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PEPFAR, AIDS Mexico, and the politics of social welfare

Two-thirds of all people with HIV-AIDS live in sub-Saharan Africa. So the disease is, not quite but almost, an African problem. American taxpayers, through their vessel, the lame duck president George Bush, this week showed enormous generosity in extending for another five years a program called PEPFAR that essentially makes possible anti-retroviral treatment for people with full-blown AIDS. The treatment works in most cases, though as the Financial Times reported yesterday, a growing number of people — perhaps as many as 25% — have resistant strains of HIV/AIDs.

The problem of drug resistance is neither new nor insurmountable. At this week’s international conference on the disease in Mexico City, many words will be spilled on how to limit the growth of resistant strains — and extend the effectiveness of front-line drugs. These are technical issues of course. The grand policy has been set: U.S. taxpayers, and their elected representatives, have a long-term stake in African health-care policies. Rather sadly, an American who needs AIDs treatment may not receive such generosity from taxpayers; for the uninsured and uncovered in the U.S., the humane deal offered ailing and anonymous Africans is rarely available.

the Afro-geeks of Nairobi get their 15-seconds of fame

The New York Times published my Ping column — the twentieth in as many months, if you are counting — yesterday. The column was devoted to the unnoticed emergence of an underground Geek culture in Nairobi, Africa’s most dynamic and cosmopolitan city. Over the coming days, I’ll be tracking reaction to the piece, which looked at the interaction between African aspirations for a greater role in the digital revolution and the engagement of leading technology agents, most notably Google, which has opened a development office in Nairobi and is hiring technical people from around Africa. In this Ping, I explored some of the dynamics of trying to innovate in unlikely places. For people who care deeply about the prospects for more even development of technological changes around the planet, the question is perhaps the hardest of all the hard questions inspired by the Internet revolution. If the Net is truly a force for democratic advance, must we not have more democratic — and truly diverse — activities supported by it? I doubt I will live long enough to learn the answer. So asking — and asking again — the question must be enough.

the Kenyan way: past as prologue

Since I visited Kenya last month (and then again early this month), friends and strangers have asked me for my impressions about efforts to reconcile the disputing sides in the country’s post-election turmoil. I made no serious examination of this question while in Kenya, only coming across random impressions in passing. My sense is that life in Kenya is back to normal and that supporters of Kibaki and Odinga (who are both in government under a power-sharing arrangement) simply are denying their differences. My discussion with people at media houses in Nairobi supported the denial explanation. Media actors are promoting reconciliation in the abstract but they are unwilling to examine ethnic pride, mobilization and discontent. Indeed, there is essentially a regime of self-censorship in Kenyan media around the subject of ethnicity and “tribal” affiliations. That people in Kenya who identify with the Luo group (of Odinga) feel unfairly treated by people who identify with the Kikuyu identity (of Kibaki) is undeniable. Yet from reading the media, the existence of both the Luo and the Kikuyu would seem to be in great doubt.

There is much to applaud in people who can see the worst in each other and then move in, forgiving and forgetting. There ought to be more of that in the world, I suspect. Yet Kenyans, from the very start of their history as independent country some 45 years ago, have shown an outsized willingness to set aside past differences — to pretend, in short, that the past does not matter. Kenya’s first president, Kenyatta, from the very start of his new nation in December 1963, chose to set aside concerns about who did what during the violent campaigns by British colonial authorities and “Mau Mau” freedom fighters to alter political arrangements in Kenya during the 1950s. Kenyatta decided not to examine ethnic differences in his country; he chose instead to priviledge the “fiction” of Kenyan identity in hopes of turning this lie into a reality.

To some degree, Kenyatta succeeded. I was struck in Nairobi by the intense patriotism of young Kenyans with education; people of talent and good character who weren’t born even during the last years of Kenyatta’s stern rule. For these young strivers in Nairobi, their pride in nation is palpable and, actually, moving. Kenya is a destroyer of hopes as much as a creator because of the long night of poor governance under Kenyatta’s successor, Moi. Today, hopes are reviving and young Kenyans can dream of a better day without suspending either their reason or their morality.

Which brings me back to the post-election violence. The willingness of people to move on, without examining what happened only a few months, is of a piece with Kenya’s modern history, which has never received even a rough kind of reckoning, either inside Kenya or without. These closing words in Caroline Elkins disturbing book, “Imperial Reckoning: The Untold Story of Britain’s Gulag in Kenya,” could well stand as a coda on the Odinga-Kibaki rivalry — and the ethnic violence it spawned earlier this year. Elkins is writing of course about political violence in Kenya 50 years ago. Her words seem eerily relevant to the recent crisis and not only because of the obvious observation that if Kenyans can’t come to grips with the history of a half-century ago, what chance exists to reconcile less distant, more hot and painful conflicts of the moment.

