Hi Jim,

I think this is something you might want to read. Enjoy the reading.And not forgetting,enjoy your trip on Tuesday.Write to me when you get back.

Yours,
Sulayman S.Jawara

>
>
> ---------- Forwarded message ----------
> Date: Fri, 16 Nov 2001 09:48:17 -0500
> From: Africa Action <[log in to unmask]>
> To: [log in to unmask]
> Subject: Africa: Global Health Fund
>
> Africa: Global Health Fund
> Date distributed (ymd): 011116
> Document reposted by APIC
>
> Africa Policy Electronic Distribution List: an information
> service provided by AFRICA ACTION (incorporating the Africa
> Policy Information Center, The Africa Fund, and the American
> Committee on Africa). Find more information for action for
> Africa at http://www.africapolicy.org
>
> +++++++++++++++++++++Document Profile+++++++++++++++++++++
>
> Region: Continent-Wide
> Issue Areas: +economy/development+ +security/peace+ +health+
>
> SUMMARY CONTENTS:
>
> This posting contains excerpts from the keynote speech by Malawi
> Vice President Justin Malewezi, at the Africa Consultation Forum on
> the Global Fund to Fight AIDS, Tuberculosis and Malaria. The full
> text of the speech is available in the archives of the "Break the
> Silence" E-mail Forum, available on http://www.hdnet.org/home2.htm
> or at http://archives.hst.org.za/bts, along with ongoing discussion
> on the Global Fund, with many African participants. The Brussels-
> based Transitional Working Group settting up the Fund has a web
> site at http://www.globalfundatm.org
>
> The posting is preceded by a short update note from Africa Action.
>
> +++++++++++++++++end profile++++++++++++++++++++++++++++++
>
> Africa Action Update Note
>
> Developing countries and non-governmental groups are critical of
> many aspects of the joint statements agreed at the conclusion of
> the World Trade Organization ministerial summit in Doha earlier
> this week. But the combined impact of activism, public outrage,
> and the determination of developing countries led to a significant
> breakthrough with the key declaration that the existing trade
> agreement "can and should be interpreted and implemented in a
> manner supportive of WTO Members' right to protect public health
> and, in particular, to promote access to medicines for all." For
> full text: http://www.ictsd.org or http://www.wto.org
>
> The declaration failed to include a clear statement explicitly
> authorizing export of generic medicines to countries without a
> manufacturing capability of their own. Moreover, after its initial
> shock, the pharmaceutical industry is already trying to claim that
> nothing has changed. However, the text represented an unprecedented
> victory for the stance taken by African and other developing
> countries. It clearly paves the way for more agressive action to
> make lower-cost drugs available. Whether this happens now depends
> primarily on political will and resources, both in key countries
> that have hesitated to act and in international agencies, including
> the new Global Fund.
>
> For "can and should" to be turned into reality, African countries
> and non-governmental organizations must mobilize to take full
> advantage of the opening offered by the Doha declaration. And they
> must demand adequate resources and guidelines be given to the
> Global Fund, including support for global bulk drug procurement
> mechanisms that can further lower prices while maintaining quality
> control.
>
> -----------------------------------------------------------
>
> Republic of Malawi
>
> Statement by The Right Honourable Justin Malewezi, Vice President,
> delivered at The Consultation Forum on Global Fund to Fight AIDS,
> Tuberculosis and Malaria
>
> November 12-13, 2001
> Le Meridien Capital, Lilongwe
>
> Office of the Vice President, P.O. Box 30399, Lilongwe 3, Malawi
> Tel:(265) 788 444; Fax: (265) 788 362; E-mail: [log in to unmask]
>
> 3. Every minute we have been sitting in this room, ten people have
> died of the three diseases HIV/AIDS, Tuberculosis and Malaria.
> This translates to 15,000 people a day. This is not only appalling
> and tragic, it is scandalous. It is scandalous because we have the
> knowledge, the technology and the resources to address the
> challenges posed by HIV/AIDS, Tuberculosis and Malaria, but have
> not yet mobilized sufficient political will to prevent and treat
> these diseases in a comprehensive manner and on a scale
> commensurate with the devastation facing the human family. The same
> vision that fuelled our struggle for freedom in Africa, the same
> vision that mobilized every nation after the Second World War to
> sign the Universal Declaration of Human Rights, it is the same that
> is now needed to fight and conquer the triple threat from HIV/AIDS,
> Tuberculosis and Malaria. ...
