Slums

If anyone else was distressed by all the stuff we did on slums in 202, I have found a great website where you can donate money to upgrade sanitation facilities in slums around the world, and lots of other projects too.

www.globalgiving.com

everyone should take a look!

Radio 4 "Africalab"

An interesting programme on brain drain and its contribution to African underdevelopment. You can listen to it by going to Radio 4 'Listen Again' 

http://www.bbc.co.uk/radio4/atoz/

and finding 'Africa Lab' (under A)

Targeting versus Universalism

Here is an interesting paper on Targeting versus universalism

Mkandawire, T. (2005) "Targeting versus universalism in poverty reduction" United Nations Research Institute for Social Development. Programme paper nb 23.

http://www.unrisd.org/80256B3C005BCCF9/(httpAuxPages)/955FB8A594EEA0B0C12570FF00493EAA/$file/mkandatarget.pdf

if not just search the paper on UNRISD website: http://www.unrisd.org

generally Thandika Mkandawire (who is also the director of UNRISD) is a very interesting person writing on development. Always check his publications and UNRISD publications generally. They are very credible and not quite mainstream.

Enjoy,
Dina

From WID to GAD an Article on Gender

Good article on the Gender week:

Razavi, S. and Carol Miller (1995) From WID to GAD: Conceptual Shifts in the Woman and Development Discourse. United Nations Research Institute for Social Development (UNRISD)

You can access it from the UNRISD website http://www.unrisd.org/

Your Development Photos!

This is an invitation for you to post photos you took while travelling in the south, on gap year or working/volunteering with an NGO or just randomly found online (but please put the source then) and to comment on them. Now I know that you might already have them on your facebook profiles! But I am hoping this blog will give you an opportunity to reflect on these experiences in the light of what you have been reading/discussing (Which I am not sure would be very interesting to do on facebook!). As I said earlier in the beginning of the term, one of the objectives of this class is to help you relate development theories/materials to real things that happen on the ground everyday. So let's experiment a bit and see what we'll get out of this.

Once you put some, I will also share with you some of the ones I collected during my work in an international development NGO in Egypt and some comments about them.

An Excellent Paper by David Mosse on Poverty

Hi All,

Here is an extra reading for your spare time. This is a paper by David Mosse, who is a development anthropologist based at SOAS. The paper is titled Power and the durability of poverty: a critical exploration of the links between culture, marginality and chronic poverty. It was just published in 2007.
It is a bit long and a bit dense but very very interesting linking the structural and social causes/meanings of poverty. And also linking poverty and power.

Here is a link to the paper:

http://www.chronicpoverty.org/resources/cp107.htm

Read the abstract and then you can download the paper from the right hand side icon (pretty obvious I think :))


David Mosse is generally someone whose work in development is very interesting to read. He published a book called Cultivating Development, which is basically an ethnography of a development project he worked in as part of a consultancy team with DFID. Another interesting book of his is called On Brokerage and Translation, which is an edited piece with David Lewis. This one is about people who are in between two worlds(for example those who work with local NGO's) and how they translate the meanings of development between development workers and aid receivers.

A new way of looking at "development".

I don't know if you all have seen this already, but there's a fantastic statistician called Prof Rosling, who organises development statistics in a very interesting way. His research shows that we can't think about the "developing" and "developed" world by looking at countries alone.

There is a YouTube video of one of his lectures (where he shows that students in one elite university get lower marks than chimps in a quiz on development) http://uk.youtube.com/watch?v=RUwS1uAdUcI

There's lots more on his Gapminder project website, including some very cool interactive graphs.

Interview with Hernando De Soto (Part 1)

http://www.youtube.com/watch?v=g9S5hPnEcL0&feature=user

This interview is interesting. Most importantly it shows how his ideas are integrated into a neo-liberal understanding of markets and the need to de-regulate them by reducing the "bureaucratic" nature of regulations, eventually dismissing the structural problems behind informality.

Interview with Hernando De Soto (Part 2)

http://www.youtube.com/watch?v=IRjQ1tkUa5M&NR=1

This interview is interesting. Most importantly it shows how his ideas are integrated into a neo-liberal understanding of markets and the need to de-regulate them by reducing the "bureaucratic" nature of regulations, eventually dismissing the structural problems behind informality.

Interview with Hernando De Soto (Part 3)

http://www.youtube.com/watch?v=HLgVLVIyyy0

This interview is interesting. Most importantly it shows how his ideas are integrated into a neo-liberal understanding of markets and the need to de-regulate them by reducing the "bureaucratic" nature of regulations, eventually dismissing the structural problems behind informality.

