Friday I had a meeting at the National AIDS Commission of Malawi, housed in a beautiful, albeit ridiculously out of place building in Lilongwe that is made entirely of green glass. The NAC was established by the Malawian government in 2001 to provide overall leadership and coordination of the national response to HIV and AIDS. “The Commission was established following Government realization that the response to the HIV and AIDS pandemic required a multi-sectoral approach and interaction between HIV and AIDS and broader issues of population, economic development and management, social service provision, culture, community development, human rights, and gender.”
The meeting itself was with the Director of Policy and Programmes, and although short and not really that productive, I did get the opportunity to spend about an hour and a half in their Resource Center where I had access to a wealth of information on HIV/AIDS in Malawi generally, and for my purposes, several documents and reports about gender and HIV/AIDS in the country. Here’s just a few basic facts from the Malawi HIV and AIDS Monitoring and Evaluation Report 2005-2006:
- 14% of the population aged 15 – 49 years is infected with HIV, totaling about 1 million cases in the country; AIDS ranks as the leading cause of death among the most economically productive age group (20-49)
- HIV/AIDS has caused a major human resource crisis in Malawi, like in many sub-Saharan countries; for example, between 1999-2005 over 6,000 teachers in Malawi died of AIDS
- It is estimated that there are about half a million orphans as a direct result of AIDS deaths, and slightly over a million orphans total in the country
- Only 5% of HIV positive pregnant women in the country accessed Nevirapine for PMTCT, of which a single dose to mother and newborn can decrease the risk of vertical transmission by 50% (see the original HIVNET 012 trial in Uganda if you’re interested)
- Only 14% of Malawians had ever been tested for HIV in 2004; thankfully, that number is steadily increasing
- Only about 30% of those who need treatment are on ART (anti-retroviral therapy), although this is reported as one of the higher coverage rates in southern Africa; the coverage rate for children however is tragic–25% of those who need ART are children aged 0-14, but only 6% of children are receiving it
- Women are nearly 4 times more likely to be HIV positive than men
My work this year is on a much more policy/structural level compared to my work/experiences in Kenya the past two summers, so it’s hard to tell what’s actually happening “on the ground” … but from this perspective, I am impressed with Malawi’s response to HIV/AIDS. Their National Action Framework 2005-2009 is very comprehensive, and reading the M&E report, they are definitely getting started on just about every initiative/problem/correlate of HIV/AIDS given their limited resources and economy. A long way to go, but it seems hopeful.
And although there are certainly still huge walls of stigma and discrimination that must be torn down, the level of awareness, advocacy, activism, and yes, hope, does seem apparent. As I was out for a walk today, I strolled past this huge stadium up on a hill, and although I could only see the outer brick wall, I knew something was happening. I went in to check it out and sure enough, I caught the tail end of the International AIDS Candlelight Memorial 2008, sponsored by the Global Health Council. The crowd was almost entirely women activists/advocates and late primary / early secondary school students. The motto of the event was “Never Give Up, Never Forget”
“When I look at the world it fills me with sorrow
Little children today are really gonna suffer tomorrow” is how Brother Marvin put it back in 1971. We got the save the kids, everyone too, but definitely the kids man. The future. I’m doing the best I can on the Western front and I see you in Mother Africa doing the best you can too. Much respect, we are watching! Stay up and be peace.
Merc, the blog is too legit to quit. I had an interesting conversation with a Canadian friend of mine about the legal responsibilities of the ‘haves’ in aiding the ‘have-nots’. This banter was mainly centered on the Burma/China disasters but has implications anywhere there is extreme poverty. Anyways, Garrett Hardin and “Lifeboat Ethics” was at the epicenter of our discussion and I wondered how you (and your educational peers) respond to/discount Hardin’s conclusions…
Trav P,
Great to hear from you buddy.
First, you’re language of the “haves” aiding the “have-nots” is just the kind of thing I struggle with. Mainly… by writing this blog, I’m acknowledging that I’m a “have.” And I certainly am, but still, it rips at me…
Anyways, in response Hardin, you’re right, I do discount his conclusions. I admit, I have not explored in depth his theories, but I have read his landmark essay on Lifeboat Ethics (http://www.garretthardinsociety.org/articles/art_lifeboat_ethics_case_against_helping_poor.html)
Other than Hardin, there certainly are other critics of humanitarian aid, and even of helping poor countries with economic development.
My very superficial responses are threefold:
1) I do not believe economic development, or even humanitarian aid for that matter, is a zero sum game. Aid, or development assistance, provided by rich countries to poor countries does not necessarily take resources from the “haves” and transfer them indefinitely to the “have nots.” One country does not have to prosper at the expense of another.
2) Hardin’s argument about uncontrolled population growth in poor countries is superficial. He treats this phenomenon as a de facto reality of poor nations. Rather, higher birth rates and populations growth rates in poor countries relative to rich ones, is a consequence. It is a consequence of poverty… a consequence of the consequences of poverty, such as illiteracy and lack of education, poor access to health care and contraceptive use, gender inequalities, rape, and discrimination.
3) From a human rights perspective, helping poor countries is the right thing to do. I have found no other way to reconcile being born a “have” and not a “have not.”
Great discussion. During my time here in the inner city with Mission Year, coming into this understanding of being a said “have” has definitely worn away at me in ways I often wish I could undo, or AT LEAST reconcile (…someday).
I see the idea of “have” vs. “have not” in this context refers towards the having of money, education, access to resources, freedom—tangible needs, things we see as absolute needs in terms of quality of life. The challenge/struggle I’ve come across this year is the question of what have the “have nots” that we as “haves” have not. To re-word, being a “have”, I/we often tend to think of the “have nots” as lacking and in need of the things that we have. And yes, they are in many tangible terms. BUT I am learning, at least on a philosophical/social/spiritual level that there are many things we as “haves” are in need of that those we see as “have nots” can offer us. That we may indeed be “have nots” in spite of, even possibly BECAUSE of, our state of being “haves”. A thought/challenge to think on…
****Disclaimer–I know this is outside the realm of tangible development aid and health reform, etc. mentioned in the above discussion BUT I believe we are more than just our physical selves, we are spiritual, social, mental beings as well (although CLEARLY those aspects of ourselves are incumbent upon our physical state of being). I do believe there are many ways we can be poor- social, emotional, spiritual and mental poverty is very real, on top of or aside from the physical manifestations of poverty. That goes for both the haves and the have nots.