>
> 5. Nowhere has the impact of HIV/AIDS been more severe than in
> Sub-Saharan Africa. The region with less than 10 percent of the
> world's population is home to 70 percent of people living with
> HIV/AIDS. The HIV/AIDS pandemic will kill more people in Africa
> than all the casualties of all the wars of the 20th Century
> combined. AIDS is devastating Africa - AIDS is destroying our
> hopes, our lives and our future. AIDS has a uniquely devastating
> impact on development and is at the centre of a global development
> crisis. AIDS kills young adults in their most productive years
> leaving grandparents to bring up their children. AIDS reduces life
> expectancy. Child mortality and poverty are projected to increase
> fuelling a secondary pandemic of orphans throughout the region.
>
> 6. The HIV/AIDS pandemic in Africa has been described as a
> "catastrophe in slow motion" and as a "development and security
> crisis". While these descriptions capture the devastating impact of
> the epidemic, they do not bring out the urgency and immediacy of
> the danger facing Africa and, indeed the whole world. Nor do the
> statistics capture the tragedy of lives destroyed. Every day we are
> burying our children, our sisters and brothers, our workmates, our
> leaders, our teachers, doctors and other professionals. In the
> suffering and death of our brothers and sisters, we face grief
> beyond words and sorrow beyond tears. We cannot stand by and watch
> while our people are dying. The HIV/AIDS pandemic is the greatest
> threat to our future - it is an emergency and requires an emergency
> response by the international community.
>
> 7. Although these health problems often originate in contexts
> related to poverty, they have also become a major obstacle to
> reducing poverty itself. Increased investment in health is a
> critical challenge for our future as health is a fundamental human
> right. The burden of disease in Sub-Saharan Africa stands as a
> stark barrier to economic growth and therefore must be addressed
> centrally in any comprehensive development programme.
>
> ...
>
> 11. As you discuss and consult on the Global Fund to fight
> HIV/AIDS, Tuberculosis and Malaria, I would like to address six
> issues.
>
> 12. First, the HIV/AIDS pandemic is a threat to global security.
> Although Africa is the epicentre of the AIDS pandemic, AIDS is
> growing throughout the world. In the growing populations of India
> and China, AIDS is gaining ground with close to four million people
> already infected. The number of AIDS cases in Russia and Burma are
> also increasing. If AIDS takes a deeper root in India, China and
> other countries that have a combined population of more than two
> Billion, the resulting carnage could far exceed that of the current
> tragedy in Africa.
>
> 13. We are part of a world community. The recent appalling
> terrorist attacks in America were shattering and have been
> condemned worldwide. Thousands of lives were destroyed and families
> devastated. The tragic events of September 11th have altered the
> world fundamentally and a new Global Alliance has been forged to
> fight international terrorism. We need the same political will,
> unified resolve and resources to fight disease.
>
> 14. AIDS threatens to fundamentally destabilize the world. This
> latter concept was formally recognized in the UN Security Council's
> first debate on AIDS in January 2001. The debate also marked a
> shift in the concept of security from the absence of armed conflict
> to a wider definition of human security encompassing the
> fundamental conditions that are needed for people to live safe,
> secure, healthy and productive lives.
>
> 15. A whole generation of children are growing up without their
> parents. The current estimate of 13 million AIDS orphans is
> projected to increase to 40 million within the next decade.
> Children are growing up deprived of the most basic human rights of
> family, education and confidence in their future. Many are
> condemned to live their lives in poverty and are vulnerable to
> abuse. Apart from the tragedy of every life not lived to its full
> potential, the orphan crisis is breeding ground for conflict and
> disintegration of the very fabric of society. This is a security
> risk.
>
> 16. The second issue I would like to address is the key constraints
> to addressing challenges posed by HIV/AIDS, Tuberculosis and
> Malaria. HIV/AIDS and other infectious diseases affect Africa
> exceptionally, but Africa's ability to respond to the unique
> challenges posed by HIV/AIDS is limited by the following
> constraints: -
>
> 17. The first constraint is that GDP growth rates have consistently
> been below the six percent growth rate that is required for Africa
> to achieve sustained economic growth and poverty reduction. It is
> also important to recognize that the HIV/AIDS pandemic itself
> undermines growth prospects. AIDS erodes saving and investment by
> both individuals and Governments. ,,, Conservative estimates for
> Africa suggest that the reduced productivity and costs associated
> with the AIDS pandemic alone are equivalent to more than 20 percent
> of GDP. These figures do not include the external effect of the
> disease on families, communities and enterprises.