Part 2: ILO Documentary on Decent Work Agenda in Ghana's Informal Sector. Interesting but Tricky!

http://www.youtube.com/watch?v=YhiBlrdZPS8&feature=user

ILO Documentary on Decent Work Agenda in Ghana's Informal Sector. Intresting but Tricky!

http://www.youtube.com/watch?v=S_dILqcSqOE

William Easterly Article on AIDS

A review of Helen Epstein's book from the NYRB:

http://www.nybooks.com/articles/20492

olume 54, Number 13 · August 16, 2007

How, and How Not, to Stop AIDS in Africa

By William Easterly

The Invisible Cure: Africa, the West, and the Fight Against AIDS

by Helen Epstein

Farrar, Straus and Giroux, 326 pp., $26.00

One of the classic works of journalism of the last couple of decades was Randy Shilts's And the Band Played On^[1] about the sluggish response to AIDS in the 1980s in the United States, which indicted both the Reagan administration and the leaders of the gay community. I still remember the sense of outrage I felt when reading Shilts's book; it struck just the right note, leaving one both horrified about the tragic incompetence of so many and yet also hopeful that someone, somewhere could do things better next time.

Yet after reading Helen Epstein's masterful new book, the response to AIDS in America now looks in retrospect like a model of courage, speed, and efficiency by comparison with the response in Africa. In the US, the government publicized the threat and funded research, the gay community reduced its infection rates by encouraging less risky sexual behavior, the dreaded breakout into the heterosexual population never happened, and AIDS receded to become a disease that, while still tragic, could in most cases be kept under control with expensive new antiretroviral drugs (ARVs).

The opposite is true in every respect of AIDS in Africa, which was anticipated as a looming crisis already in the 1980s, yet governments, foreign aid agencies, and even activists reacted with denials and evasion. The disease rampaged through the heterosexual population and is still rampaging, ARVs were too late, too costly, and available to too few, and Africa is still in the midst of an epic disaster without a solution in sight. As of the latest figures in 2006, 25 million Africans are HIV-positive, 2.1 million die from AIDS every year, and 2.8 million are newly infected each year.^[2]

Epstein's book lays all this out in courageous and thought-provoking detail, describing the maddening complexity of the AIDS crisis in Africa, and the reprehensible and simplistic evasions of nearly everyone involved. It is not only a book that should be required reading for people concerned in the least with AIDS or with Africa; it is also compulsively readable.

It is not without some flaws. Epstein's discussion of the economics of African poverty is overly simple—it sometimes sounds more like flat statements about corporate and official power than deep analysis. More seriously, for some of her key points, the evidence base—the numbers of studies and of people and the different groups whose experience she draws on—seems a little thin, although I found her points plausible and largely convincing. Perhaps the fact that there is insufficient evidence about so many aspects of AIDS in Africa is itself a symptom of the skewed priorities that the book describes as afflicting the international AIDS effort.

he history of the response to African AIDS can be divided into two phases: (1) fiddling while Rome burns, and then (2) trying to use the fiddles to put out the fire.

Phase I began long ago, undermining any claims of any of those involved to ignorance of the problem. An article published in the London Times on October 27, 1986, said:

A catastrophic epidemic of AIDS is sweeping across Africa.... The disease has already infected several millions of Africans, posing colossal health problems to more than 20 countries.... "Aids has become a major health threat to all Africans and prevention and control of infection...must become an immediate public health priority for all African countries," says a report published in a leading American scientific journal.

Signs of the coming epidemic had appeared even earlier. A sample of prostitutes in Butare, Rwanda, in 1983 found that 75 percent were infected with HIV. A later study reporting this statistic dated the general awareness that Central Africa was at risk for the spread of AIDS back to 1983 as well.^[3] An article in 1991 in the World Bank/ International Monetary Fund quarterly magazine predicted that 30 million people would be infected worldwide by the year 2000 if nothing were done.^[4] This was not far off the actual outcome in 2000, so sixteen years ago many knew that a catastrophic epidemic was underway.