“To this day [Elkins writes] there has never been any form of official reconciliation in Kenya. There are no monuments for Mau Mau, children are not taught about this part of their nation’s past in school, few speak about it in the privacy of their own homes, and, with the exception of the relatives of the Hola massacre victims, there has never been any kind of financial consideration given to those who lost family members in the camps and villages, or property to the local loyalists [to the British]. Some men and women lost the use of their limbs, others their minds, as a result of years spent behind the wire…. But they too have insisted that bygones remain bygones.”

Is this the Kenyan way?

Technological hubris: the folly, futility and lasting allure of an AIDS vaccine

Mourn the death of the campaign for an AIDS vaccine but also cheer it. The push for a “silver bullet,” however human an impulse, reflected as much an overwhelming arrogance on the part of scientists as the inherent difficulty of engineering a preemptive technological response to a protean disease.

The field of vision should be clearer now. Pragmatic and relentless behavioral and societal adaptations are the best (and most humanistic) responses to the persistence of new cases of HIV/AIDS. As Helen Epstein wrote last year in her brilliant polemic on the disease, “The Invisible Cure,” the most effective responses in Africa — where the disease remains an enormous public-health issue — are animated by mass-based social mobilizations. In Uganda, where social mobilization has perhaps gone the furthest on matter of AIDS, the results have been impressive.

After 20 years of discussing the possibility of an AIDS vaccine, the time has come to pause and let the social mobilizers hold sway in the field of prevention, unburdened by the “noise” of well-meaning technocrats holding out the hope of a swift and easy intervention, unfettered by concerns about social organization and culture. In fighting AIDS, as in much else, social values and political mobilization, is decisive. The failure of the vaccine movement provides a convenient opportunity to remember the limits of technological innovation and the perils of engineering arrogance.

To be thrown on the social and cultural, however, is not to escape the awful dimensions of HIV/AIDS. On my visit early this month to a community of farmers in eastern Uganda, I was humbled by the capacity of human beings — alone and in their chosen groups — to deny, dissemble and even self-destruct in the face of lethal threats. In the foothills of beautiful Mount Elgon, the leaders of a community I’ve come to know and respect have fallen prey to new cases of HIV/AIDS. These men and women only fitfully sought treatment, and their “prevention strategies” remain flawed.

The hollow promise of an AIDS vaccine had never reached this Ugandan village. In the homes of the stricken, there are no technocratic delusions, only evidence of flawed humanity.

Mugabe’s end game

The impasse in Zimbabwe is unfolding under the glare of global media. The big outlets — the CNNs, the BBCs and the world’s major newspapers — are all looking for a dramatic resolution to Africa’s latest leadership drama. An aged Robert Mugabe, one a liberator of a long-oppressed people, today stands discredited around the world, having wrecked his legacy and the lives of millions of people. He refuses to leave office, insists on maintaining power by any means. His hold power stems not merely from the imposition of harsh rule; he also exploits powerful psychological symbols, which are newly described by my friend Daniel Morris in the Globe & Mail of Toronto.

That Mugabe deserves to be replaced by his chief domestic opponent is without doubt. More likely, he will be replaced by a leader of the military junta that actually runs Zimbabwe. Mugabe is too old and feeble to hold his shattered state together, even in its current dismal form. The Zimbabwean regime depends on a cabal of Mugabe loyalists operating in the shadows. One of them is likely, before long, to seize power, declare Mugabe history — and appeal for recognition and assistance from the international community.
Zimbabwe’s next strong man will do what others in African have long done: say they need time to stage legitimate elections. Perhaps they will need 18 months or even two years to prepare the way for real democracy in Zimbabwe. Faced with a Hobson’s Choice, the international community will go along, satisfied that at least Mugabe is off the stage.

The aid money will pour into Harare, so will the tecnical experts. Improvements in the material life of the people will come quickly, though more educated Zimbabweans — those few who remain — will leave the country. Then about a year from now, the regime’s leader will declare that he is decided, after much anguished reflection, that he will stand as a candidate for president in the “free and fair” elections to come. The international community will moan and groan, diplomats will say they’ve been cheated, the opposition will cry foul. But after a week or two, the decision will come to be accepted.
Is this Mugabism without Mugabe? Is this Zimbabwe’s future? To go from one dictator to another?

