Stephen Lewis: Beyond AIDS and genocide, the search for hope in Africa
In 2000, the United Nations established eight Millennium Development Goals, a series of targets designed to tackle poverty, hunger and the spread of HIV/AIDS. The world’s countries and development agencies agreed to meet these goals by 2015. We’re almost half-way there, and throughout continental Africa, things are no better.
I’ve said it a thousand times on here and in other media. We ignore Africa. We ignore it at our peril, but we ignore it and it is our greatest shame. One man who has not ignored it is Stephen Lewis, United Nations Special Envoy to Africa for HIV and AIDS. Truly one of the greatest and most decent men on the planet — father in law of Naomi Klein and father of Avi Lewis (with whom I spoke last year regard his film The Take, an interview I will post someday soon), former Canadian ambassador to the UN, Canadian of the year and one of Time magazine’s 100 most influential people in the world, there are few people as qualified to speak on the west’s failings in Africa as he. He has recently published a book, Race Against Time: Searching for Hope in AIDS-ravaged Africa, which examines the complicity of the United Nations and the G8 in Africa’s plight, and surveys the situation from his meetings with Rwandan orphans to his frustrations at the highest levels of global bureaucracy. Promises? The West has those by the sackful. But we’ve been making and breaking them for far too long.
There’s a tendency to think of Africa as hopelessly, endemically sick, moribund almost, and there’s often an assumption that this is purely a legacy of colonialism and everything that’s happened since. This is not an interview focussing on the worst ravages of corruption that tear Africa apart. If you want that, I recommend the first part of Allan Little’s extraordinary Faultlines series for the BBC World Service. Lewis is a man who, despite all he has seen since his early visits in his youth, insists on searching for the hope in the continent.
In your book you talk of the visits to Africa in your youth, your real romance with the continent. It was a very, very different place then…
I was in Africa in the immediate post-colonial period when there were very high expectations, enormous enthusiasm, great excitement. You break through the basis of slavery and all of the neo-colonial angry, nasty, manipulative, controlling impulses and suddenly you’re out into the light of day with all of the possibilities stretching out before you. The place was alive with music and enthusiasm and hope, and it was pretty depressing to see the decline of the continent over the subsequent number of years.
Simple question, then. What happened?
A combination of things. I think that the colonial powers continued unexpectedly to manipulate Africa from a distance, to use African leaders as their pawns. There’s no questions that Africa got caught in the cold war and sawed off between east and west, as it was availed by the communist bloc on the one hand and the western bloc on the other. I think that the international financial institutions — the World Bank, the International Monetary Fund — engaged in an imposition of constraints on the African economies, they imposed conditions, they made it very difficult, particularly in the social sectors. All in all, it was rough for Africa, and as a result, in this manipulative orgy, you had a number of African leaders who themselves became corrupt and totalitarian, and that made things even worse.
So now you have a continent that’s being simultaneously ravaged by AIDS on the one hand and criminal governance on the other. They’re interlinked problems. It seems that you have a continent that is dying.
I don’t agree with the analysis. I don’t think AIDS and criminality are intertwined. I think what is intertwined is AIDS and poverty. Terrible and desperate and almost incomprehensible poverty. The relative aspects of corruption, there are countries which are obviously corrupt, but there are 53 countries in sub-Saharan Africa and the great majority of them are increasingly re-elected in democratic traditions and they’re working very, very hard to quell corruption.
My god, I’m on a continent where in the United States, corruption is dealt with before grand juries almost on a daily basis. In my own country of Canada, the last election was fought on an issue of corruption and the government was defeated on an issue of corruption. One shouldn’t be too smug and self-righteous about it. Africa is a continent which is desperately poor, which has a lot of disease, it has incidental conflict, not unlike other continents, but it also has, at the grassroots level, a tremendous resilience and generosity of spirit and sophistication and if Africa had the resources which are constantly promised it and forever betrayed in the delivery, Africa could break the back of the AIDS pandemic and Africa could come out of the economic doldrums.
Do you find there is a tendency in the circles of bureaucracy to treat Africa as one generic country rather than a disparate set of nations and cultures?
