Features

US ‘Racism’ over AIDS Drugs in Africa Adds Insult to Injury

2001-06-18, Issue 26

http://pambazuka.org/en/category/features/1660

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The recent remarks by Andrew Natsios, head of the U.S. Agency for International Development, on the capacity of Africans to time manage the supposedly complex drug regime of AIDS anti-retrovirals, are astonishing in their ignorance. Natsios has gone on record in a speech made to Congress, and in an interview with the Boston Globe as saying the money raised by a new global fund to fight AIDS should be used almost entirely for prevention services, not for the anti-retroviral drugs that have been so successful in extending the lives of people infected with HIV. Among the more ‘politically correct’ reasons Natsios cited for the difficulties posed in getting such drugs to AIDS victims in Africa - a lack of roads, shortages of doctors and hospitals, and wars – he also stated there is a problem with Africans themselves. Many Africans, he told The Globe, "don't know what Western time is. You have to take these (AIDS) drugs a certain number of hours each day, or they don't work. Many people in Africa have never seen a clock or a watch their entire lives. And if you say, one o'clock in the afternoon, they do not know what you are talking about. They know morning, they know noon, they know evening, they know the darkness at night."

As Bob Herbert, writing in the New York Times points out, this view of Africans as “so ignorant they can't master the concept of taking their medicine on time has become a touchstone of the Bush administration”. As many African specialists have pointed out, the education levels and health infrastructure vary significantly on the 54-nation continent, rendering generalizations about the people of Africa at best useless, and at worst, deeply offensive. Moreover, recent advancements now allow people to take one or two pills daily that each contain several anti-AIDS drugs. This regimen, now being used in several small African trials, means that anti-retrovirals can be taken without the need for exact time keeping methods. Although several groups have called on Secretary of State Colin Powell to fire Natsios for his “racist” remarks, Natsios has declined to comment since his testimony, although a spokesperson has said he regrets offending anyone because of his comments.

This ignorance is a crude example of the Bush administration’s attitude towards issues facing developing countries, and towards the AIDS crisis in particular. The real worry of many, including Natsios and other top US policymakers, is that falling drug prices will shift global funding of diseases such as HIV/AIDS away from prevention efforts, into much more costly drug treatment. This anxiety is shared by many in the West. It was recently reiterated at a United Nations conference in Geneva which announced that the best way to manage spending on AIDS from the proposed new multi-billion dollar global fund for health was to concentrate on prevention strategies rather than the mass purchase of expensive anti-retroviral drugs – despite the fact that these drugs are routinely offered to western AIDS patients. The fear behind Natsios’ ignorance of the facts – and behind much of Western policy on this issue - is that the bill for providing such drugs to those millions suffering from HIV/AIDS in desperately poor parts of the world will simply be too expensive to contemplate.

But the problem of the cost of treating AIDS patients in Africa and in developing countries is not one that is going to go away. Despite some recent advances in this struggle, such as South Africa’s landmark legal victory against pharmaceutical companies allowing it to buy cheap drugs and the offer of cheaper drugs from pharmaceutical companies - resulting in an 85% fall in the cost of anti-retrovirals to developing countries in the last few months; and depite the establishment of a new global health fund, and mounting pressure on the WTO to reform patent rules when they meet later this month in Geneva, many countries in Africa face enormous problems in their ability to afford AIDS treatments, and to administer them. South Africa has recently said it will not embark on a large programme of AIDS treatment, arguing that anti-retrovirals are still too expensive and beyond the budget of the health department. But if South Africa, with a relatively good health care infrastructure, seems unable to initiate such a regime, what chance is there that other African countries can afford to do so either?

AIDS threatens to wipe out an entire generation in Africa, and to destroy gains that have been made in political and economic development. If such a horrendous epidemic is to be prevented, adequate resources are needed, and both prevention and drug therapy treatments should be made available to its people. Yet while the international community considers that preventing such a death toll is simply too expensive, and while it harbours influential leaders in its midst who appear to believe that Africa’s people are even too ignorant to receive help, adequate funding needed to solve Africa’s AIDS crisis seems – shamefully - unlikely to materialise.

To send your comments or corrections to Administrator Natsios directly, use the link: http://www.usaid.gov/public_inquiries.html or send a message to pinquiries@usaid.gov

For further coverage of this issue, see:

AfricaAction Letter to Powell Protests Racism at USAID http://www.africapolicy.org/docs01/nat0106.htm

AfricaAction Strategic Action Issue Area: Treatment Access
http://www.africapolicy.org/action/access.htm

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