Even the normally discerning Guardian journalist Chris McGreal could not contain himself, commenting in an article called “George Bush: a good man in Africa”, that Bush’s African HIV initiative is “transforming healthcare in Africa and has been praised as the most significant aid programme since the end of colonialism”.
The President’s Emergency Plan for Aids Relief (Pepfar) is a much-hyped project that provides funding for communities affected by HIV. Launched in 2003 as Bush’s individual answer to the fight against HIV, Pepfar intentionally bypassed existing international campaigns. The headline figure of $15 billion already spent is cited as proof that funds are being made available. But there is a catch. Pepfar aid is only released if there is an emphasis on abstinence. The slogan “abstinence until marriage” underpins the philosophy of the project. Life saving condoms play no part in Aids education supported by the programme, while religious organisations are used to deliver care.
Take Uganda. The country is frequently held up as a success in bringing down the rates of HIV infection after sustained campaigning that advocated the use of condoms. These advances are now threatened by funding that rejects the promotion of condoms.
There is also a corporate sting to Bush’s initiative. The lion’s share of Pepfar funding is used to purchase life-saving anti-retrovirals (ARV) from large US pharmaceutical corporations that make massive profits in the process. So in 2006, for example, 73 percent of ARVs for the fund were purchased from the big corporations, this was 20 percent of Pepfar’s entire aid budget for that year. By refusing to be bound by World Health Organisation guidelines on drug efficacy, few of the much cheaper generic ARVs are used. So US foreign aid to combat HIV is making vast profits for US firms.
Nor is the funding generous. International public health experts agree that a minimum of $50 billion is needed by 2013 to make HIV/AIDS programmes really function. Bush is offering $30 billion, which fails to keep up with demand for treatment and continues to waste funds on expensive drugs.
Debt cancellation is a solution that is not being considered. Government budgets have been cut so that debts could be repaid. Health services across the continent were also hit by World Bank and IMF structural adjustment programmes in the 1980s and 1990s that insisted on slashing health costs. Thousand of community health centres closed and with them an important rampart against the spread of HIV.
But there was another element to Bush’s trip. The visit marks a year since the US defence department set up the new Africa Command (Africom) to direct US strategic interests on the continent. This reflects the renewed importance of African resources, particularly oil, for the US. As part of this project Bush is desperate for new allies on the continent to collaborate in the scramble for Africa.
Traditional US allies on the continent can no longer be relied on. Ethiopia is embroiled with the US in the disastrous intervention in Somalia, while Kenya’s crisis ruled out Bush’s visit. Africa is no friend to Bush. The White House has been unsuccessfully trying to find a base for Africom – even friendly governments are wary about providing a home for the US imperial project. Only Liberia, one of the countries Bush visited, has been vocal in insisting that Africom be housed on African soil.
But even in the countries Bush could visit he aroused deep anger. Protests marked his trip. In Tanzania demonstrators marched chanting, “Bush is an oil thief,” and “Who is a terrorist? Bush.” Sheikh Mussa Kundecha one of the protest organisers in the capital Dar es Salaam spoke for thousands: “We will be the first to receive Bush by protesting against him and cursing his visit.”
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