AIDS and Power: Why There Is No Political Crisis - Yet (African Arguments) - Softcover

De Waal, Alex

Softcover

ISBN 10: 1842777076 ISBN 13: 9781842777077

Verlag: Bloomsbury 3PL, 2006

Inhaltsangabe

One in six adults in sub-Saharan Africa will die in their prime of AIDS. It is a stunning cataclysm, plunging life expectancy to pre-modern levels and orphaning millions of children. Yet political trauma does not grip Africa. People living with AIDS are not rioting in the streets or overthrowing governments. In fact, democratic governance is spreading. Contrary to fearful predictions, the social fabric is not being ripped apart by bands of unsocialized orphan children.

AIDS and Power explains why social and political life in Africa goes on in a remarkably normal way, and how political leaders have successfully managed the AIDS epidemic so as to overcome any threats to their power. Partly because of pervasive denial, AIDS is not a political priority for electorates, and therefore not for democratic leaders either. AIDS activists have not directly challenged the political order, instead using international networks to promote a rights-based approach to tackling the epidemic. African political systems have proven resilient in the face of AIDS's stresses, and rulers have learned to co-opt international AIDS efforts to their own political ends.

In contrast with these successes, African governments and international agencies have a sorry record of tackling the epidemic itself. AIDS and Power concludes without political incentives for HIV prevention, this failure will persist.

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Alex de Waal is a writer and activist on African issues. He is a fellow of the Global Equity Initiative, Harvard; Director of the Social Science Research Council program on AIDS and social transformation; and a director of Justice Africa in London. In his twenty-year career, he has studied the social, political and health dimensions of famine, war, genocide and the HIV/AIDS epidemic, especially in the Horn of Africa and the Great Lakes. He has been at the forefront of mobilizing African and international responses to these problems. His books include, 'Famine that Kills: Darfur Sudan,' (1989, revised 2004), 'Famine Crimes: Politics and the Disaster Relief Industry in Africa,' (1997), 'Islamism and Its Enemies in the Horn of Africa,' (2004) and (with Julie Flint) 'Darfur: A Short History of a Long War' (Zed Books, 2005).

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AIDS and Power

Why There is No Political Crisis — Yet

By Alex de Waal

Zed Books Ltd

Copyright © 2006 Alex de Waal
All rights reserved.

ISBN: 978-1-84277-707-7

Contents

Acknowledgements, ix, 
1 A Manageable Catastrophe, 1, 
2 Denial and How It Is Overcome, 11, 
3 AIDS Activists: Reformers and Revolutionaries, 34, 
4 How African Democracies Withstand AIDS, 66, 
5 The Political Benefits of AIDS, 94, 
6. Power, Choices and Survival, 117, 
Notes, 124, 
Bibliography, 133, 
Index, 144, 

CHAPTER 1

A Manageable Catastrophe

Perhaps the most extraordinary aspect of the African AIDS epidemic is its limited social and political effect. This is a disease which in a number of countries will be the cause of death of half the population. It has increased the mortality levels of adults in their prime, 20–40 years, to pre-modern levels. At any one time one third of the people one meets in cities like Harare or Blantyre are infected and have at the most only a few years to live.... The additional death rate because of the epidemic, up to ten per thousand annually in some countries, is of a similar magnitude to the experience of France during the First World War, an experience that traumatized the French. Yet East and Southern Africa are not traumatized. Governments are not threatened by accusations of mishandling the epidemic. Not a single protest demonstration has occurred. Life goes on in a surprisingly normal way. There has not even been any very marked change in sexual behaviour, and society is not dominated by government demands that there should be. There is no paranoia and little in the way of new religious or death cults. In some ways it is very impressive.

Recently a peaceful demonstration in [Queenstown, South Africa] by AIDS patients begging for drugs to treat their otherwise fatal disease was broken up by riot police. The demonstrators, most of whom were HIV-positive women, were beaten, and 10 were shot. The next day in Moscow, people infected with HIV chained themselves to government buildings, also demanding access to life-sparing medicines. We are entering a new stage in the world's great modern plague in which long-complacent governments are awakening to discover that the HIV virus, first noticed in 1981, now threatens to foment social unrest, undermine state authority, weaken armies, challenge economies and reverse hundreds of billions of dollars' worth of development investment.

