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An Effective Approach to AIDS in Africa (by Fr. Terry Charlton, S.J.)

I work in one of the largest slums in Africa - Kibera - located in Nairobi, Kenya. Some years ago, I started St. Aloysius Gonzaga Secondary School to educate young people who have lost either both parents to the AIDS-pandemic, or one parent and the remaining parent is infected. I am proud to say we now have 265 students, and we are supporting another 50 graduates to go on to college.

Kenya and several other countries have made real progress in fighting AIDS with US support. On his recent trip to Africa, President Bush rightly received recognition for getting the ball rolling on expanding access to AIDS services in our region of the world, especially treatment and care for the sick and orphaned.

But, quite frankly, I am alarmed at how far removed from African reality his proposal is for the next five years of the program. Since Congress is now debating what direction to take this program, along with programs to address many health and development issues related to AIDS, I want to share what I have seen in Kibera and make a plea for realism.

We have learned a great deal about AIDS since 2003, when the U.S. first began its emergency response to the crisis in Africa. Anyone visiting us in Kibera would see that the AIDS issue cannot be viewed in isolation. My students, teachers, and their extended families face interrelated problems rooted in poverty, issues of gender, and a broken-down health system. A smart U.S. response must address this context, including the dearth of qualified medical personnel and community health workers. And to be effective, it would confront tuberculosis head on, since, as we have seen in Kibera, TB is what actually kills most people living with AIDS.

But the Bush approach, now taken up by the Republican leadership in the House, ignores these lessons. It does not seriously address any of these related issues and, worst of all, freezes funding at the current level for the next five years, even as the world is racing to meet the goal of universal access to all AIDS services by 2010.

This funding freeze would have a devastating impact on programs that serve the children I work with every day. So far, the U.S. AIDS initiative has provided crucial funding for programs that provide care for children - including school feeding programs, which have a broad impact. Yet, the president and his allies in the Congress would have these programs frozen in place instead of expanding them to meet the growing need.

Fortunately, an alternative is available. Congressman Tom Lantos, as chairman of the Committee responsible for AIDS programming in the House, understood that significantly greater funds were needed to fight AIDS and address basic capacity issues. One of the last things he did before he died of cancer was to propose five-year legislation which would update the U.S. response and provide $50 billion - not only for AIDS, but also for children's programs, TB, and malaria.

The Lantos proposal would also better meet the needs of women and girls. It would allow voluntary family planning services to women who are HIV positive and who do not wish to become pregnant. We can agree or disagree about the morality of contraception, but the truth is that helping women who may be weak and ill to avoid a dangerous pregnancy is about saving lives; and it would not promote abortion, as some pro-life groups have inaccurately stated.

The Lantos approach also eliminates the requirement that one-third of all HIV prevention dollars be spent on abstinence and fidelity. This funding restriction has been shown to not be workable on the ground. As someone profoundly committed to promoting abstinence and fidelity, my experience is that I can do my job most effectively when young people have the freedom to make moral choices. I am glad to see the Lantos bill still requires the U.S. to promote abstinence and fidelity as a part of a comprehensive approach.

Working in Kenya, I see people suffering and dying all too often from a disease that can be prevented. It is crucial that this program not become a political football, and I hope members of Congress of goodwill, from both sides of the aisle, can find a way to work together for the sake of Africa. Unless the U.S. AIDS program goes forward, together with programs that address the broader context of the epidemic, the ones who suffer the most will be the children I work with every day.

Father Terry Charlton, S.J. is the Jesuit vocation eirector for Kenya, the national chaplain of Christian Life Community, and co-founder and chaplain of the St. Aloysius Gonzaga Secondary School in Kibera.

 

Comments

Freezing funding is unrealistic in the new stagflation era, where the last year's inflation rate (the fall in the domestic purchasing price of the dollar) was 7.5%. We are likely looking at a range in the near future that's substantially more than that under the Keynesian Arthur Burns clone in the Fed chair who sees inflation as the way to burn our way out of recession.

Moreover, just as war and occupation in Afghanistan financially crippled the old Soviet Union, leading to its superpower demise and eventual drastic political change, the United States is facing just the same sort of unsupportable financial quagmire.

The difference now between us and the Soviets is that we're spending far more in two adjacent war zones, and that up until recently we've had a lot of foreign lenders willing to finance our adventurism. However, that's all coming to an end, not only because there's no successful end in sight, not even a definition of what success could be redefined to be, but because the Fed's inflation "solution" is scaring off those foreign lenders, who would be paid back in increasingly valueless dollars, and at interest rates that are effectively negative. There are other venues to put that money to real work, whose leaders haven't bogged themselves down with financially destructive wars.

All this bodes ill for initiatives like the African AIDS bills competing for the shrinking value of the dollar, as well as with the needs of crumbling internal US infrastructure.

Things have grown so desperate that the Secretary of Defense has been reduced to going to foreign governments, hat in hand, to plead with them to purchase US armaments made by US corporations, with both the massive amounts US cash they hold and their US-denominated debt. The country, as its manufacturing capacity implodes, retains 86% of its manufacturing infrastructure in tax-dependent corporations that exist mostly on defense contracts, which the governmenty is finding insupportable. We have become so poor that we must accelerate arming the world as a means of earning and sharing our own weapons development and manufacturing costs.

At some point, we will find that we will have to make soime very hard choices about what we want to do. Our choice for war is increasingly swallowing up all choices not related to it as a consequence.

In order to serve humanitarian needs, we would have to give up our propensity for violence to try to solve problems - which only exacerbates them - and the system that now feeds economically on it.

Yours is a brilliant analysis that makes you truly worthy of your blog name Sojourner Truth. This very day President Bush declined to use the word 'recession' to describe what's happening with the U.S. economy. I'm sure he would like even less 'stagflation', the word I keep seeing in the news.

A country that is dependent on one area of the economy--whether it's arms or something else--is gambling with its economy. By urging countries to buy arms whether they need they or not, just to (marginally) reduce U.S. indebtedness, however, is also gambling with its, and the world's, security. Is there a country that buys arms and then stores them? I doubt it. The temptation to use these arms is great.

Great post and keep em coming.

p

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