The Guardian September 20, 2000

Africans spurn US loan offer for anti-AIDS drugs

Medical experts have hailed the decision, by three southern African 
governments, to spurn loan offers from the US Export-Import Bank for the 
purchase of anti-AIDS drugs.

The three southern African countries, Namibia, South Africa and Zimbabwe 
have rejected the United States' offer of US$1 billion in yearly loans to 
finance the purchase of anti-AIDS drugs.

The US Export-Import Bank made the loan offer to 24 African countries, but 
none have formally accepted the offer so far, fearing that it would enrich 
American and western drug manufacturers while creating an extra debt burden 
for African nations.

Nearly 40 per cent of Africa's annual budget goes to servicing foreign 
debts estimated at US$350 billion in 1998.

According to the World Health Organisation (WHO), debt remains a barrier to 
accelerating growth and improving the distribution of the benefits of 

"African leaders seem to be waking up", says Faleyimu Bode-Law, a member of 
an e-mail discussion forum HIV/AIDS in Africa.

"The loan was definitely a debt trap that will lead to poverty, which is 
actually the co-factor for both HIV transmission, development of AIDS and 
its progression", says Bode-Law.

"I think African leaders need to follow the Brazilian way of getting 
cheaper generic drugs rather than wait for these loans that their great 
grandchildren will not be able to pay, as is the case for us, in Nigeria", 
he adds.

The loans, part of President Bill Clinton's initiative to combat HIV/AIDS 
in Africa, offered interest rates of about seven per cent. President 
Clinton this week toured Nigeria where he talked about the need to work 
toward halting the spread of HIV/AIDS.

Although the southern African region has one of the highest HIV/AIDS 
infection rates in the world, health experts do not see any country jumping 
to take up the US loan offer.

Life expectancy at birth in southern Africa, which climbed from 44 in the 
early 1950s to 59 in the early 1990s, is expected to drop back to 45 
sometime between 2005 and 2010.

The UN Development Program (UNDP) estimates that fewer than 50 per cent of 
South Africans, currently alive, can expect to reach the age of 60, 
compared with an average of 70 per cent for all developing countries and 90 
per cent for industrialised countries.

The Geneva-based UNAIDS, says each country has the right to decide whether 
they would like to accept these loans or not.

Hailing the rejection, Professor Norman Nyazema, a pharmacist in Zimbabwe 
wonders: "Why the sudden magnanimity to give the loans. Why not give us the 
drugs free? Anti-retrovirals should not be made available in a poor and 
non-existent health structure such as ours in Zimbabwe."

Nyazema calls for better treatment of opportunistic infections, such as 
tuberculosis and pneumonia, which cause unnecessary and premature death. 
About 78 per cent of HIV positive people in Zimbabwe have TB, he says.

"This agenda (for anti-retrovirals) is being pushed by people who can 
afford these drugs. If the West is serious about helping us, then we need 
essential drugs for TB, diarrhoea", says Nyazema.

"It does not make political and economic sense to get a loan to buy anti-
retrovirals. We don't know much about these drugs. Even for vaccine 
research, who does the research? It is the US who will then patent the 
drugs and it becomes their intellectual property but they will have used 
our own people for the research", says Nyazema.

The cost of a month's supply of one anti-retroviral drug has increased from 
11,000 Zimbabwe dollars in June to 14,782 currently. (one US dollar equals 
51 Zimbabwe dollars.)

"Even for rich countries, anti-retrovirals are completely off their means. 
We should direct action to treating diseases such as TB and other 
opportunistic diseases and pain relief", says Dr Sunanda Ray, deputy 
director of programmes for Southern Africa AIDS Network (SAFAIDS)....

"Our emphasis should be on stopping new infections and supporting people 
already infected." 

Over the next decade, the UN warns, AIDS will kill more people in sub-
Saharan Africa than all the wars of the 20th century. There are an 
estimated 14,000 new HIV infections in sub-Saharan Africa everyday.

According to the World Bank, between one billion US dollars and $2.3 
billion are needed annually for prevention alone in Africa, but official 
assistance for AIDS is something in the region of $160 million.

The situation is grave. More than 23 million Africans are estimated to be 
infected with HIV. Since the pandemic began, 50 million people worldwide 
have been infected with HIV, of whom 16 million have died.

In Sub-Saharan Africa, 55 per cent of infected adults are female. UNAIDS 
estimates that 12.2 million African women and 10.1 million African men aged 
15 to 49 are living with HIV.

The UN's analysis suggests that, because of AIDS, by 2005 the gross 
domestic product (GDP) of most southern African countries will have shrunk 
by at least 14 per cent. Per capita income will drop by 10 per cent.

Labour costs are rising due to morbidity and absenteeism, and training new 
workers brings an added burden. AIDS will reduce life expectancy in Africa 
by 20 years. It is destroying families and wiping out economic gains as 
fast as nations can make them.

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