>
> 18. The second constraint is the debt burden of US$206 billion and
> debt service obligations of around US$13.5 billion per annum. Debt
> remains a pervasive obstacle to Africa's capacity to invest in
> economic infrastructure; it also diverts resources from the fight
> against poverty and HIV/AIDS. In the majority of African countries,
> we spend more on debt service annually than on education and health
> combined. In the words of a recent UNICEF report "To spend more on
> external debt than on social services when hundreds of millions of
> children lack access to basic education, primary health, adequate
> food and safe drinking water is not only morally wrong, it is also
> economically senseless. Hunger, disease and ignorance have never
> been a foundation for rapid and sustained economic growth"
>
> 19. The third constraint is that levels of official development
> assistance (ODA) to Africa have declined substantially over the
> past two decades. By 2000, real per capita inflows were less than
> one-third of the level reached two decades earlier. Only the Nordic
> countries of Sweden, Norway and Denmark and the Netherlands have
> met the target of allocating 0.7 percent of GDP to official
> development assistance. The average ODA/GNP ratio of the developed
> countries declined from 0.33 percent in 1992 to 0.24 percent in
> 1999.
>
> 20. The fourth constraint is that Africa has faced a long-term
> decline in the terms of trade and Africa's share in world trade has
> declined substantially. Furthermore, Africa has faced extreme
> volatility in export prices and difficulty in accessing Northern
> markets. After the Uruguay Trade Round, it was estimated that the
> new agreements would lead to an increase in global income of some
> US$212 to 510 Billion. However, Africa did not share in the
> benefits of global trade. Africa experienced a net loss of US$1.2
> Billion per year. This reflects the fact that global economic
> policy making occurs in a world of grossly unequal economic and
> political power. ...
>
> 23. The third issue I would like to address is the need for a
> comprehensive approach to HIV/AIDS covering prevention, care and
> treatment. It is a paradox that for the majority of diseases in the
> world, it is accepted wisdom that disease prevention, care and
> treatment should be addressed in a comprehensive manner as
> prevention and treatment are complementary and have major public
> health benefits. None, for example would question the wisdom of
> treating Malaria, Tuberculosis or indeed any other common
> communicable disease. Indeed with the exception of childhood
> immunization, no major disease control programme focuses on
> prevention alone. However, it was only this year that consensus
> emerged that there is need to provide comprehensive treatment for
> HIV/AIDS.
>
> 24. Until a few years ago, HIV infection led almost inevitably to
> an early death from AIDS. However, in the mid 1990s the HIV/AIDS
> community saw a scientific breakthrough with the introduction of
> anti AIDS drugs. These regimens have resulted in a reduction in HIV
> levels in the blood often to undetectable levels and lead to a
> markedly improved immune function in HIV infected individuals. Anti
> AIDS drugs have transformed HIV infection into a chronic condition
> that frequently remains without symptoms for years. Moreover with
> the ability of these drugs to dramatically decrease viral
> replication, the chance of transmitting the virus has diminished
> correspondingly thus reducing rates of mother to child transmission
> and reducing death rates.
>
> 25. The picture of continued improvement in the prevention and
> treatment of AIDS in high-income countries is in marked contrast to
> the situation in low-income countries. Sub-Saharan Africa in
> particular has been unable to effectively control the epidemic.
> This has been so because HIV/AIDS programmes in Sub Saharan Africa
> have not been comprehensive in approach to cover prevention, care
> and treatment. ...
>
> When these therapies will become available the lives of HIV
> positive people will be prolonged thus also reducing the number of
> orphans. People will also be more willing to go for testing as
> access to treatment reduces the stigma associated with HIV/AIDS.
> ...
>
> 29. The fourth issue I would like to address is the need to invest
> in public health as the foundation of human development and
> economic growth. Low-income countries, especially countries in
> Africa have far lower life expectancy and far higher mortality
> rates than the rest of the world. ...Improvements in health
> translate to higher rates of economic growth and reduced population
> growth. The world needs to implement such a comprehensive and broad
> programme.
>
> 30. This will require high-level political commitment in the
> developing and developed world. The investment would be repaid many
> times over in saved lives, enhanced economic growth and global
> security.
>
> 31. The fifth issue I would like to address is the need for
> countries themselves to determine their priorities for investment
> by the Global Fund. We in Malawi are close to finalizing our
> proposal to the Global Fund. The proposal has been developed over
> a period of six months and is based on extensive consultation
> within Malawi and with international experts. ...