Yes, that’s an absolutely good observation. There’s a tendency to make sweeping generalisations about the continent. Of course it’s profoundly different. South Africa is a nation with considerable economic power and clout, which power is being compromised by the centrality of the AIDS pandemic — there are between 5.5 and 6.5 million people infected in South Africa, the highest number of infections in the world. So that the country is struggling with disease but it has a great deal of economic strength.
Nigeria has oil, but it’s also struggling over artificial boundaries and divisions of ethnic groups imposed by the foreign powers back at the end of the nineteenth century. You have Kenya, which could be a quite remarkable nation if it can get past the internal corruption which has harassed it for some time. And then you get countries like Rwanda, which came out of a dreadful genocide and are in fact seeming to restore their democratic traditions and working hard at overcoming the resentments and the hostilities and the fratricide. The same is true of Angola, the same is true of Mozambique, every country is quintessentially different from its surrounding neighbours. It’s a fascinating continent, everything exists in Africa and one should not make generalisations.
Tell me about visiting a country like Rwanda after the genocide, as it is rebuilding and redefining itself. What are the feelings that you have in those moments when you go to these places?
Rwanda’s a particularly haunting example —- it feels as though there have been two genocides. You had a terrible genocide in the 100 days between April 6, 1994 and early July when 800,000 people were slaughtered in the full light of the world and the world raised not a finger. To overcome that, to overcome the trauma of that internal horror, takes a lot of work at human rights, at tolerance, at dealing in the schools with peace studies, of trying to overcome ethnic divisions by seeing everyone as a Rwandan, not a Rwandan tutsi, not a Rwandan Hutu, but a Rwandan.
They’ve worked at it so hard, but then along comes AIDS. And it’s so accentuated in Rwanda because so many women were raped during the genocide for the purpose of transmitting the virus. The depravity that that suggests is almost more than the mind absorbs, but there’s no question that there was a deliberate transmission of the virus through rape and sexual violence of horrific kinds, so you have so many women now who went through rape during the genocide who are experiencing full-blown AIDS, and that presents a whole new pattern that the country has to deal with. It’s so sad, and it’s so difficult. After the genocide, so many parents died, you had the phenomenon of child-headed households, where the oldest sibling in the family looks after the youngest sibling. There were 60,000 child-headed households after the genocide and then along comes AIDS, and again the entire extended family is demolished, the grandmothers die, and what you have left are child-headed households from AIDS. So this is a country which was ravaged by conflict, ravaged by disease. And yet if you go to Rwanda today, everywhere you go there’s hope. Everywhere you go they’re rebuilding, and there’s a sense of purpose, and the kids are in schools, they’ve got health centers and they are doing an excellent a job of treatment with anti-retroviral drugs for AIDS, so I actually like visiting Rwanda. You know, the commemorative sites of the genocide are heartbreaking, but the determination of the people is exhilarating.
Your book talks a lot about the relationship between the reforms and conditions of the IMF and things such as structural adjustment policies and the spread of HIV. You talk of the IMF actively denying countries the right to invest in health care. Even though we know so much about the failure of the IMF over a long period of time, some of that is pretty shocking.
Actually, let me bring it right up to date, because it continues to be shocking. In the country of Kenya, which is struggling hard against the virus, and has a wonderful minister of health by the way, a woman named Charity Ngilu, you have a country which has 4000 retired nurses, and the government is desperate to get the nurses back into employment in the hospitals and the health centers, because they are struggling so desperately against AIDS, tuberculosis and malaria. And they cannot hire the nurses. It is so crazy, it takes your breath away.
Why can’t they hire the nurses? Because it would break the macro-economic framework imposed by the IMF. In other words, the IMF has said to Kenya, you want to continue to have those loans, you want to continue to have those grants, then you cannot break the economic strait-jacket which we have imposed on you with our own dogmatic version of economic truth.
They must live in some other world, because when you’re dealing with the pandemic of AIDS, you have to show a degree a flexibility about the human condition. You’ve got too many people dying, too many people struggling, too many orphan children emerging, too many women suffering such disproportionate vulnerability because there’s gender inequality everywhere and the women are the target of the virus, so you have to have flexibility. You have to have common sense. These economic nostrums which the international financial institutions continue to impose on Africa, they’re nuts, frankly. I don’t know how they will ever be overcome but they have to be overcome.