One of the lead organizations for fighting the African epidemic was the World Bank, which says today on its AIDS Web site that it is "the largest long-term investor in prevention and mitigation of HIV/AIDS in developing countries." In its first AIDS strategy report in 1988, the World Bank said the crisis was urgent. It presciently detected "an environment highly conducive to the spread of HIV" in many African countries. It noted that the epidemic was far from reaching its full potential and that "the AIDS epidemic in Africa is an emergency situation and appropriate action must be undertaken now."^[5]

Yet the World Bank's effort at the time was pitiful: it made a grant of $1 million to the World Health Organization (WHO) in the 1988–1989 fiscal year to fight AIDS. The World Bank sponsored only one project dedicated to AIDS before 1993 (an $8 million loan to President Mobutu of Zaire in 1988). Over the entire period between 1988 and 1999, it spent $15 million a year on all AIDS projects in Africa. In 1992, another World Bank report noted that it "has done little to initiate prevention in countries in which the risk of spread is high." Yet the 1992 report closed with the inexplicable admonition that "AIDS should not be allowed to dominate the Bank's agenda on population, health, and nutrition issues in Africa."

ther aid organizations did little better. What explains such fateful inaction? There was a failure of courage on the part of both Western aid agencies and African leaders, and misinformation that made both parties reluctant to press the issue. As Epstein explains, Western scientists had identified the continent as the source of the worldwide epidemic, and pinpointed a virus in monkeys that had somehow jumped to humans as having initiated it. There were still plenty of mysteries: How had the jump happened? When did it happen and why? Why did the virus not spread before the 1980s and then why did it spread so rapidly in Africa afterward? Epstein discusses what is known and unknown about these questions, which makes fascinating reading. Perhaps what is even more relevant than the right answers to the questions, however, is the way that the wrong answers inhibited the response to the epidemic.

Western scientists flew into Africa, collected blood samples, and flew out, seemingly much more interested in getting recognition in the Western press than in communicating useful and sensitive knowledge to African leaders and the public. Scientists carelessly put forward hypotheses about African promiscuity without considering how important it was to avoid any unnecessary stigma that would provide an excuse for denial by African leaders. The press and television portrayed (and still does portray) Africans as being almost universally HIV-positive. Would African AIDS become less of a tragedy if the press reported accurately that HIV-positive individuals make up just 3 percent of the population of sub-Saharan Africa? Of course, being accused of promiscuity and having Africans labeled as the equivalents of Typhoid Mary did not make their leaders or the general population all that receptive to messages from Western scientists on how to confront the epidemic.

Many Africans reacted with a mixture of denial and conspiracy theories. Maybe the CIA had targeted Africans during the cold war with a scientifically engineered virus, perhaps spread through vaccination campaigns. In South Africa, there was a claim that the apartheid government had targeted black South Africans for decimation through the HIV virus (a conspiracy theory that may not have seemed so far-fetched in view of the evil deeds of the South African secret service under apartheid). As Epstein chronicles, South African President Thabo Mbeki and Health Minister Dr. M.E. Tshabalala-Msimang also consorted with AIDS quacks who doubted that HIV caused AIDS. Few in Africa or the aid agencies lending to Africa wanted to talk about AIDS with these ideas in the air.

A more mainstream but also damaging view of the Western AIDS experts was that the spread of AIDS in Africa was driven by "core transmitters," such as prostitutes and the truck drivers and migrant workers who patronized them. This was a theory favored by the World Health Organization and World Bank, as set out in the bank's 1997 AIDS report. This new theory added yet more layers of stigma and denial. If AIDS victims were prostitutes or patrons of prostitutes, who was going to admit being HIV-positive? Or that their late relatives died of AIDS? This could explain some of the astonishing wall of silence surrounding AIDS that Epstein documents and that still prevails among both the African public and politicians.

Of course, such theories may well have been true—maybe AIDS was the result of the sex trade and promiscuity. So some Westerners advised Africans: just try to overcome the stigma as best you can. Treat the problem at its source by getting prostitutes to force condoms on their customers. The rest of the population could breathe easy as long as they did not use prostitutes or sleep promiscuously with men who did.

pstein's contribution is to say loudly that this conventional wisdom is wrong. The stigma attached to the HIV-positive, and the implied general stigma for Africa, were tragically misguided. According to survey evidence Epstein provides, Africans are no more promiscuous than most other people, as measured by numbers of sexual partners in a lifetime, casual sexual encounters, and visits to prostitutes. As she says, sexual behavior in Africa is governed by strict rules; they are just different rules from those prevailing elsewhere. She argues that in many African countries the large numbers of people willing to follow those rules have a great deal to fear from AIDS; and they must know they cannot dismiss the problem of infection as one of a whoring minority. The international aid agencies and Western governments are only now belatedly coming around to Epstein's perspective (which is based on the findings of a number of independent researchers), over two decades after the start of the epidemic, and they still don't know quite how to handle it.

