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Global Apartheid

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Perhaps more than any other manifestation of global apartheid, the AIDS pandemic exposes the fact that the distribution of current suffering associated with global inequality, as in the past five centuries, is clearly linked to place and race. According to the World Health Organization (WHO), forty-four of the fifty-two countries with life expectancies of less than fifty years are in Africa (with life expectancies still declining due to AIDS). The glacial pace of the international response to AIDS reflects an entrenched double standard characteristic of the apartheid system. As Dr. Peter Piot of UNAIDS remarked just before the World AIDS conference in South Africa last year, "If this had happened with white people, the reaction would have been different."

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About the Author

William Minter
William Minter is senior research fellow at Africa Action, in Washington, DC, which is conducting a campaign for "...
Salih Booker
Salih Booker is executive director of Africa Action, the oldest US-based advocacy group on African affairs,...

Also by the Author

The Africa trip of Treasury Secretary Paul O'Neill and Irish rock star
Bono produced a bumper harvest of photo ops and articles about aid to
Africa. Unfortunately, media coverage was mired in the perennial and
stale aid debate: Should we give more? Does it work?

If the O'Neill-Bono safari resulted in Washington finally paying more of
its proper share for global health, education and clean water, that
would be cause for applause. But any real change requires shifting the
terms of debate. Indeed, the term "aid" itself carries the patronizing
connotation of charity and a division of the world into "donors" and
"recipients."

At the late June meeting in Canada of the rich countries known as the
G8, aid to Africa will be high on the agenda. But behind the rhetoric,
there is little new money--as evidenced by the just-announced paltry sum
of US funding for AIDS--and even less new thinking. Despite the new
mantra of "partnership," the current aid system, in which agencies like
the World Bank and the US Treasury decide what is good for the poor,
reflects the system of global apartheid that is itself the problem.

There is an urgent need to pay for such global public needs as the
battles against AIDS and poverty by increasing the flow of real
resources from rich to poor. But the old rationales and the old aid
system will not do. Granted, some individuals and programs within that
system make real contributions. But they are undermined by the negative
effects of top-down aid and the policies imposed with it.

For a real partnership, the concept of "aid" should be replaced by a
common obligation to finance international public investment for common
needs. Rich countries should pay their fair share based on their
privileged place in the world economy. At the global level, just as
within societies, stacked economic rules unjustly reward some and punish
others, making compensatory public action essential. Reparations to
repair the damage from five centuries of exploitation, racism and
violence are long overdue. Even for those who dismiss such reasoning as
moralizing, the argument of self-interest should be enough. There will
be no security for the rich unless the fruits of the global economy are
shared more equitably.

As former World Bank official Joseph Stiglitz recently remarked in the
New York Review of Books, it is "a peculiar world, in which the
poor countries are in effect subsidizing the richest country, which
happens, at the same time, to be among the stingiest in giving
assistance in the world."

One prerequisite for new thinking about questions like "Does aid work?"
is a correct definition of the term itself. Funds from US Agency for
International Development, or the World Bank often go not for economic
development but to prop up clients, dispose of agricultural surpluses,
impose right-wing economic policies mislabeled "reform" or simply to
recycle old debts. Why should money transfers like these be counted as
aid? This kind of "aid" undermines development and promotes repression
and violence in poor countries.

Money aimed at reaching agreed development goals like health, education
and agricultural development could more accurately be called
"international public investment." Of course, such investment should be
monitored to make sure that it achieves results and is not mismanaged or
siphoned off by corrupt officials. But mechanisms to do this must break
with the vertical donor-recipient dichotomy. Monitoring should not be
monopolized by the US Treasury or the World Bank. Instead, the primary
responsibility should be lodged with vigilant elected representatives,
civil society and media in countries where the money is spent, aided by
greater transparency among the "development partners."

One well-established example of what is possible is the UN's Capital
Development Fund, which is highly rated for its effective support for
local public investment backed by participatory governance. Another is
the new Global Fund to Fight AIDS, Tuberculosis & Malaria, which has
already demonstrated the potential for opening up decision-making to
public scrutiny. Its governing board includes both "donor" and
"recipient" countries, as well as representatives of affected groups. A
lively online debate among activists feeds into the official
discussions.