I notice that the British have decided that they’ve got to rethink conditionality, I notice that someone as illustrious as Mary Robinson, the former International High Commissioner for Human Rights, was making this same point about Kenya: how could it happen that these financial institutions could behave in a fashion that so defies common sense?
And on the other side of the world in the lush Scottish countryside, you have the G8 last year meeting and paying an extreme kind of lip-service to the problems of Africa, when right there you see the problems as you talk about that sit directly with them. You’re very critical of Bob Geldof’s seduction by the power in that process of Live8. I remember reading similar sentiments from George Monbiot at the time — Live8 may have done, in the long term, more harm than good.
I know something about the seduction of power. I was once an ambassador to the United Nations, and you do get a little self-congratulatory and self-impressed, and you’ve got to fight those kinds of things when you’re in the rarefied halls of power. Bob Geldof obviously enjoys it, and he engaged in such ridiculous hyperbole about what a wonderful conference it was and that it had saved Africa, and that he gave it ten out of ten. It seems to me that he was transported into his own private world of irrationality, but in truth the promises that were made at the G8 summit at Gleneagles in July were quickly sabotaged by performance.
Just eight weeks later at a major replenishment conference for something called the Global Fund on AIDS, Tuberculosis and Malaria — which is the chief international financial vehicle through which money gets to these countries to fight the disease of AIDS and others — which everybody assumed would be a success because of all the promises and all the words at the G8 summit; well, lo and behold they didn’t get half of what they needed and had asked for. That was quite a shock and it showed how insubstantial are the promises, how quickly they are abandoned. I don’t understand that.
I have to say, Patrick, I am completely bewildered by the continued willingness to write off a continent, to behave towards Africa the way the G8 countries behave towards no other section of the planet. We’re losing millions of lives, mostly women, and I don’t understand how you can live with losing millions of lives unnecessarily, because we have the drugs to prolong the life and the prices have now been reduced to a level where, were the western countries to deliver on their promises, we could keep millions of people alive who are otherwise going to die. It’s beyond me. I’m 68 years old, I don’t know whether I’ve passed into my dotage and I’m no longer able to understand the way the world works, but I have to say it’s really lamentable, the way we’re behaving.
What fault the United Nations in this? Is it an institution that needs to be or can be reformed? It’s an almost depressing repetition in your book, that every great idea in the end disappears into the void of United Nations bureaucracy. What can be done?
Boy, I worry, I tried to give in the last chapter a number of potential solutions and I worry about my own tendency to convey distortion. I actually quite like the United Nations and I have a deep faith in it, and in some ways I’m a shameless apologist for it. But it has failed in many areas around the AIDS pandemic, and it’s really a matter of leadership I think. There’s a lot of great talent on the ground in the various agencies, whether you’re talking about UNICEF, or the World Health Organisation, the United Nations Development Program or the World Food Program, there’s a lot of talent on the ground in countries but at the headquarters of these organisations, it’s not that there’s rigor mortis, it’s just that there’s a certain inertia, there’s a certain lack of vision, there’s a certain lack of urgency.
I’m so fascinated by the dynamic, as I’ve watched things unfold in the last four or five years, if I were to identify the group that I’ve been most impressed by with their absolute urgency in response to the pandemic, it’s the Bill Clinton Foundation. It’s Clinton’s foundation and his initiative which has without question demonstrated they really know people are dying, and they cannot fool around. So when you ask them for something on Monday, they get it to you by Wednesday. If you ask something of some of the bilateral donors and some UN agencies on Monday, you’ve got to wait three months. It’s that lack of the sense that you’re fighting to save lives, that you just can’t delay, that you have to intervene, that you have to have a vision.
The closest we’ve come to a vision, and it’s commendable, is the World Health Organisation effort to put three million people into treatment by the end of 2005. As we know from their recent report, they didn’t succeed, they barely made it to halfway, they didn’t quite get to halfway, but they unleashed a momentum which is now irreversible and they will keep a lot of people alive.
But by and large, the UN, like most of us — and I was guilty of it myself in the 1990s, I’ll never forgive myself for it — we’ve just all moved too slowly. In the last five crucial years, the organisation I quite love and work for, the UN, has moved far too slowly and I’m not prepared to take them off the hook.
Some of the content of Lewis’ Massey Lectures series that forms the basis of Race Against Time can be found on the CBC website