Epstein's view is that the cause of the AIDS crisis in Africa is what has now become known in AIDS jargon as "concurrent" relationships. Africans have about the same number of sexual partners as anyone else; they are just more likely to have more than one long-term partner at a time. Crucially, both men and women have multiple partners, in contrast to other poor societies where men may often stray but women's monogamy is jealously guarded. Western men and women are more likely to practice serial monogamy or engage in one-night stands. To oversimplify a little, Africa's AIDS tragedy is that it combines greater Western-style sexual equality for women with social norms that permit simultaneous long-term sexual relationships for both partners.

Multiple long-term relationships are prevalent in Africa for many reasons. In southern Africa (where the epidemic is concentrated), one of the few opportunities for gainful work open to men is to become long-distance migrants to the mines. Both husbands and wives may have other long-term partners during the months when they are separated. The African tradition of polygamy (described by historians like John Iliffe as a cultural response to maximize fertility in what used to be a lightly settled continent) has given way to modern relationships between older, well-to-do, gift-bestowing men and multiple young girlfriends. This is not so different from the successive trophy wives of American fat cats, but much more widespread since Africa's poverty often makes it a matter of survival for African young women to have a rich (older) boyfriend. The desire of young women for young boyfriends can be accommodated on the side.

For many reasons, concurrent, long-term sexual relationships are much more dangerous for the spread of AIDS than serial monogamy. When both men and women have concurrent relationships, they are part of a huge web of sexual partners by which the HIV virus moves through the population. Long-term relationships are much more likely to spread AIDS than one-night stands because of the low probability of a single sex act spreading the virus. Since the HIV-positive are most contagious soon after they themselves become infected, a long-term partner who has just become infected in another relationship poses much more risk than a prostitute who has been infected for a long time. Serial monogamy in the West kept the virus largely trapped within single relationships, a fact Epstein nicely illustrates with some clever graphs. Her explanation based on concurrent relationships has gained broad acceptance and has been confirmed by mathematical modeling and by surveys of sexual habits in various countries; but one still wishes the evidence was a little more extensive for such a critical issue. At this point, however, it looks like much stigma, denial, and inaction took place simply because of lack of understanding of African sexual behavior.

e have since emerged from the Age of Inaction to the Age of Ineffective Action. In Africa, AIDS is now a multibillion-dollar industry, with the US President's Emergency Plan For AIDS Relief (PEPFAR), the Global Fund for AIDS, Tuberculosis, and Malaria (GFATM), the United Nations' AIDS consortium, UNAIDS, and major efforts by the World Bank, the World Health Organization, the Gates Foundation, and national aid agencies. Unfortunately, these well-meaning efforts are badly weakened by political agendas, misdirected priorities, ignorance, and plain incompetence.

To illustrate the role of political agendas, Epstein discusses the famous success story by which AIDS infection rates in Uganda decreased as a result of the ABC campaign—"Abstain, Be Faithful, and Use Condoms." Epstein damns both the Western right and left for their misuse of the lessons of Uganda. The religious right played up the "Abstain" part because it happened to fit their particular moral preferences. People on the left, who had different sexual morals, said just use condoms. The "Be Faithful" message, precisely the one in Epstein's story that was critical in Uganda (led by Ugandan President Yoweri Museveni, who called for "Zero Grazing"), was a political orphan, disdained by both left and right.

The response of the aid industry to AIDS has its own ABC, much less effective than its Ugandan counterpart: antiretroviral drugs, bureaucracy, and consultants. A huge part of the Western response has been concentrated on getting antiretrovirals to those in Africa with full-blown AIDS. There is nothing wrong with the urge to treat the sick, but in practice it has crowded out nearly every other response to the epidemic. ARVs are now reaching only a tiny minority of those in need and it will never be feasible to treat everyone. Even if you avoid the Scylla of insufficient money to pay for the expensive treatments, you run into the Charybdis of Africa's dysfunctional health care systems. And even if you did treat everyone who has AIDS with ARVs, which add a few years—four or five, Epstein notes, according to current UN estimates—to the lives of people who remain terminally ill, that would still ignore the omnipotent question: How do you stop AIDS from spreading further through this generation and into the next generation?^[6] Alas, the glory that people get from sponsoring AIDS treatment so blinds the politicians and celebrities involved in AIDS causes that they can't keep elementary medical math straight. So not only did the most relevant part of prevention strategies—"Be Faithful"—lack political sponsorship. But prevention itself has been badly neglected in favor of the privileged method of treatment.