Funding for agencies like these is now by "voluntary" donor
contributions. This must change. Transfers from rich to poor should be
institutionalized within what should ultimately be a redistributive tax
system that functions across national boundaries, like payments within
the European Union.

There is no immediate prospect for applying such a system worldwide.
Activists can make a start, however, by setting up standards that rich
countries should meet. AIDS activists, for example, have calculated the
fair contribution each country should make to the Global AIDS Fund (see
www.aidspan.org).

Initiatives like the Global AIDS Fund show that alternatives are
possible. Procedures for defining objectives and reviewing results
should be built from the bottom up and opened up to democratic scrutiny.
Instead of abstract debates about whether "aid" works, rich countries
should come up with the money now for real needs. That's not "aid," it's
just a common-sense public investment.

The battlefield death on February 22 of Jonas Savimbi marked the end of an era. With undiluted ambition, consistent ruthlessness and extraordinary skill in manipulating both friend and foe, he repeatedly dashed Angolan hopes for peace. Today almost 4 million Angolans have been displaced by war, and although Angola is potentially one of the richest countries in Africa, infant mortality is the second highest in the world. The United States must now help Angolans rebuild. That means both paying our fair share of the bill for reconstruction and insisting on transparency in the use of revenues Angola gains from US oil companies.

The United States has a particular obligation because it intervened decisively for war in the key period just before Angola's independence in 1975. As has been long known to specialists and conclusively documented in a new book by historian Piero Gleijeses, US covert military action in Angola preceded rather than followed the arrival of Cuban troops. In the 1980s the United States again joined South Africa to build up Savimbi's war machine.

Savimbi's death removed the single greatest obstacle to peace. Three weeks later, the Angolan government declared a unilateral halt to offensive military actions, and a formal ceasefire was agreed to in early April. But the war has left generalized insecurity in the countryside that may well continue. The decades of conflict have also entrenched a climate of distrust throughout Angolan society.

These results come in part from Savimbi's military strategy, which was to make Angola ungovernable. His forces systematically targeted civilians and cut the economic links between city and countryside. He also eliminated internal rivals he regarded as too open to peace. But Savimbi did not create the cleavages in Angolan society that he exploited. There is a profound gap between those who profit from Angola's links to the world economy and those with little chance to do so. This division, more accurately described as regional and structural than ethnic in character, dates back to the colonial era. Since independence, Angola's oil wealth combined with war has further reinforced inequality.

Paradoxically, the Angolan government has served as an unwitting ally of Savimbi. Relying on income from oil to feed the cities and to buy arms while leaving the interior to neglect, Luanda sealed the success of Savimbi's strategy of dividing city from countryside. At the same time, Savimbi's intransigence raised the credibility of the Luanda government. In the 1992 election campaign, for example, the ruling party won support from many Angolans who recoiled from Savimbi's threats more than they resented the government's failures.

The Angolan government has taken the first step with its unilateral truce, but more fundamental changes are also essential. Speaking in Washington on February 27 after he and Angolan President Eduardo dos Santos met George W. Bush, Mozambican President Joaquim Chissano listed some lessons learned from Mozambique's experience. He stressed the need for a comprehensive peace-building process, including greater openness to dissent and to the connection between social and economic development and peace. President dos Santos's peace plan acknowledges these points; however, acceptance of the need for voices from civil society and independent media has been slow and inconsistent.

The hardest tests will be outside Luanda. Delivering material benefits to these long-neglected areas will be critical, but humanitarian operations are stretched to the limit and badly underfunded. Here Angola's international partners--governments, multilateral agencies, oil companies and nongovernmental organizations--have a role to play. The United States and others should quickly provide the remainder of the UN consolidated appeal for Angola for 2002, which as of mid-March had received only 10 percent of the $233 million required. They should also join Angolan civil society in insisting that the government commit its resources to schools, clinics and rebuilding the infrastructure, as well as to immediate humanitarian needs. Angola earns at least $3 billion each year from oil exports, but as much as a third disappears into a complex web of transactions among foreign companies and the Angolan elite.

