria among other philanthropic agencies explain a per capita spending on H.I.V./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?

Across Zimbabwe over a million children are experiencing poverty, enormous mental stress from witnessing the illness and death of their parents and loved ones, and a profound sense of real insecurity. These inadequately met concerns are the fundamental human rights and needs of children and there is an urgent requirement to ameliorate their physical and psychosocial distress and suffering. It can not be argued otherwise that the health care system in Zimbabwe has long since collapsed and Zimbabwe's internal efforts to fight AIDS have in fact been constantly thwarted and undermined by the international community for "technical" and yet ultimately political reasons.

I was one of the first persons 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. This in itself demonstrates a more sinister motive to discredit the AIDS response by Zimbabwe based purely on political indifference of the international community and indigence by the Zimbabwean government. Furthermore, there is no logical explanation as to why Zimbabwe was not included in President Bush's Emergency Plan for AIDS Relief when all of its 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. Alas on AIDS in Zimbabwe the United States has led the entire 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 likely increased instability, crime and other social problems and human rights abuses. H.I.V. 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 H.I.V. infection and social insecurity.

No "terrorist attack" or war has ever threatened the lives of over 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 morbid desire by the international community to punish President Robert Mugabe and his government for alleged human rights abuses, flawed electoral laws and an unpalatable land reform and redistributing program.

Never in history has there arisen such a widespread fundamental threat to human development as AIDS, and Zimbabwe is experiencing the most severe H.I.V./AIDS epidemic in the world today. National Antenatal prevalence is in parts of the country between 35 percent and 70 percent. This clearly threatens development, food security, productivity, human resources and soon national and regional security. This is a long term development disaster for the region on a scale never witnessed before, yet the major limitations of the response to AIDS has been the failure of others to learn and act effectively from those most impacted.

This is a time for decisive leadership, a time for action, a time to put aside political demagoguery; this is a time to think and act for the cause of humanity. We need to re-focus and channel resources to rebuild and strengthen Zimbabwe's health care and response mechanism. Agreed, there remains a question of accountability on the part of the Zimbabwe government, but surely there are ways to go around that threat. For instance, channel the AIDS response funds through the United Nations Theme Group on H.I.V./AIDS or through the World Health Organization or more directly to N.G.O.s - not withstanding the recently passed N.G.O. Bill of Zimbabwe which to this day the president has not assented to. The bill in material terms does not prohibit external funding to N.G.O.s that are providing humanitarian services not linked to the internal politics of Zimbabwe.

If we do not act fast and now, history and posterity will judge us all for our inaction. Zimbabwe's children are a generation in peril and it's our time to show that we care. Yes it is our time to show that the international community will stand by the most vulnerable and weak in their time of need. It is not the "body politick" that has H.I.V./AIDS in Zimbabwe and are bearing the burden of care. But it is the ordinary men, women and children who are now looking up to the international community for their own survival.

*Dr. Frenk Guni is an AIDS activist and the winner of the 2003 Jonathan Mann Award for Global Health and Human Rights among other international accolades in public health.

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