For example, take the World Health Organization/UNAIDS April 2007 publication, Towards Universal Access: Scaling Up Priority HIV/AIDS Interventions in the Health Sector. Somehow prevention did not make the cut as an intervention deserving priority in this document, which is all about treatment. (There is one mention of "counseling" that hints prevention may have briefly crossed the minds of the authors.) To promise "universal access" to treatment—a promise that cannot be kept and that nobody is held accountable for keeping anyway—while saying nothing about the prevention that would stop the epidemic itself is so irresponsible that even a hardened student of UN evasions is left gasping. The UN's lack of accountability perhaps explains such flagrant irresponsibility.

President Bush's PEPFAR doesn't fare much better in Epstein's account. In fiscal year 2006, by design, less than a quarter of PEPFAR's budget was spent on prevention, and a hefty chunk of that went for the useless abstinence campaigns. In a revealing incident earlier this year, the American ambassador to South Africa sent a letter to PEPFAR contractors telling them to cut back on prevention—but not treatment—activities for the next year because of a budget squeeze. He said: "Our priority must be delivery of treatment services."^[7]

The neglect of prevention is bipartisan. Former President Bill Clinton has been admirably active in fighting AIDS in Africa. The issue that occupies him is of course treatment (specifically, negotiating cuts in drug prices). In his speech to the International Aids Conference in 2006, he went into great detail about what the Clinton Foundation had accomplished in making treatment available; but he talked of prevention only in a kind of ritual incantation with no details, except to mention quick technical fixes like microbicides and AIDS vaccines—which at this point don't exist—or the magic bullet of HIV testing, although there is little evidence that it is effective in preventing the disease.

When well-conceived efforts to improve prevention do exist, they often run afoul of the aid industry. Epstein observes that there was already a huge international bureaucracy devoted to combating population growth by distributing condoms. When suddenly condoms became marketable for preventing AIDS as well as pregnancy, this presented a huge new growth opportunity for family-planning organizations (which had been losing foreign aid market share as people realized that population growth was not as scary as originally thought). The condom bureaucracy did what it does best, which is flood countries with condoms. Alas, supply does not create its own demand. Condom-saturated countries like Botswana have made little progress in reducing new AIDS infections, since people there don't like to use condoms and are not yet convinced that they are at risk of HIV infection if they don't. Meanwhile, the "Be Faithful" message was neglected because it was not of interest to the bureaucracy concerned with AIDS. As Epstein muses acidly: "Zero Grazing" had "no multimillion-dollar bureaucracy to support it."

Then there is the bureaucracy's bean-counting approach to problem-solving. Epstein describes how the measurement of "results," such as the number of people counseled to practice safe sex, defeated its own purposes. The "results," as is common in foreign aid, were really inputs rather than outputs—what was being measured was the numbers of people counseled, not the behaviors actually changed by counseling. Moreover, the emphasis on quantities had the predictable effect of diminishing the quality of the aid being given. As one frustrated counselor quoted by Epstein said:

If you have to do one thousand people by the end of the month, you end up not doing good counseling.... They're not asking "are we really meeting the needs of these people."

Alas, even these efforts look like models of bureaucratic efficiency compared to some of the other activities of the UN agencies and the World Bank. Plans, strategies, and frameworks are favored activities in foreign aid—this is what aid bureaucracy does. Then the bureaucracies "coordinate" their respective strategies with the others. One bureaucracy's output serves as another bureaucracy's input, with the output of the second bureaucracy then feeding back as an input into the first bureaucracy's output.

For example, the World Bank announces that its plan to fight AIDS is to produce more plans. It advocates

strengthening national HIV/AIDS strategies, to ensure they are truly prioritized and strategic, integrated into development planning.... The World Bank will focus intensively on improving national HIV/AIDS strategies and annual action plans. ... Support for a network of country practitioners will be provided to help countries to develop strategic, prioritized national plans.... Enhanced Country Assistance Strategy (CAS) and Poverty Reduction Strategy (PRSP) guidelines and assessment criteria will aim to support better integration of HIV/ AIDS into national development planning and better aligned national AIDS responses.... The Bank will continue to provide financial and technical support...to enhance country capacity and systems to implement national HIV/AIDS plans...[and] work with countries and Bank project teams to further improve planning.^[8]

This repetitive exposition on how strategies should be strategic is to be found in the short version, or executive summary, of a seventy-eight-page report. Those who can, act; those who can't, produce plans.