It would be wrong to punish Angolans by holding up humanitarian relief, but there are other ways to exert pressure. Currently, the World Bank and the IMF are conducting a review of the oil sector with the stated goal of promoting transparency and accountability of oil revenues; this study should be concluded rapidly and made public both in Washington and Luanda. The issue of where the money goes and how to use it must be debated openly. Angolans will quickly be able to see whether the dividends of peace begin to flow. If that happens, this time peace will have a chance.

Also by the Author

Africa Action has launched a petition, supported by the Congressional Black Caucus, that calls on Secretary of State Colin Powell to name the genocide in Darfur and to support immediate intervention to stop the killing.

The Africa trip of Treasury Secretary Paul O'Neill and Irish rock star
Bono produced a bumper harvest of photo ops and articles about aid to
Africa. Unfortunately, media coverage was mired in the perennial and
stale aid debate: Should we give more? Does it work?

If the O'Neill-Bono safari resulted in Washington finally paying more of
its proper share for global health, education and clean water, that
would be cause for applause. But any real change requires shifting the
terms of debate. Indeed, the term "aid" itself carries the patronizing
connotation of charity and a division of the world into "donors" and
"recipients."

At the late June meeting in Canada of the rich countries known as the
G8, aid to Africa will be high on the agenda. But behind the rhetoric,
there is little new money--as evidenced by the just-announced paltry sum
of US funding for AIDS--and even less new thinking. Despite the new
mantra of "partnership," the current aid system, in which agencies like
the World Bank and the US Treasury decide what is good for the poor,
reflects the system of global apartheid that is itself the problem.

There is an urgent need to pay for such global public needs as the
battles against AIDS and poverty by increasing the flow of real
resources from rich to poor. But the old rationales and the old aid
system will not do. Granted, some individuals and programs within that
system make real contributions. But they are undermined by the negative
effects of top-down aid and the policies imposed with it.

For a real partnership, the concept of "aid" should be replaced by a
common obligation to finance international public investment for common
needs. Rich countries should pay their fair share based on their
privileged place in the world economy. At the global level, just as
within societies, stacked economic rules unjustly reward some and punish
others, making compensatory public action essential. Reparations to
repair the damage from five centuries of exploitation, racism and
violence are long overdue. Even for those who dismiss such reasoning as
moralizing, the argument of self-interest should be enough. There will
be no security for the rich unless the fruits of the global economy are
shared more equitably.

As former World Bank official Joseph Stiglitz recently remarked in the
New York Review of Books, it is "a peculiar world, in which the
poor countries are in effect subsidizing the richest country, which
happens, at the same time, to be among the stingiest in giving
assistance in the world."

One prerequisite for new thinking about questions like "Does aid work?"
is a correct definition of the term itself. Funds from US Agency for
International Development, or the World Bank often go not for economic
development but to prop up clients, dispose of agricultural surpluses,
impose right-wing economic policies mislabeled "reform" or simply to
recycle old debts. Why should money transfers like these be counted as
aid? This kind of "aid" undermines development and promotes repression
and violence in poor countries.

Money aimed at reaching agreed development goals like health, education
and agricultural development could more accurately be called
"international public investment." Of course, such investment should be
monitored to make sure that it achieves results and is not mismanaged or
siphoned off by corrupt officials. But mechanisms to do this must break
with the vertical donor-recipient dichotomy. Monitoring should not be
monopolized by the US Treasury or the World Bank. Instead, the primary
responsibility should be lodged with vigilant elected representatives,
civil society and media in countries where the money is spent, aided by
greater transparency among the "development partners."

One well-established example of what is possible is the UN's Capital
Development Fund, which is highly rated for its effective support for
local public investment backed by participatory governance. Another is
the new Global Fund to Fight AIDS, Tuberculosis & Malaria, which has
already demonstrated the potential for opening up decision-making to
public scrutiny. Its governing board includes both "donor" and
"recipient" countries, as well as representatives of affected groups. A
lively online debate among activists feeds into the official
discussions.

Funding for agencies like these is now by "voluntary" donor
contributions. This must change. Transfers from rich to poor should be
institutionalized within what should ultimately be a redistributive tax
system that functions across national boundaries, like payments within
the European Union.

