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AIDS, orphans, and the future of Africa.

THROUGHOUT HUMAN HISTORY, tragedies have served as opportunities for the church to be a source of hope, conscience, and witness. In the crucible of unbelievable human suffering, God offers various generations the privilege to be a light during seasons of great moral tragedy.

Fortunately, such occasions of world historical significance are rare. On such occasions, the church has too frequently failed to obey God's call to be a witness against despair and death, and then stands naked before God and the world with the blood of the innocent on its hands. The church's inadequate response to the destruction of European Jewry during World War II and the genocide in Rwanda are clear and unfortunate examples of such missed opportunities.

Admittedly, such crises are complex and do not yield to simplistic rhetoric or solutions. And on more than a few questions, well-intentioned solutions are worse than the "disease" they are intended to cure. However, even with the complexities and tragedy noted, the church is obligated to stand on the side of the poor and neglected.

At the beginning of a new century, the church in the United States has a unique challenge and opportunity to be a powerful voice of conscience and practical reason in the face of the greatest humanitarian crisis of our times: The AIDS holocaust in sub-Saharan Africa.

AIDS is the leading cause of death in sub-Saharan Africa. Consider the facts:

* Of the 5.6 million new HIV infections in 1999, according to the U.N. Program on AIDS, fully 4 million were in Africa. Half were among young people ages 15 to 24, and far more than half of those afflicted were female.

* Two-thirds of the AIDS cases in the world are now in sub-Saharan Africa. One adult in four in Namibia, Zimbabwe, Swaziland, and Botswana now has the HIV virus. Half of these cases in sub-Saharan Africa are women.

* The numbers are so massive in southern Africa that life expectancy is likely to drop to 45 years within the next five years after climbing to 59 in the early 1990s. In the past five years--according to a U.S. Census Bureau report--life expectancy in Zimbabwe has dropped from 61 years to 39 years; in Botswana it has fallen from 60 to 40, and in Kenya the situation is very similar.

AS UNBELIEVABLE as these statistics are, things are only getting worse. A survey of pre-natal clinics in one southern province in Zimbabwe indicated a 67 percent infection rate for the women there. In Zambia there are communities consisting of only the elderly and the very young; the rest have been obliterated. The AIDS epidemic is even contributing to the deforestation of significant areas--because of coffin construction. In southern Africa we are witnessing the creation of a virtual biological underclass.

In this situation in which millions are perishing, the behavior of the citizens of the affected countries is profoundly troubling. For example, it is reported that in South Africa a woman is raped every 26 seconds, contributing to the 1,600 people a day who are infected with HIV. Just as disturbing is the rumored source of the increase in the rate of rape: a spreading myth that sexual intercourse with young girls can cure or prevent the disease.

Behind the statistics on rape lurk facts that are in some respects just as ominous. In sub-Saharan Africa, AIDS is transmitted primarily through heterosexual contact. Widespread promiscuity--essentially fatal behavior--is typical. The head of the UNAIDS program for Eastern and Southern Africa said, "Without addressing behavior, the response to prevention strategies will always be limited." Promiscuity and rape now objectively function as weapons of suicidal mass destruction. In such a context of cultural decay, abstinence and sexual fidelity appear as revolutionary concepts.

Within five years, 61 of every 1,000 children born in Namibia, Botswana, Zimbabwe, Swaziland, and South Africa won't reach their first birthday, according to U.N. estimates. By 2001 there will be 13 million AIDS orphans in sub-Saharan Africa, according to figures presented at the September 1999 International AIDS conference in Zambia.

In too many cases African leaders have not confronted the problem of AIDS: The South African government has spent only $13 million on AIDS education and care programs in the last 5 years. At the same time it is spending $6.5 billion on three new submarines and other military hardware. Not a single African head of state attended the AIDS conference in Zambia, including the president of the host country. Unfortunately this is not an isolated incident, but an example of a pattern of deliberate neglect by these leaders.

While these African nations obviously do not have the resources to treat AIDS victims using the extremely expensive cocktail of drugs now widely available in the West, their public education efforts have clearly failed to communicate to the masses of citizens the urgency of the situation and the exigencies of preventative behavior. Deep-rooted cultural patterns are implicated, which call for sensitively crafted solutions. It does not appear that many African governments have engaged the issues at this level.


In order to address the crisis, black and white churches in the United States, both Protestant and Catholic, must work in strategic partnerships to address both the long-term and the short-term foreign and development policy implications of the AIDS crisis in Africa.

In view of the horror that confronts literally millions of African women and children, U.S. church leaders face three main tasks: public education, political advocacy, and humanitarian assistance.