The World Bank will do all this through "partnerships across Bank units, working closely with client countries, UNAIDS co-sponsors, GFATM and other development partners." As for UNAIDS, it is "monitoring the progress on the UNGASS [the apt acronym for the UN General Assembly] Declaration of Commitment on HIV/AIDS." It was one of these progress reports that ignored the need for prevention. UNAIDS issues such documents when it is not busy engaging "diverse partners and stakeholders, including inter-governmental bodies, governments, other key partners, UNAIDS and the broader UN system." This Kafkaesque maze of the AIDS bureaucracy would be comic, except for the millions of nonbureaucrats who are dying of AIDS.

The C in the aid industry's ABC is for the consultants from the West who implement AIDS programs, often slighting homegrown efforts. Epstein gives an example of how a decent homegrown organization that cares for AIDS orphans, called Sizanani, was starved of funds in South Africa. Meanwhile, high-powered, foreign-sponsored organizations like one called Hope Worldwide (founded by American fundamentalists) skillfully captured PEPFAR dollars. Hope Worldwide offered Sizanani a "memorandum of understanding" in which it would provide advice but no money. Apparently it wanted to count Sizanani's orphans toward its target of "orphans helped" in order to meet PEPFAR's demand for results. Elizabeth Rapuleng, an elderly African woman who founded Sizanani, said, "When the Americans come, we sing, we dance, they take our picture, and they go back and show everyone how they helping the poor black people. But then all they do is hijack our projects and count our children."

Other firms engage in Madison Avenue marketing campaigns to spread sexy messages about safe sex. Epstein dissects one such Western-funded campaign called loveLife, whose leader describes it as "a brand of positive lifestyle." Throughout South Africa, the campaign has built recreation centers (loveLife Y-Centers) for young people, where they can hear American motivational speakers tell them to believe in themselves, all of which has shown no sign of working to halt the spread of AIDS. Why would it? As Epstein describes a bitter saying in Uganda, there is Slim AIDS and Fat AIDS. Slim AIDS is what happens to the emaciated victims of HIV. Fat AIDS is what happens to the consulting companies who win contracts from International AIDS Inc.

Epstein argues that it violates both common sense and the evidence to put much faith in vague, happy-sounding messages about self-esteem and safe sex. During visits to Africa I have often seen the ubiquitous donor-funded "AIDS prevention" billboards, featuring beautiful young couples who are meant to convey—well, what exactly? Epstein (backed up by an epidemiological study of the Uganda prevention success story) argues that the prevention campaigns could use less sexiness and more fearfulness. What worked in Uganda, she writes, was the "ordinary, but frank, conversations people had with their family, friends, and neighbors—not about sex—but about the frightening, calamitous effects of AIDS itself."

This is Epstein's "Invisible Cure." Ugandans had enough social cohesion in their densely settled agricultural country so that the discussions about the calamity of AIDS and the urgent need to change behavior could well up from the bottom of society, rather than resulting from any bureaucratic action plan or consultants' marketing campaign. What was crucial was open and active recognition of the danger, and community encouragement of families to avoid risk. By contrast, in the more dislocated and anonymous environments of southern African cities and mining camps, denial of the AIDS problem behind a wall of silence was the dominant attitude (undeterred by the efforts of Western AIDS bureaucrats, who didn't even understand the problem). One still wishes that the evidence for what works was a little more substantial than one Ugandan success story that lasted a few years, but Epstein is such a persuasive storyteller that she earns a serious hearing. To illustrate what's needed, Epstein draws an analogy to the medical activ-ism of women's groups in nineteenth-century America. Once they understood the germ theory of disease, they were able to spread habits of hand washing, covering your mouth while coughing, not spitting in public, etc. This successfully reduced disease even before the invention of antibiotics.

The Ugandan AIDS activist Beatrice Were told Epstein:

As a woman living with HIV, I am often asked whether there will ever be a cure for HIV/AIDS, and my answer is that there is already a cure. It lies in the strength of women, families and communities who support and empower each other to break the silence around AIDS and take control of their sexual lives.

In Epstein's words, "When it comes to fighting AIDS, our greatest mistake may have been to overlook the fact that, in spite of everything, African people often know best how to solve their own problems."