Nairobi

I got a chilly welcome when I arrived in Nairobi this morning on a Virgin flight from London. June is perhaps the coldest month of the year here, and many wore jackets on the ground. We hit a big traffic jam on the way to my hotel, near the Israeli embassy. Wi-fi worked immediately, and the hotel’s staff were excellent — ending immediately any concerns I might have that Kenyans are back to work after the post-election troubles. They are.
My arrival coincides with Odinga’s appearance in Washington, where he is talking about his important reconciliation agenda. The Nation newspaper had a good, if brief, account of the new Prime Minister’s speech before a DC think-tank.

Naming the problem In Zimbabwe

Let’s hope Morgan Tsvangirai has not only now realized that Robert Mugabe is merely the old worn-out front-man for the corrupt clique that runs Zimbabwe. In any case, his days of calling Mugabe a political opponent are over. Taking a lesson from Orwell, Tsvagirai, the best hope to spare Zimbabwe’s people even further distress and anguish, has started speaking truth to power, insisting that Zimbabwe’s government is essentially a “military junta.”

Even these two words are polite.

“Africa’s rice card” is getting a hearing

The intelligent editors at the Yale Global website has taken seriously my argument for disciplined management of rice imports by African nations — as a way of stimulating their own rice farmers to do more. Any forms of protectionism tend to be dismissed by economists and trade policy analysts — but then they don’t have to live in an African country. Africans in the real world need to defend themselves — and advance their own economic prospects — with the very same tools that people in wealthy countries use. These tools work. And employed intelligently, they will work for Africans. The blinding notion of unrestricted trade led Africans don’t a blind alley — and now they are finding their way back towards a middle road between openess and control. Stirking that balance is an endless quest — not only in agriculture but across the range of human activities.

A New Bidding War for Aid to Africa?

The government of Japan, the Financial Times reported today, plans to double assistance to African governments as part of a new charm offensive aimed at winning Tokyo more international allies.

With China and India already wooing Africans, Japan’s increased attentions are no surprise. As I have written elsewhere, Asians are suddenly in love with Africa, trying to elbow aside Europeans and Americans who have long dominated discourse on how to help Africans. I call the phenomena, “the browning of Africa,” in reference to a decisive turning point in world history: once a stage for whites and blacks to play out historic psycho-economic dramas, Africa is now becoming multicultural, and Asians see the opportunity to destroy “white” hegemony over the “dark continent” through economic penetration and technical assistance. Given the sorry history of black-white relations in Africa over the centuries, the Asian insertion can only be good news, even though interest in Africa by official agencies of India, China and Japan reflects complex motives.
For decades, the Japanese have quietly run curious aid programs in sub-Saharan Africa. This past January, in Kampala, I met a young Japanese man who confessed to being an auto mechanic assigned by the Japanese government to train the Ugandan police “motor pool” on how to repair their growing fleet of automobiles.

When I asked how long Japanese taxpayers were covering his stay in Uganda, the Japanese car mechanic gleefully confessed, “One year!”

When I expressed astonishment on the length of his stay, he explained, “Toyotas are popular here.”

And about to become more so. This week Japan’s prime minister Fukuda expects to hold marathon private meetings with the governments of 45 African nations. Does he even have the auto mechanic to help him?

Mr. Bemba, Meet Mr. Bentham

The arrest of Jean-Pierre Bemba, the Congolese warlord and former vice-president of the DRC has been arrested on war-crimes charges. Bemba’s arrest creates a new opportunity for the UN’s International Criminal Court to demonstrate both consistency and determination in the prosecution of cases against African outlaws. As the trial of Charles Taylor is showing, convicting rogue African leaders for crimes against humanity is difficult, especially when conventional rules on evidence and testimony are followed. Bemba’s case is complicated, but his arrest at least takes him out of play. For years he has destablized electoral politics in central Africa. Some time ago, I argued he should be banned from political particpation because of his lengthy resume of violent actions. Instead, the international community allowed him to stand for president in the last Congolese national elections, which proved both to be an embarassment for the election’s sponsors (the European Union) and harmful to the Congolese (who suffered violence during the pre- and post- runoff period).

Bemba’s arrest is not a pure victory, however. His jailing represents a compromise between human-rights “purists” (who, absurdly, would probably like to arrest — on general principles — every African leader that ever picked up a gun) and pragmatic “problem solvers” around the world who would admit that Bemba is being selectively prosecuted but that imprisoning him simply carries too many utilitarian benefits to argue against. In short, Bemba’s arrest means — pace Bentham — the greatest good for the greatest number.


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