There is no immediate prospect for applying such a system worldwide.
Activists can make a start, however, by setting up standards that rich
countries should meet. AIDS activists, for example, have calculated the
fair contribution each country should make to the Global AIDS Fund (see
www.aidspan.org).

Initiatives like the Global AIDS Fund show that alternatives are
possible. Procedures for defining objectives and reviewing results
should be built from the bottom up and opened up to democratic scrutiny.
Instead of abstract debates about whether "aid" works, rich countries
should come up with the money now for real needs. That's not "aid," it's
just a common-sense public investment.

Health is one of the fundamental human rights embodied in the 1946 constitution of the WHO and the 1948 Universal Declaration of Human Rights. Specifically, the WHO constitution says, "The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition." Article 25 of the Universal Declaration states that "Everyone has the right to a standard of living adequate for the health and well-being of himself and his family, including food, clothing, housing and medical care and necessary social services." As even mainstream economists increasingly recognize, health is one of the fundamental prerequisites for development. Along with education and income, it is one of the three components of the UN's Human Development Index, which has gained wide acceptance in theory, if not in practice, as a better benchmark than purely economic indicators like per capita income. In fact, health is the human right that in practice most visibly marks distinctions of race, or of economic or social condition.

Whether governments and international organizations actually have an obligation to enforce this right is hotly disputed. The Bush Administration, following in the steps of its predecessors, stressed in its March 30 response to the UN's draft declaration on AIDS that "for legal and constitutional reasons, the United States cannot accept a 'rights based approach' to HIV/AIDS--any more than it can accept a rights based approach to food, shelter or hunger." At the UN High Commission on Human Rights in April, the United States alone abstained on an otherwise unanimously supported Brazilian resolution recognizing "that access to medication in the context of pandemics such as HIV/AIDS is one fundamental element...of the right... to health."

The scale of the AIDS pandemic is unprecedented. But AIDS is like other widespread diseases in that it is fueled not only by unequal access to medical care but also by social and economic conditions. Poverty and gender inequality fuel the pandemic in Africa. Malnutrition reduces resistance to disease. Migrant labor patterns (well entrenched in Africa from colonialism and apartheid) raise the risk of infection. The proximate cause of the spread of AIDS is HIV, but vulnerability to infection is linked not only to behavior but especially to unequal power relations between women and men, and to poverty and living conditions [see Eileen Stillwaggon, "AIDS and Poverty in Africa," May 21]. Poverty, in turn, is linked to race and to the structural position of communities within countries and of countries within the world economy.

Thus debating what is to be done about AIDS keeps leading back to broader issues. Unless women have the freedom to negotiate the terms of sex, increased awareness and availability of condoms will have only limited impact. Health services deprived of basic resources will be unable to meet the need for treatment or prevention of AIDS. Meeting in Abuja, Nigeria, in April, African leaders agreed on a target of spending at least 15 percent of their national budgets on health, two or three times the current levels. But their chances of meeting this target are slim if they are forced to give priority to paying illegitimate foreign debts over making investments in public health (or if they choose to divert resources to war or personal gain).

Some cite such factors as excuses for inaction. Even as prices of antiretroviral drugs drop in response to protest and generic competition, the lack of health infrastructure and the inability of governments to pay even the reduced prices become new rationales for denying antiretroviral treatment to Africans. As one unidentified international health official told the Washington Post on April 23, while deploring the political stance of activists, "We may have to sit by and just see these millions of people die."

The alternate response is to address the reasons for lack of infrastructure and inability to pay. That leads back to policies imposed by international financial institutions in the 1980s and 1990s and, in a longer view, to harsh historical legacies that policy-makers still refuse to confront. Granted, corruption and policy mistakes by African leaders also play a role. But in Africa and in other developing regions, unsustainable debt and weakened health systems result in large part from economic policy conditions imposed by international creditors during the past two decades. The imposition of "user fees" for primary healthcare, for example, drove large numbers away from public health services, contributing to increased rates of sexually transmitted diseases. More generally, cutbacks in the public sector helped send health professionals to the private sector or abroad and reduced investments in healthcare delivery systems. Creditors representing a collective economic colonialism managed by the World Bank and IMF increasingly dictated public health and other policies of poor countries. Debt provided the leverage to enforce the economic diktat of global apartheid by the rich upon the poor.

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