Alas, as Epstein notes, this "Invisible Cure" is unlikely to commend itself either to big-budget Western AIDS programs or to the bureaucrats and consultants who are committed to them. The cure Epstein describes can't be carried out by a World Bank strategy; it can't be bought by aid dollars, or put on a billboard. But perhaps, by reading her book, AIDS International will learn a lot about what not to do. Maybe Epstein's account of the dangers of multiple long-term partners will be more widely understood and decrease some of the stigma and denial that have hampered frank discussion of AIDS in Africa. Maybe some politicians and citizen activists in both the West and Africa will dare to challenge the wall of silence surrounding the spread of AIDS. And maybe, through research and experiment, some well-meaning Westerners will find a way to reinforce the homegrown "Invisible Cure," and to make it more likely to happen sooner rather than later.

Just read The Invisible Cure. If you do, you will be mortified that such an epic tragedy has found so few heroes and so many opportunists and bumblers. And you'll hope that someone will do better next time. Except that this particular next time is already here.

Notes

^[1] And the Band Played On: Politics, People, and the AIDS Epidemic (St. Martins, 1987).

^[2] UNAIDS report, December 2006.

^[3] Bekki J. Johnson and Robert S. Pond, AIDS in Africa: A Review of Medical, Public Health, Social Science and Popular Literature (Aachen: MISEORE, Campaign Against Hunger and Disease in the World, 1988).

^[4] Jill Armstrong, "Socioeconomic Implications of AIDS in Developing Countries," Finance and Development, Vol. 28, No. 4 (December 1991), pp. 14–17.

^[5] World Bank, Africa Technical Department, "Acquired Immunodeficiency Syndrome (AIDS): The Bank's Agenda for Action in Africa," October 24, 1988.

^[6] Some treatment advocates claim that HIV testing and treatment themselves have preventative effects, but Epstein notes that there is little evidence to support this politically convenient claim.

^[7] Letter to PEPFAR partners from Ambassador Eric M. Bost, Embassy of the United States of America, Pretoria, South Africa, January 26, 2007.

^[8] The World Bank's Global HIV/AIDS Program of Action, December 2005.

A Basic Documentary from the International Federation of the Red Cross and Red Crescent Societies on the Challenges of Complex Political Emergencies

http://www.youtube.com/watch?v=Yx9QB-pSpwc

The Documentary the Iron Wall on the Palestinian-Israeli War (Settelments as a weapon of war and ideas of peace without justice)

http://www.youtube.com/watch?v=R8PKqqMOOtU

Part of the 2003 documentary "Plan Colombia: Cashing in on the Drug War Failure"

http://www.youtube.com/watch?v=3uxEP7C4wxk

A Documentary on the Sudan War (interesting narration/footage, not sure about the conclusion)

http://www.youtube.com/watch?v=gB8n44fX-U0

An Interesting Paper by Mark Duffield on the Relation between Complex Political Emergencies and Developmentalism

http://www.ids.ac.uk/UserFiles/File/publications/classics/duffield_25_4.pdf

BBC's Q&A: Sudan's Darfur Conflict

BBC News, Thursday 15 November 2007,

The United Nations Security Council has approved a 26,000-strong peacekeeping force to replace the 7,000 African Union (AU) observer mission struggling to protect civilians in Sudan's western province of Darfur.

But the exact make-up and deployment date for this beefed up force is still to be determined.
In the meantime, more than 2m people are living in camps after fleeing more than four years of fighting in the region and they are vulnerable without peacekeepers.

Sudan's government and the pro-government Arab militias are accused of war crimes against the region's black African population, although the UN has stopped short of calling it genocide.
Peace talks involving the government and most of the myriad rebel groups have recently resumed, but until the new UN-AU force deploys in Darfur the prospects for an end to violence look remote.

How did the conflict start?

The conflict began in the arid and impoverished region early in 2003 after a rebel group began attacking government targets, saying the region was being neglected by Khartoum.
The rebels say the government is oppressing black Africans in favour of Arabs.
Darfur, which means land of the Fur, has faced many years of tension over land and grazing rights between the mostly nomadic Arabs, and farmers from the Fur, Massaleet and Zagawa communities.

There are two main rebel groups, the Sudan Liberation Army (SLA) and the Justice and Equality Movement (Jem), although both groups have split, some along ethnic lines.
More than a dozen rebel groups are now believed to exist. Most will attend the talks in Libya, but one key leader, Abdul Wahid el-Nur, is boycotting the talks until the conflict ends.

What is the government doing?

