Asia Russell ACT UP Philadelphia Health GAP asiacritpath'org www'globaltreatmentaccess'org 215 47493

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The IMF, World Bank, and the AIDS crisis

• Asia Russell ACT UP Philadelphia Health
  GAPasia_at_critpath.org www.globaltreatmentaccess.
  org 215 474-9329

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The AIDS crisis is a political crisis that
requires political action.
1987 CIA research on the AIDS pandemic
anticipates 52 million people infected by 2000.
1992 World Bank on mass death in Africa If
the only effect of the AIDS epidemic were to
reduce the population growth rate, it would
increase per capita income growth rate in any
plausible economic model. 2001 UN Secretary
General Kofi Annan declares There has been a
world-wide revolt of public opinion. People no
longer accept that the sick and dying, simply
because they are poor, should be denied drugs
which have transformed the lives of others who
are better off.
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Donate the Dollars, Treat the People, Drop t he
Debt
In order to make significant gains in the global
AIDS epidemic, ACT UP and Health GAP are working
with global allies on 4 fronts Demanding
lowest cost, quality HIV/AIDS medications
regardless of drug patent status Demanding the
World Bank, IMF and US support full debt
cancellation to allow poor countries to have
resources to fight the epidemic Demanding money
from wealthy countries to fund effective
treatment, care, and prevention programs in
hard-hit nations. Demanding multinational
corporations provide treatment to HIV positive
workers in cash-poor countries
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Realities AIDS death rates drop in the U.S. and
other rich countries
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But life expectancy plummets in Africa.
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Adults and children estimated to be living with
HIV/AIDS as of end 2001
Eastern Europe Central Asia 1 million
Western Europe 550 000
North America 950 000
East Asia Pacific 1 million
North Africa Middle East 500 000
South South-East Asia 5.6 million
Caribbean 420 000
Sub-Saharan Africa 28.5 million
Latin America 1.5 million
Australia New Zealand 15 000
Total 40 million
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Estimated number of adults and childrennewly
infected with HIV during 2001
Eastern Europe Central Asia 250 000
Western Europe 30 000
North America 45 000
East Asia Pacific 270 000
North Africa Middle East 80 000
South South-East Asia 700 000
Caribbean 60 000
Sub-Saharan Africa 3.5 million
Latin America 140 000
Australia New Zealand 500
Total 5 million
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Estimated adult and child deaths from HIV/AIDS
during 2001
Eastern Europe Central Asia 23 000
Western Europe 8 000
North America 15 000
East Asia Pacific 35 000
North Africa Middle East 30 000
South South-East Asia 400 000
Caribbean 40 000
Sub-Saharan Africa 2.2 million
Latin America 60 000
Australia New Zealand lt100
Total 3 million
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About 14 000 new HIV infections a day in 2001

• More than 95 are in developing countries
• 2000 are in children under 15 years of age
• About 12 000 are in persons aged 15 to 49 years,
  of whom
• almost 50 are women
• about 50 are 1524 year olds

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The drugs are where the people are not. --Dr.
Peter Mungyenyi, an AIDS doctor treating people
in Kampala
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IMF and World Bank

• International financial institutions that lend
  money to poor countries in need
• Require countries to restructure their economies
  in ways that devastate social services, health
  care, and food security in exchange for loans
• Many older loans supported corrupt (ex-Zaire) or
  illegitimate (apartheid South Africa) governments
  
• WB/IMF economic models are based on beliefs
• --free markets always pull countries out of
  poverty
• --privatizing government services saves money
  in the long run, with no negative outcomes
• --tightening the belt is always better than
  investing money in people

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Countries ask for relief from the World Bank
and are told they are too rich to need it.
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Illegitimate Debt Africa

• Africas external debt burden is more than 300
  billion
• Debt burden and structural adjustment have
  reversed positive economic and development
  trends, post-independence
• The money has already been written off by the IMF
  and WB, but nevertheless countries service their
  debts, and accrue more interest monthly
• Debt burden is a massive obstacle to fighting
  AIDS in Africa
• Scant foreign aid goes straight to paying back
  debts, not for medicines, clinics, schools

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Linking Debt, Structural Adjustment, and AIDS

• WB/IMF structured poverty increases vulnerability
  to HIV infection
• WB financed projects increase vulnerability
• Countries are discouraged from investing money in
  AIDS treatment and care not cost effective
• Health care services privatization has decreased
  access for the poorest
• Structural adjustment erodes life-saving
  services, crucial to communities responding to
  AIDS

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Whats the outcome?

• ZAMBIA more than 4 teachers die daily of AIDS
  for every 1 spent on health care, 4 are spent
  servicing debt. TOTAL DEBT 6.8 billion
• UGANDA per capita health spending 2.50 per
  year, per capita debt servicing 15.00 per year
• ZIMBABWE 1 in 4 adults have HIV. In the 1980s,
  Zimbabwe got 500 mn loan from IMF. Social
  spending was slashedjust as the AIDS epidemic
  was taking off
• IVORY COAST 1 in 10 adults living with HIV.
  Before IMF loans, 18 live on lt1/day. Now? 37.

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What makes the United States special?
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How generous is the U.S. in the fight against
global AIDS?

• U.S. wealth is 40 of the GNP of all donor
  countries.
• The U.S. ranks last among rich countries in
  assistance measured as percent of GNP.

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Compare and contrast

• Rwanda gives 1 million to Global Fund
• US gives 200 million to Global Fund
• Making Rwanda more ten times more generous,
  proportionately

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