The Africa Prize For Leadership

Address By Joan Holmes, President of The Hunger Project

October 13, 2001, The New York Hilton Hotel

 

AIDS IN AFRICA – A CRISIS OF LEADERSHIP

Welcome to the first Africa Prize for Leadership event in this new millennium. This evening is dedicated to a renewed commitment to the well being of the human family.

To begin, may I request that you stand and join me in a moment of silence in remembrance of the global citizens from 65 countries who lost their lives on September 11^th.  One of those who perished, Nick Humber, had been a Hunger Project investor for 16 years.

We’ve come together to celebrate courage and commitment.  Therefore it seems appropriate to start the evening by having you acknowledge yourself and each other for coming to New York. Tonight we prove that in times of crisis we can live up to our commitments.

The HIV/AIDS Crisis in Africa

For just a moment, imagine a scenario in which every child and adult in New York, Los Angeles, Chicago, Houston and the next 46 largest cities in the United States – were either dead or infected with a deadly condition - for which there is no cure or vaccine.  Such a tragedy would still fall short of what is happening in the HIV/AIDS pandemic.

36 million people are living with HIV/AIDS in the world, 25 million live in Africa. 22 million have died worldwide, 17 million were African. 13 million children have been orphaned by AIDS, 12 million in sub-Saharan Africa.  It is estimated that by the year 2010 there will be 40 million AIDS orphans in Africa.

We used to think of HIV/AIDS as a health crisis. Today, HIV/AIDS can no longer be confined to the health or social sectors.  In Africa today, AIDS is a health crisis, an economic crisis, and a threat to political stability.

This epidemic is shredding the social fabric of community and village life.  It is destroying precarious health care systems and wiping out years of progress in all areas of development. Those most affected are vital, productive people, between the ages of 20-50 years. Many countries in Southern Africa where the crisis is most severe will lose at least 20 or more years of life expectancy in the next decade. Already, in countries like Botswana and Zimbabwe, life expectancy has dropped from 70 to 39 years.  At the same time, infant mortality rates will double and child mortality rates will triple.

Increased demand for health care from people with HIV-related illnesses is over-stressing already inadequate public health systems. In some countries, doctors, nurses and teachers are dying faster than they can be replaced. In Kenya, 1500 teachers died in 1999, up from 10 teachers dying in 1993.  A rapidly increasing number of children - particularly girls - are dropping out of school to act as substitute labor or caregivers for their sick or dying parents.

AIDS is now becoming a greater threat in the rural areas than in the cities.  This has serious implications for food security. Rural households affected by AIDS can experience a 50% decline in agricultural output.

In purely economic terms, over the next 20 years, AIDS will reduce the economies of sub-Saharan Africa by 25%. And to date, there is no sign that this crisis is abating. Today and everyday there are 11,000 new infections in sub-Saharan Africa.  This means that there is a new infection every 8 seconds.

AIDS is the deadliest epidemic since the bubonic plague in the Middle Ages. The difference is we know what causes this disease and we know how it can be prevented. In confronting the horror of HIV/AIDS, we cannot forget that this disease is 100% preventable.

A Crisis of Leadership

Above all, the crisis of AIDS is a crisis of leadership.  Leadership is the single most important factor in reversing this epidemic.  To stop the spread of HIV/AIDS and to treat those who are infected will require leadership at all levels and in all sectors of society.  Most of all it requires, leadership at the top political level.

In Uganda, President Museveni acknowledged the problem of AIDS soon after coming into power in 1986.  He launched a national campaign for AIDS prevention that same year. Through the leadership of President Museveni, the incidence of HIV in Uganda has been reduced from as high as 30 percent in some areas, down to 8 percent countrywide.

In Senegal, when the first six HIV cases appeared in 1986, President Diouf and his government immediately developed a program to protect the national population.  They stopped the epidemic before it started.  Senegal now has an infection rate of less than 2% - one of the lowest of any country in sub- Saharan Africa.

All of our African sisters and brothers deserve this kind of courage, commitment and effectiveness from their leaders: No longer can leaders keep silent in the face of this devastation. No longer can leaders spend 70 times more financing a war, and a war in another country, than is spent on HIV/AIDS prevention for their own people. No longer can leaders deny pregnant women drugs which prevent the transmission of HIV to their children: drugs, which are proven to be safe - effective - have few side effects, and are offered free by a pharmaceutical company for the first 5 years.

Let us be clear, for African leaders – the response to this crisis is the supreme test of their commitment to the wellbeing of their people.

The Link to Gender Inequality

Medically speaking, HIV is a virus and AIDS is the consequence of a viral infection.    It is spread through unprotected sex with an infected partner, contaminated needles, contaminated blood, and mother to child transmission. In Africa, HIV is predominantly transmitted by heterosexual activity.