Laurie Garrett, 2005

At present levels of infection, about one sixth of all the people in sub-Saharan Africa will contract HIV in their lifetimes. But the epidemic does not threaten the continent's rulers – democratic or otherwise. AIDS kills millions every year, more than war and famine combined. It kills adults, devastating families and leaving orphans. But governments are not being overthrown. Indeed, with a few exceptions such as Botswana, African leaders' responses lack urgency and scale. Governments find resources for many things, but AIDS programmes are rarely near the top of their list. There are straightforward reasons for this neglect. African electors are not demanding that their governments make AIDS a priority. Society is neither collapsing nor being transformed in revolutionary ways. African rulers, with a sound appreciation of how power functions, know that they won't be removed from office or even face political threats on account of AIDS. John Caldwell is right.

Laurie Garrett says that 'this is the Black Death'. By invoking this spectre and predicting social meltdown in Africa, she wants to frighten powerful governments into massive and urgent action. This drumbeat of doomsaying has made an impact in Washington DC and New York, but not in Africa, where pundits' forecasts of collapse are routinely discounted and fear of an abstract apocalypse has long since failed to spur political action.

This book argues that African governments, civil society organizations and international institutions have proved remarkably effective at managing the HIV/AIDS epidemic in a way that minimizes political threats. In doing so, they have adopted a model of response to AIDS that focuses on process rather than outcome – chiefly the smooth and coordinated functioning of their own institutions, but also adherence to certain principles, some of which are based on evidence, and some on faith. These process indicators, such as UNAIDS's 'three ones', are rigorously assessed. Encouragingly for democrats, this process emphasizes human rights and the participation of civil society leaders, and it has thereby ensured that democracy in African is not threatened by the epidemic and may even be strengthened. With a few important exceptions where different intersecting stresses come together, AIDS is unlikely to cause socio-political crisis.

Providing antiretroviral treatment to people living with HIV and AIDS is the most effective means of managing AIDS. It is an easily measured service-delivery operation. It is a humanitarian activity that prolongs people's lives and reduces the social and economic impacts of the disease. Treatment has a ready constituency — people living with HIV and AIDS — and it is unsurprising that it has recently received a great deal of political energy and commitment. Amid the current enthusiasm for scaling up treatment, it is easy to overlook the fact that it will not roll back the epidemic.

The HIV/AIDS epidemic is being managed, not solved. For HIV/AIDS to be rolled back, the right political incentives for HIV prevention need to be in place. The first requirement is a good and rapid measure of success. Astonishingly, the only good indicator — incidence of HIV infections — simply isn't measured. Instead, HIV prevalence — the total number of existing infections — is monitored rather inadequately. Prevalence can go up and down for many reasons, including changes in surveillance methods, population migration and deaths of people living with AIDS, as well as new infections. Relying on prevalence figures, we have only the vaguest grasp of whether prevention measures are having any impact at all. Even if African publics and international activists wanted to call governments and agencies to account for their performance, they do not have the tools to do so. A government's political commitment to preventing HIV/AIDS consists solely in a promise to implement a package of internationally recommended prevention strategies. There is no discernible system of political rewards for success and penalties for failure, so we should not be surprised that governments and international institutions have not made much progress in preventing HIV infections.

Life Expectancy and Public Opinion

Caldwell's sketch of AIDS's demographics remains broadly correct today. Table 1.1 ranks selected countries on the basis of the additional life expectancy of a 20-year-old. Countries with HIV prevalence over 10 per cent of adults are marked in bold.

Column 1 shows that a young adult in the United States in 2006 can expect to live until nearly eighty; a Zambian teenager to less than fifty (e20 is the number of additional years a 20-year-old can expect to live, while e0 is life expectancy at birth). From a class of 100 ninth-grade American girls aged fifteen, 90 will see their sixtieth birthdays. Less than one third of their counterparts in Malawi can expect to live that long (45q15 is the probability of a fifteen-year-old dying in the next 45 years of life). A Batswana teenager today has a...

Details zur Ausgabe

• Verlag: Bloomsbury 3PL
• Erscheinungsdatum: 2006
• Sprache: Englisch
• ISBN 10: 1842777076
• ISBN 13: 9781842777077
• Einband: Taschenbuch
• Anzahl der Seiten: 160
• Kontakt zum Hersteller: Nicht verfügbar
• Verantwortliche Person: gpsr@libri.de; gpsr@libri.de; ; Friedensallee 273; Hamburg; 22763; Deutschland