EDUCATION. U.S. church leaders have the political clout and the access to the levers of power that are needed to educate elected officials about this issue. At the same time the public, especially the black public, must be educated to advocate for foreign and development policy decisions that will support and encourage African governments in their efforts to confront this crisis. Black Protestant and Catholic students, seminarians, and intellectuals must now mount a grassroots campaign that focuses on the relationship among sexual behaviors, AIDS, and poverty.

POLITICAL ADVOCACY. The churches must challenge African leadership to be more accountable to the needs of their own women and children. We must, on humanitarian grounds, challenge African leaders to mobilize their societies to exact a high price for rape.

This raises an important question: Why haven't black churches, especially the seven major black denominations, used their unique position to serve as more effective advocates for the needs and interests of millions of orphans in Africa? They should develop a strategic alliance with the IMF, the World Bank, and other international lending agencies to demand debt cancellation for African nations, thereby freeing up financial resources to be redirected towards the AIDS crisis.

It is also critical that churches apply moral, economic, and political pressure to pharmaceutical companies directly. Western pharmaceutical companies have been implicated in monopoly pricing practices, effectively shutting out access for poor Africans to life-preserving AIDS drugs (see "Protecting Profits," below). These pharmaceutical companies no longer can be permitted to exploit the suffering of millions of black people.

HUMANITARIAN ASSISTANCE. The U.S. churches are in a unique position to lend support to African efforts to combat the disease. Protestant and Catholic churches should partner with African governments to spearhead a drive to build combination boarding schools and orphanages for the 40 million children left without guardians. (In comparison, there are currently about 40 million children in the whole U.S. public school system.) With 500 children per orphanage, 80,000 such institutions must be built over the next 10 years. In addition to providing shelter, care, and education, these boarding schools-orphanages should serve as civic education and leadership development sites.

In addition to caring for orphans, these religious partnerships must focus on caring for those who are sick and dying. It is critical to break down stigmas that lead to violence against those who are sick--especially women and children. In many African countries, admitting having AIDS means ostracism, emotional and psychological abuse, and outright physical violence. Such treatment only exacerbates the fraying of community structures. It is imperative that those who are sick be treated with compassion and dignity. Religious partnerships that include African institutions and clergy can play a pivotal role in promoting community care structures. The families of the sick and dying also need support, as a further hedge against community erosion. Religious partnerships can also play a pivotal role in promoting community care structures to address these needs.

WHAT IS NEEDED is a pan-African, charismatic, evangelical congress working with community-based efforts to address the crisis in affected African countries. The goal of this congress would be to develop a program modeled on the Peace Corps and focused on providing assistance to the countries most ravaged by AIDS, and with the highest HIV infection rates.

The first steps towards developing this pan-African evangelical congress must be the identification of African religious entities and leaders to guide the work on the local front. Collaboration with both the private sector and the government in the United States, and with the Catholic Church here and in Africa, will be critical to the success of these efforts. Finally, a massive call to the church world and to the universities and seminaries must be issued to recruit young people with the willingness, time, and dedication to commit two years to working in such a program.

THE AIDS HOLOCAUST in Africa presents the perfect political context to engage some of the most difficult policy questions in the arena of post-Cold War international relations and U.S. foreign policy. The theological and political debate must include the black, Protestant, and Catholic peace and justice communities, in strategic partnership with the academic theological community. Clergy, laity, church leaders, and theologians must deepen their understanding of the political realities of international relations and of the role of the United States, with particular focus on the implications for Africa. "The Harvest of Justice is Sown in Peace," a 1993 statement produced by the U.S. Catholic Conference, provides useful insights into the moral dilemmas of this era.

The primary question for the church is: How does it wisely apply gospel values to define the legitimate values and interests and role of a superpower? For example, what are the necessary normative and political criteria for the construction of a coherent post-Cold War policy framework for Africa? How does the church wisely respond to international crises in which the available political actors or outcomes are less than desirable or at best morally ambiguous? Even as the church struggles to craft nuanced and convincing answers to difficult questions such as these, it must assist in the implementation of foreign policy decisions and offer oversight to others engaged in the work.

FINALLY, THE BLACK church must face one vital issue of its own. New black church leadership has the responsibility to lay the groundwork for an alternative to the high visibility model of engagement in international affairs that has been practiced in some quarters, and especially the extremely low impact this model has had on policy. Black church leadership must outgrow plantation-style dependence upon the Democratic Party. The black poor have no permanent friends, just permanent interests. Black church activists must build a broad faith coalition to promote issues relating to African development. The political leadership of both the Democratic and Republican parties must be challenged with equal vigor on the issue of AIDS and U.S. foreign policy.

