5th June, 2007

TIM COSTELLO

When I was in Africa’s Democratic Republic of the Congo, last month, I was struck down by malaria.

It is not unusual when you consider that Africa is still ravaged by diseases such as malaria. I had simply joined the ranks of 300 million people succumbing to the disease each year.

GLENEAGLES LEGACY? Some of the crowd that marched in Edinburgh during the G8 meeting in Gleneagles, Scotland, in 2005. Tim Costello says that many of the promises made at the summit have not yet been met. "The reality is any effort to foster private investment in Africa stands little chance of success without the G8 keeping their promises made at Gleneagles in 2005."

What was unusual is that I was able to access simple medication at the Goma Hospital to help me recover. It is a medication that is still today denied most people across Africa and tens of thousands of Congolese children die each year because they can’t afford the treatment I took for granted.

A curse of geography means that many African countries have the malaria-carrying mosquito species and the weather conditions that allow it to thrive.

Up to 1.5 million people die every year from malaria, millions of others are debilitated, costing the African continent an estimated $US12 billion in lost productivity and expense. Every day 3,000 people die from malaria in Africa, mainly children. It is the biggest killer of African children and it is so easily preventable with $4 mosquito nets and cheap medication.

My experience with malaria is a salient reminder of the challenges confronting G8 leaders this June as they meet in Berlin. German Chancellor Angela Merkel is promising a ‘better deal for Africa’ by moving to boost private investment in the continent.

But the reality is any effort to foster private investment in Africa stands little chance of success without the G8 keeping their promises made at Gleneagles in 2005.

Where promises have been met there has been progress - most African countries are recording strong economic growth, governance and regional cooperation is improving, millions more children are sleeping under anti-malarial bed nets at night, measles deaths have dropped dramatically, more children are going to school and many more people are receiving treatment for HIV and AIDS.

However it is clear that on current projections the internationally agreed aim of halting and reversing the spread of HIV, TB, malaria and other major infectious diseases will not be achieved in Africa, and nor will the other Millennium Development Goals.

In 2005, G8 leaders committed to a goal of universal access to services for prevention, care and treatment of HIV as part of its $50 billion package for Africa. Yet a 20 country survey of World Vision’s own HIV and AIDS projects reveals that two years on, increased access to anti-retroviral treatment (ART) is being undermined by failing national health systems and poor food security.

Even where ART is available and free, there are not enough nurses, not enough doctors, not enough drugs and not enough food. In rural Malawi more than 70 per cent of nursing positions were vacant. Supply chains for key supplies like HIV test kits and antibiotics for opportunistic infections are hopelessly unreliable.

We have a global shortage of health professionals, and a global market for their services. Government health services in developing nations just can’t compete. We need to make it possible for people to stay in these roles where they are so desperately needed, and that’s going to require major investment.

Our research found doctors were despairing because they couldn’t provide follow-up to people who were starting ART. In some cases staff at the local clinic level and community health workers have little understanding of HIV and no training in ART. Inadequate follow-up means high rates of treatment failure, and unnecessary deaths. The study also found that the most common reasons for treatment failure were practical issues like transportation and access to food.

International Labor Organisation research shows that where the HIV/AIDS prevalence rate reaches eight per cent it cuts one per cent off a country’s GDP per year. In 2005 10 African countries had prevalence rates of eight per cent or higher.

In many communities, there are just not enough workers left to tend the fields, so there’s not enough food to go around. Unlike most diseases, AIDS mainly incapacitates and kills people in the prime of their life, farm workers, teachers, nurses and parents. Combined with unpredictable weather patterns due to climate change, this loss of a country’s most productive workers is leading to frequent, devastating food shortages.

Even taking into account recent large increases in funding it is clear there is likely to be a $US5 billion shortfall in 2007 in the funds needed to fight AIDS. This shortfall is likely to balloon out to $US26 billion for the four years to 2010. This does not make economic sense when the cost benefit ratio of effective HIV prevention and care programs is around 40 to one.

This week, US President George Bush announced a proposal to double his country’s support for HIV and AIDS responses. If his proposal proceeds through Congress the resources will go some way to redressing this imbalance, but this will not make Australia’s contribution any less important.

And this does not include funding for critical improvements in basic health systems. The best estimates for global aid required for basic health indicate that a total of US$40 billion per year in aid is currently required rising to around US$50 billion by 2010.

At Gleneagles in 2005 the G8 made a detailed list of commitments to Africa including increasing aid to US$25 billion per year by 2010, to forgive the multilateral debt of the highly indebted countries, to deliver support for African trade development and to provide support for efforts to beat AIDS and malaria. There was also a promise to provide universal AIDS treatment by 2010. Yet to date only the debt relief initiative is on track and the urgent aid that will save lives has not flowed from Gleneagles. As the OECD has pointed out “aid will now have to increase very substantially in 2007 and 2008 if there is to be a realistic prospect of meeting 2010 targets”.

It is critical that as G8 leaders meet in Berlin they don’t forget their promises. Any moves to ‘create a better deal for Africa’ must incorporate the fulfillment of past pledges.

Africa’s challenges can be tackled and the situation is far from hopeless, but not if the history of broken pledges continue.

Tim Costello is the chief executive officer of World Vision Australia. This article was first published in The Age newspaper.

~ www.worldvision.com.au