>
> 32. May I suggest five key principles for the operation and
> governance of the Global Fund.
>
> i) The countries themselves should develop proposals that they have
> authored themselves independently. Countries are best placed to
> determine the appropriate balance between the three diseases and
> the balance between prevention, care and treatment. ii) The
> resulting proposal should be subject to scientific and public
> health scrutiny by a panel of independent experts serving as an
> independent advisory group to the Global Fund. iii) Funds should be
> disbursed as grants not loans. iv) Build in a clinical and
> operational research component into every programme so that the
> lessons learned from scientific research should be applied in the
> programme and that international best practices should be
> developed. v) Developing country governments should be adequately
> represented on the Board of the Global Fund.
>
>
> ... The Malawi Government proposes four actions for consideration
> by the international community.
>
> 38. First there is need for faster and deeper debt relief. We
> endorse UNCTAD's proposal for a "comprehensive assessment of the
> sustainability of African debt". An independent body that would not
> be unduly influenced by the interests of creditor nations should
> carry this out. Consideration should be given to the suspension of
> debt payments by all African HIPC countries until a final agreement
> is reached on debt reduction. This initiative could make a
> significant contribution to growth and poverty reduction provided
> that it is combined with additional financing on grant basis to
> fill the external financing gap.
>
> 39. Second we call on the international community to fully finance
> the Global Fund for HIV/AIDS, Tuberculosis and Malaria to the
> required level of US$10 Billion per annum as a matter of urgent
> priority.
>
> 40. Third, we call on the intentional community to increase
> international aid in order to invest in health as the foundation of
> economic development. We call on the international community to
> increase levels of ODA by 0.1 percent of GDP in 2002 in order to
> invest in global health. In the longer term, we endorse Article 83
> of the United Nations General Assembly Special Session on HIV/AIDS
> Declaration and ask the international community to increase aid
> levels to the agreed target of 0.7 percent of GDP and to increase
> the proportion of aid directed to the poorest countries.
>
> 41. Fourth, we call on the international community to mobilize
> global science for the benefit of the poor. There is need for a
> significant investment in further research into safe and affordable
> HIV vaccines and their delivery including methods to prevent mother
> to child transmission and to improve our understanding of factors
> that influence the epidemic and actions that address it. ...
>
> In conclusion, Mr. Chairman
>
> 42. People are suffering and people are dying. A whole generation
> of children are growing up without their parents, condemned to live
> their lives in poverty. Tens of millions of people have died of
> AIDS, Tuberculosis and Malaria. This is a new holocaust. Without
> serious action now, tens of millions more will die. Every single
> death is an indictment on our consciences. The HIV/AIDS pandemic
> threatens world security. How long is the world prepared to wait?
> How many tens of millions more have to die before we address this
> situation seriously? ...
>
> The international community must invest in health as the most
> urgent priority and allocate a minimum of 0.7 percent of GDP to
> overseas development assistance. Such an investment is required
> if we are to meet the human development targets agreed at the
> Millennium Summit. We need to make essential drugs and vaccines
> available to the worlds poor. Every nation has signed the Universal
> Declaration of Human Rights. It states that all human beings are
> equal in rights and dignity. The Universal Declaration of Human
> Rights places a moral obligation on the international community to
> invest in human development. I am not asking for charity, I am
> asking for justice.
>
> 44. We do not need further intellectual debate about whether to
> focus on prevention or treatment. We have to do both. We do not
> need further debate about cost-effectiveness of focusing on
> principal communicable diseases or HIV/AIDS. We have to do both. We
> do not need further debate about whether health sector reform
> should precede a significant increase in investment for health. We
> have to do both. ...
>
> 45. Now is the time to take action. Now is the time to invest in
> health. Now is the time to translate our commitments into reality
> and fully finance the Global Fund. Humanity demands that we do not
> delay or prevaricate or find excuses any longer. Let us build an
> international alliance for justice as the foundation of a lasting
> peace. ...
>
> ************************************************************
> This material is being reposted for wider distribution by
> Africa Action (incorporating the Africa Policy Information
> Center, The Africa Fund, and the American Committee on Africa).
> Africa Action's information services provide accessible
> information and analysis in order to promote U.S. and
> international policies toward Africa that advance economic,
> political and social justice and the full spectrum of human rights.
>
> Documents previously distributed, as well as a wide range of
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