Rarely has the U.S. church had a greater opportunity to speak as a fresh voice of reason and solidarity in the arena of foreign and development policy. Sub-Saharan Africa is facing a monumental tragedy in the AIDS crisis. When the history of this sexual holocaust is written, one of the most important questions to be addressed will be: What has been done by the church in the United States?


* Approximately 40 thousand Africans will die this week from AIDS.

* Since the start of the epidemic, an estimated 34 million Africans have been infected with HIV/AIDS.

* Some 11.5 million of these people have died, a quarter of them children.

* One-third of Zimbabwe's population is HIV-positive, as is a quarter of South Africa's.

* In some villages, the HIV refection rates are over 50 percent.

* Many African funeral homes now stay open 24 hours a day to meet demand.

* The need to build so many coffins has become one of the major reasons for deforestation in Africa.

Compiled by Marsha Coleman-Adebayo. Sources: UNAIDS (Joint United Nations Programme on HIV/AIDS), World Health Organization, UNICEF, U.N. Development Programme.


Why a low-cost anti-AIDS tool remains out of reach.

Since the start of the epidemic, an estimated 34 million Africans have been infected with HIV/AIDS--a number nearly equivalent to the size of our own country's African-American population. Some 11.5 million of these people have died, a quarter of them children.

There are medicines that could prolong the lives of Africans, but they are available only to a small minority--these pharmaceuticals are reserved for the rich and the developed world. "Triple therapy," the combination of anti-retroviral drugs that has cut AIDS mortality by 60 percent in the West, is virtually unaffordable in Africa.

Bernard Lemoine, director-general of France's pharmaceutical industry association, is not particularly sympathetic to the voices calling on his industry to aid the pandemic's victims. "I don't see why special effort should be demanded from the pharmaceutical industry. Nobody asks Renault to give cars to people who haven't got one," said Lemoine.

Five pharmaceutical companies announced in May that they will drastically reduce the price they charge for AIDS drugs used in developing countries. It's a positive step, if they follow through, but the industry has much to make up for. In 1998, more than 40 pharmaceutical companies operating in South Africa and the country's pharmaceutical manufacturers association filed a legal challenge to block the manufacture of cheaper generic drugs. According to James Love, director of the Consumer Project on Technology, "For decades, the U.S. government has advanced the interests of large pharmaceutical companies in its trade policy ... [and] the commercial interests of companies like Merck, Bristol-Myers Squibb, [and] Pfizer."

Under emergency circumstances, international trade agreements permit "compulsory licensing," which allows countries to produce cheaper, generic versions of patented drugs, as well as "parallel importing," which allows countries to shop around for the lower-cost drug in the international marketplace. Major pharmaceutical companies, like those that hold the patents on drugs such as AZT, have opposed such practices. The U.S. government has historically sided with the pharmaceutical companies.

THERE IS, HOWEVER, a low-cost measure that would assist the poor. This measure is a place where the faith community could provide an immeasurable assistance and advocacy for the impoverished and voiceless.

The U.S. government spends billions of dollars each year to fund health care research. This taxpayer-funded research has created thousands of patents and other types of intellectual property on health-care inventions. Under U.S. law, our government could give poor countries--or international organizations such as the World Health Organization--the right to use patents funded by the taxpayers to produce low-cost drugs for use in countries facing health-care emergencies.

The U.S. government has very broad rights for inventions that are made by its employees, and for inventions made by private parties when they were funded by a government grant or contract. Under every contract and grant, the federal government could require that WHO be allowed to use these inventions to produce affordable drugs in poor countries.

Last year, public health groups asked the Clinton administration to enter into such an agreement with WHO or UNAIDS and to modify all NIH grant and contract agreements to reserve rights in patents for use in developing countries. The administration refused on the grounds that this would undercut the profits of the drug companies that commercialize these inventions.

--Marsha Coleman-Adebayo

MARSHA COLEMAN-ADEBAYO is chair of the International African AIDS Network (

EUGENE F. RIVERS 3d, a Sojourners contributing editor, is pastor of Azusa Christian Community in Dorchester, Massachusetts, and co-chair of the National Ten-Point Leadership Foundation. JACQUELINE C. RIVERS is co-chair of the National Ten Point Leadership Foundation, a leader in the Azusa Christian Community, and an educator and activist. They have two children.
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Article Type:Statistical Data Included
Geographic Code:1USA
Date:Jul 1, 2000
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