HIV-AIDS: Poverty Disease?

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Should Africa focus on trade and investment or on HIV/AIDS handouts? In his State of Union address, President Bush of America announced that he would ask the Congress to commit $15 billion over the next five years to turn the tide against HIV/AIDS in the most afflicted nations in Africa and the Caribbean.

Kenya will finally receive $179.4 million from the UN Global Fund to fight AIDS and other diseases. The health ministry indicated that $129 million of this would go to the fight on HIV/AIDS, $33.6 to malaria and $11.2 to tuberculosis. However, to check the tide against AIDS Africans, really need economic empowerment through trade and productivity. Countries may receive all sorts of aid packages, but as long as they subject their populations to policies that sustain them in poverty, there is a danger diseases will be turned into a tool of global politics.


It may well be that the famine in southern African countries is largely attributable to the HIV/AIDS scourge. With over 7 million agricultural workers killed since 1985, crop output plummeted nearly 60 percent. The news from United States of America is certainly welcome. But will Africa put in place the infrastructure to absorb the aid?

Is Africa more sexually active than the rest of the world? Africa accounts for 70 percent of the global population of people with HIV/AIDS and 80 percent of global deaths from AIDS. Wealthy countries have fewer cases than the poor countries. The incidence of HIV/AIDS in the urban areas has been lower than that in the rural areas. In some countries such as South Africa, this disease has tended to annihilate more of the black Africans than the white Africans. What could really be the problem?

According to a June 2000 report on Incidence and Depth of Poverty in Kenya (by the Kenya Ministry of Finance and Planning), Nyanza province leads with 63 percent of its population living below poverty line. Coast Province follows with 61 percent, Western and Eastern 58 percent, and Central performs better with 31 percent. The report used consumption rather than income to measure living standards and defined the poor as those who are unable to afford minimum needs, such as food and non-food items. With a few exceptions, poorer districts have tended to have higher incidents of HIV/AIDS related deaths because their people have already been weakened by malnutrition, malaria, dysentery and other diseases.

Provinces like Nyanza, Western, Coast and parts of Eastern have been the hardest hit due to both poverty and culture. Taboos on sexuality and wife inheritance have contributed to high incidences of this disease in some areas; ignorance has also been a major contributor in low-income districts. With an estimated 500 Kenyans dying every day, one wonders why governments should be preaching about a population “explosion’. The figures peddled by HIV/AIDS agencies point to a possible population “implosion” that calls for emergency measures. While implementing measures to curb the HIV/AIDS epidemic, Kenya ought to review its family planning program, to ensure that its population stabilizes.

It is urgent that Kenya (and by extension Africa) addresses issues that make it difficult for her people to access health care. Our countries ought to review the regulatory and bureaucratic barriers, taxation, licensing of drugs, corruption, poverty and infrastructure that make it difficult for people to access medicines. Intellectual property rights rules have been cited as another possible barrier, although on-the-ground evidence indicates the opposite.

For instance, Kenya has recorded high incidences of malaria deaths, and anti-malarial drugs are not subject to patent restrictions. This year alone, 15 people have already lost their lives. This being a seasonal disease, it’s predictable that between May and July more people will perish. What measures are in place to reduce these deaths? The government has been unable to address this annual phenomenon. Why must it wait for aid to tackle malaria, typhoid and other diseases?

Giving medicine to the hungry that live in poor sanitary conditions, consume untreated water and are illiterate will not reverse the scourge. MERCK & Co together with other pharmaceutical companies under the umbrella of UNAIDS have reduced the prices of their ARVs by 80-90 percent to countries in the developing world where the AIDS pandemic is a threat to human populations. Niraj Doshi, a representative of MERCK in Eastern Africa estimates that since his company lowered prices in 2001 for Anti Retroviral Drugs, the number of beneficiaries increased ten times and the number could be higher if the link to economic empowerment is addressed. Despite the lowered price, it is still expensive for the average Kenyan hence the urgent need to facilitate wealth creation that will not only lead to more access but also grant economic independence to consumers.

One way to promote economic growth is to put in place policies that will make it easier for Kenyans to produce and market their commodities. In agriculture, farmers should be in a position to access credit, small business people should not be bogged down by excessive licensing procedures, and communities should be allowed to operate community tourist hotels that will cater to visitors who want to sample African lifestyles. Kenya must eliminate corruption and implement the rule of law, to ensure that contracts are enforceable. We must create a system that lets Kenyan and inter-African trade thrive.

No community or government can tackle disease when its people are barely surviving on $1 a day. Developing countries also face impossible odds because their exports are confined to only primary products, and processed commodities face high tariffs imposed by rich nations. Poor countries also lack the technical expertise to interpret legal documents and negotiate in world trade bodies. To develop this expertise, they rely on rich country machinery and NGOs that do not have Kenya’s or Africa’s best interests at heart.

Many products from the poor countries face quarantine rules, which are basically a trade barrier to agricultural products. Products from Africa are subjected to sanitary and environmental standards (on pesticides and biotechnology, for example) that simply block them out of the richer markets. In most cases, movement of people from poor to rich countries is also restricted through difficult visa requirements. One can hardly trade without surveying your potential market! Together with export subsidies and price-distorting domestic subsidies, this has severely harmed economic growth in poor countries.

Unless the people of Africa are allowed to be productive and prosperous, aid in the form of cheaper medicines alone will not alleviate its health problems. More efforts should be put in place to remove barriers to health care. The African people are not more sexually active than the rest of the world. They simply suffer from stress and generally ill health due to corruption, bad laws and harmful policies imposed by their own and rich foreign governments.

”’James S. Shikwati is the Director of Inter Region Economic Network [IREN Kenya]. He can be reached at P.O. Box 135 GPO Code 00100 NAIROBI KENYA, Phone/Fax 254-2-2723258, Cell 254-733-823062 or by email at”’ ”’His Web site is found at”’