Medical issues alone however, do not determine who lives and who dies – the underlying social, economic and cultural inequities do: In sub Saharan Africa, gender inequality is fueling the rapid spread of HIV.  This is the only region in the world where more women than men are infected. In some countries, the average rate of infection of teenage girls is 5 times higher than of teenage boys.

Women for biological reasons are more vulnerable than men to HIV.  They are also at special risk because they lack the power to determine how, when, where, and all too often with whom, sex takes place. Gender inequality keeps women uninformed about prevention, powerless to protect themselves, last in line for care and life saving treatment, and imposes an overwhelming burden on them to care for the sick and dying.  The bottom line is that there is a direct correlation between women's low status, the violation of their human rights, and HIV transmission. 

Gender inequality has always been dehumanizing.  Now it is fatal.

It is becoming clear that it is men’s sexual behavior influenced by harmful cultural beliefs about masculinity that is driving the AIDS epidemic in most African countries. These widespread beliefs encourage men to have many sex partners and unprotected sex, while taboos about discussing sex openly, discourage education.

In epidemiological terms, this means that persuading 10 men with several partners to engage in safe sex has far greater impact than enabling a thousand women to protect themselves from their only partner. The 10 men are at the beginning of the chain of infection; the 1,000 women are its last link.

In order to truly have effective prevention strategies, traditional gender roles that have gone unquestioned for generations must now be reexamined and transformed. What we must recognize is that men are as trapped in their traditional roles as women are. Men must have the courage to come together to examine and challenge old harmful concepts of masculinity, and create a new definition of what it means to be a man in this new millennium.

Women need to become more assertive, empowered and economically autonomous.  They need to continue to challenge the patriarchal system that denies them the opportunity to protect themselves from HIV/AIDS.

If this plague is to be stopped, both men and women need to be at the forefront of change, responsibility and leadership.

HIV/AIDS and Poverty

There are a lot of misconceptions about AIDS.  One of the most widespread is that poverty causes AIDS.  Poverty does not cause AIDS.

Although HIV is not caused by poverty, it is true that poverty exacerbates the HIV/AIDS crisis.  At the same time, the HIV/AIDS crisis exacerbates poverty. Most of the countries that have high infection rates are also extremely poor.  That needs to be taken seriously when considering programs of prevention, care, treatment and support.

In order to fight this disease, what poor people need now and will continue to need even when anti-retroviral drugs are available, is access to the basics: nutritious food, clean water, sanitation, simple drugs for opportunistic infections like Tuberculosis, and basic health care. We know, that if these basic elements are provided in a climate of social acceptance, individuals with HIV can lead positive lives, watch their children grow up and pass on their skills to the next generation.

International Solidarity and Action

Internationally, what is needed is solidarity, partnership, and the mobilization of resources.

The Hunger Project supports the all-out international effort to develop a vaccine. We support the pharmaceutical companies who are lowering their prices and looking to make remedies available to the developing countries. We support debt relief for African countries. We support the corporations, foundations and individuals who are joining in the commitment to fight this epidemic. We in The Hunger Project are honored to join in the struggle to stop the spread of HIV/AIDS in the 7 countries in Africa where we work.

We also support raising a multi-billion dollar fund, headed up by the United Nations Secretary General Kofi Annan. We pray that this global fund – not only addresses the care and treatment of the people infected, but also the social conditions that give rise to the problem. It is important that the global fund build sustainable health services – not only to treat this disease, but to provide for the ongoing health and wellbeing of the people of Africa. It is essential that a fair share of the financial resources benefit women and girls, and that programs are designed to relieve the overwhelming burden placed on women – who are sacrificing their lives to care for the people living with HIV/AIDS. Women must have an equal and powerful voice in the design and administration of this fund.  This is particularly important given that the two key players in this effort – the United Nations and the World Bank – have yet to meet their goals for gender equity within their own organizations.

Finally, this global fund must recognize the unparalleled contribution of grassroots leaders like the ones we are honoring this evening. It is the women and men at the grassroots level – the people at Ground Zero of this crisis – who are the true heroes.

We in The Hunger Project pay special tribute to our African sisters and brothers, who daily demonstrate extraordinary courage – resilience – and heart.  We in The Hunger Project are with you.  We have an unshakable commitment to your wellbeing.  We stand in solidarity with you now and in the future.

Conclusion

In closing, I want to thank you for the generosity of your listening.  I’ve taken the liberty of being very explicit in my speaking. This virus thrives in the darkness of fear, denial, silence, and misunderstanding. 

Tonight it is our intention to bring this disease into the light, so that we can respond with clarity, dignity, effectiveness and compassion.

Thank you so very much for being here tonight. Most of all, thank you for your enduring commitment to the wellbeing of our human family.