In southern Africa, where close to 20 per cent of the adult population carries HIV. In Swaziland the figure reaches 42 per cent in antenatal clinics. There were 1 million deaths due to AIDS in southern Africa alone each year. Clearly something isn't working in the battle against AIDS. It starts from the assumption that the AIDS burden reflects a culture of sexual promiscuity, moral depravity and basic ignorance among Africans. This is why the primary AIDS programmes - the World Bank, UNAIDS and most NGOs - peddle "awareness" and "behaviour change" as the frontline solutions which carries obvious racist undertones. It is also not true: southern Africans are not ignorant about HIV/AIDS. In fact, statistics show that most of them are highly knowledgeable about it and often know more than their Western counterparts.
Wealthy people respond to awareness campaigns because their participation in risky sexual behaviour is voluntary. Not so with the poor. For them, risky sexual behaviour is generally compelled by structural factors beyond their control. In southern Africa, poor people are often forced to pursue labour migration and engage in transactional sex just to make a living. These are the key drivers of HIV transmission. AIDS is not a disease, it is a symptom - a symptom of an unjust social system.
During the colonial era, European capitalists needed a steady supply of cheap black workers for their mines, plantations and factories. To get it, they restricted Africans' access to arable land and imposed taxes to force them onto the labour market. But Europeans didn't want African workers to settle permanently in urban areas. Instead, they ferried workers in on a temporary basis and then sent them back to the "native reserves" when they were used up. The rotating migration system allowed Europeans to rake in huge profits. Companies could pay migrant workers much less than what permanent urbanites required to support their families, since the difference was covered by unpaid subsistence activities in the reserves. This system continues to this day: for instance, unskilled workers in South Africa come from as far afield as Malawi and return home as infrequently as once a year. When HIV hit the continent in the early 1980s, it spread rapidly through these migration networks. It was an epidemic waiting to happen. In South Africa, HIV prevalence is nearly three times higher among migrant workers than among non-migrants. Migration increases high-risk sexual behaviour among men who are away for long periods of time, and this increases HIV prevalence among their female partners tenfold. Remittances sent home by migrants are critical to household survival, and many households have no other source of income; they cannot afford to forfeit such staple earnings in favour of geographical solidarity. When families are forcibly strung across the subcontinent, "abstinence" and "fidelity" - the values promoted by HIV prevention campaigns - become impossible ideals for both men and women.
Beginning in 1980, the IMF and the World Bank imposed free-market shock therapy on African economies. They did this through "Structural Adjustment Programmes" that cut spending on services like healthcare, privatised public assets and cut trade tariffs (a major source of revenue for poor countries) in order to pry open new markets and create "investment opportunities" for Western companies. They also raised interest rates to keep inflation low so that the value of debts to the West would not diminish, even though this hampered governments' ability to spur growth. These policies have been particularly rough on rural farmers. The abolition of price controls, subsidies and tariffs have all made it harder for farmers to make a living. In addition, free trade rules have allowed big agri-businesses, often foreign-owned, to capture vast swathes of the region's best farmland. As a result, farmers are forced to move to urban slums. But since there's no formal employment available in the cities anymore they can't afford to live there permanently, so they migrate back and forth.
The other key driver of HIV transmission in southern Africa is transactional sex: when women exchange sex for money. Most AIDS gurus talk about transactional sex as if it were a choice that women make, or they cast African men as sexual predators. But it's not that simple. Women engage in the sex trade with wealthier men because they lack access to the resources they need to live. This often entails relinquishing control over the terms of sexual intercourse, such as condom use. Given these conditions, campaigns that focus on awareness promotion among women have precious little effect. Report after report concludes that increased knowledge does not assist women to avoid risky sexual behaviour: their financial desperation is grave enough to outweigh concerns about their own health. In other words, women are willing to risk one health threat (HIV) in order to stave off another, more immediate one (hunger).
Women who secure formal employment feel less pressure to sell sex but such employment is almost impossible to find. Unemployment now sits at close to 40 per cent in much of the region. Swaziland's once-thriving textile industry was flattened in 2005 when the WTO liberalised the global textile trade. Factories shut down overnight as producers relocated to Asia for cheaper labour, putting some 30,000 women instantly out of work. Many of these women turned to transactional sex to fill the breach, and the fight against AIDS suffered a monumental setback.
One of the most troubling things about the AIDS epidemic is that it could have been stopped so easily by rolling out life-saving antiretroviral drugs (ARVs) early on. Not only do ARVs prevent HIV from developing into AIDS, they also reduce transmission rates and increase people's willingness to get tested. ARVs initially cost up to $15,000 per yearly and it was not until 2003 that the WTO bowed to activist pressure and allowed southern Africa to import generics, but by then it was too late - HIV prevalence had already reached devastating proportions. In other words, much of the region's AIDS burden can be directly attributed to the WTO's rules and the corporations that defended them. And they are set to strike again: the WTO will cut patent exemptions for poor countries after 2016. In addition to make matters worse WTO trade policies have forced states to cut spending on hospitals and staff in order to repay national debts to the West, weakening the first line of defence against AIDS.