It admits mobilising "self-defence militias" following rebel attacks but denies any links to the Janjaweed, accused of trying to "cleanse" black Africans from large swathes of territory.
Refugees from Darfur say that following air raids by government aircraft, the Janjaweed ride into villages on horses and camels, slaughtering men, raping women and stealing whatever they can find.

Many women report being abducted by the Janjaweed and held as sex slaves for more than a week before being released.

The US and some human rights groups say that genocide is taking place - though a UN investigation team sent to Sudan said that while war crimes had been committed, there had been no intent to commit genocide.

Sudan's government denies being in control of the Janjaweed and President Omar al-Bashir has called them "thieves and gangsters".

After strong international pressure and the threat of sanctions, the government promised to disarm the Janjaweed. But so far there is little evidence this has happened.

Trials have been announced in Khartoum of some members of the security forces suspected of abuses - but this is viewed as part of a campaign against UN-backed attempts to get some 50 key suspects tried at the International Criminal Court in The Hague.

What has happened to Darfur's civilians?

Millions have fled their destroyed villages, with some 2m in camps near Darfur's main towns. But there is not enough food, water or medicine.

The Janjaweed patrol outside the camps and Darfuris say the men are killed and the women raped if they venture too far in search of firewood or water.

Some 200,000 have also sought safety in neighbouring Chad, but many of these are camped along a 600km stretch of the border and remain vulnerable to attacks from Sudan.

The refugees are also threatened by the diplomatic fallout between Chad and Sudan as the neighbours accuse one another of supporting each other's rebel groups.

Chad's eastern areas have a similar ethnic make-up to Darfur.

Many aid agencies are working in Darfur but they are unable to get access to vast areas because of the fighting.

How many have died?

With much of Darfur inaccessible to aid workers and researchers, calculating how many deaths there have been in the past three years is impossible.
What researchers have done is to estimate the deaths based on surveys in areas they can reach.
The latest research published in September 2006 in the journal Science puts the numbers of deaths above and beyond those that would normally die in this inhospitable area at "no fewer than 200,000".

The US researchers say that their figures are the most compelling and persuasive estimate to date. They have made no distinction between those dying as a result of violence and those dying as a result of starvation or disease in refugee camps.

Accurate figures are crucial in determining whether the deaths in Darfur are genocide or - as the Sudanese government says - the situation is being exaggerated.

Have there been previous peace talks?
Lots.

KEY REBEL PLAYERS
SLM: Minni Minnawi's faction signed 2006 peace deal
SLM: Abdul Wahid Mohammad Ahmed al-Nur's faction rejected peace deal
Jem: Khalil Ibrahim, one of the first rebel groups, rejected deal
Rebel negotiator: Suleiman Jamous
SLM Unity: Abdallah Yehia
UFLD: recently formed umbrella group including SLM commanders
Other breakaway SLM commanders: Mahjoub Hussein, Jar el-Neby and Suleiman Marajan There are estimated to be more than 13 rebel factions in Darfur


The leader of one SLA faction, Minni Minawi, who signed a peace deal in 2006 after long-running talks in Nigeria, was given a large budget, but his fighters have already been accused by Amnesty International of abuses against people in areas opposed to the peace deal.
The other rebel factions did not sign the deal.

There has been a dramatic increase in violence and displacement since the deal was signed.
Amid international threats of sanctions for those refusing to attend, many rebel groups briefly attended preliminary talks with the government in Libya in October 2007 - but there is little hope of a quick breakthrough.

Is anyone trying to stop the fighting?

About 7,000 African Union troops are deployed in Darfur on a very limited mandate.
Experts say the soldiers are too few to cover an area the size of France, and the African Union says it does not have the money to fund the operation for much longer.

The recent killing of 10 AU soldiers by a rebel group in northern Darfur has highlighted the need for the new force to be deployed - but at the same time makes it harder for the AU and UN to secure pledges of troops.

The new, larger joint UN-AU force should be in place by early 2008 - if international support is forthcoming - and be better equipped and with a stronger mandate to protect civilians and aid workers.

But until recently, Sudan resisted strong Western diplomatic pressure for the UN to take control of the peacekeeping mission and their attitude to the deployment and its mandate remains ambiguous at best.

Some say even this new 26,000 force will not be enough to cover such a large, remote area.
Others point out that peacekeepers cannot do much unless there is a peace to keep.
They say the fighting can only end through a deal agreed by all sides, which has yet to materialise.

Story from BBC NEWS:http://news.bbc.co.uk/go/pr/fr/-/1/hi/world/africa/3496731.stm

Published: 2007/11/15 09:15:12 GMT
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