It is not the culture of African peasants and workers that is morally depraved, but the culture of institutions like the WTO and the IMF run by a cabal of elite corporate interests. Banks and corporations have made off with trillions of dollars from privatisation, mineral extraction, cheap labour and debt service - a net flow of wealth from poor countries to rich countries that vastly outstrips the meagre aid that trickles the other direction. The AIDS battle means challenging the control of the rich over the world's resources; it means creating a world in which Africa's wealth is harnessed to benefit humanity and not capitalism.
Adapted from this article by Dr Jason Hickel
Wealthy people respond to awareness campaigns because their participation in risky sexual behaviour is voluntary. Not so with the poor. For them, risky sexual behaviour is generally compelled by structural factors beyond their control. In southern Africa, poor people are often forced to pursue labour migration and engage in transactional sex just to make a living. These are the key drivers of HIV transmission. AIDS is not a disease, it is a symptom - a symptom of an unjust social system.
During the colonial era, European capitalists needed a steady supply of cheap black workers for their mines, plantations and factories. To get it, they restricted Africans' access to arable land and imposed taxes to force them onto the labour market. But Europeans didn't want African workers to settle permanently in urban areas. Instead, they ferried workers in on a temporary basis and then sent them back to the "native reserves" when they were used up. The rotating migration system allowed Europeans to rake in huge profits. Companies could pay migrant workers much less than what permanent urbanites required to support their families, since the difference was covered by unpaid subsistence activities in the reserves. This system continues to this day: for instance, unskilled workers in South Africa come from as far afield as Malawi and return home as infrequently as once a year. When HIV hit the continent in the early 1980s, it spread rapidly through these migration networks. It was an epidemic waiting to happen. In South Africa, HIV prevalence is nearly three times higher among migrant workers than among non-migrants. Migration increases high-risk sexual behaviour among men who are away for long periods of time, and this increases HIV prevalence among their female partners tenfold. Remittances sent home by migrants are critical to household survival, and many households have no other source of income; they cannot afford to forfeit such staple earnings in favour of geographical solidarity. When families are forcibly strung across the subcontinent, "abstinence" and "fidelity" - the values promoted by HIV prevention campaigns - become impossible ideals for both men and women.
Beginning in 1980, the IMF and the World Bank imposed free-market shock therapy on African economies. They did this through "Structural Adjustment Programmes" that cut spending on services like healthcare, privatised public assets and cut trade tariffs (a major source of revenue for poor countries) in order to pry open new markets and create "investment opportunities" for Western companies. They also raised interest rates to keep inflation low so that the value of debts to the West would not diminish, even though this hampered governments' ability to spur growth. These policies have been particularly rough on rural farmers. The abolition of price controls, subsidies and tariffs have all made it harder for farmers to make a living. In addition, free trade rules have allowed big agri-businesses, often foreign-owned, to capture vast swathes of the region's best farmland. As a result, farmers are forced to move to urban slums. But since there's no formal employment available in the cities anymore they can't afford to live there permanently, so they migrate back and forth.
The other key driver of HIV transmission in southern Africa is transactional sex: when women exchange sex for money. Most AIDS gurus talk about transactional sex as if it were a choice that women make, or they cast African men as sexual predators. But it's not that simple. Women engage in the sex trade with wealthier men because they lack access to the resources they need to live. This often entails relinquishing control over the terms of sexual intercourse, such as condom use. Given these conditions, campaigns that focus on awareness promotion among women have precious little effect. Report after report concludes that increased knowledge does not assist women to avoid risky sexual behaviour: their financial desperation is grave enough to outweigh concerns about their own health. In other words, women are willing to risk one health threat (HIV) in order to stave off another, more immediate one (hunger).
Women who secure formal employment feel less pressure to sell sex but such employment is almost impossible to find. Unemployment now sits at close to 40 per cent in much of the region. Swaziland's once-thriving textile industry was flattened in 2005 when the WTO liberalised the global textile trade. Factories shut down overnight as producers relocated to Asia for cheaper labour, putting some 30,000 women instantly out of work. Many of these women turned to transactional sex to fill the breach, and the fight against AIDS suffered a monumental setback.
One of the most troubling things about the AIDS epidemic is that it could have been stopped so easily by rolling out life-saving antiretroviral drugs (ARVs) early on. Not only do ARVs prevent HIV from developing into AIDS, they also reduce transmission rates and increase people's willingness to get tested. ARVs initially cost up to $15,000 per yearly and it was not until 2003 that the WTO bowed to activist pressure and allowed southern Africa to import generics, but by then it was too late - HIV prevalence had already reached devastating proportions. In other words, much of the region's AIDS burden can be directly attributed to the WTO's rules and the corporations that defended them. And they are set to strike again: the WTO will cut patent exemptions for poor countries after 2016. In addition to make matters worse WTO trade policies have forced states to cut spending on hospitals and staff in order to repay national debts to the West, weakening the first line of defence against AIDS.
It is not the culture of African peasants and workers that is morally depraved, but the culture of institutions like the WTO and the IMF run by a cabal of elite corporate interests. Banks and corporations have made off with trillions of dollars from privatisation, mineral extraction, cheap labour and debt service - a net flow of wealth from poor countries to rich countries that vastly outstrips the meagre aid that trickles the other direction. The AIDS battle means challenging the control of the rich over the world's resources; it means creating a world in which Africa's wealth is harnessed to benefit humanity and not capitalism.
Adapted from this article by Dr Jason Hickel
No comments:
Post a Comment