[stop-imf] Stephen Lewis: Those against education user fees were right

[Robert Weissman]

NOTES FOR A PRESS BRIEFING AT THE UNITED NATIONS, Friday, MAY 2, 2003,

12:30 PM: STEPHEN LEWIS, UN ENVOY, HIV/AIDS IN AFRICA.



Just last weekend, I returned from a trip to Kenya, during which I met, at
length, with the new President, and Ministers of Health, Education and
Information. I also met with the leadership of the National AIDS Control
Council, the UN country team, various representatives of civil society and
People Living with HIV/AIDS, and made a trip to Kabera, the huge,
sprawling, abject slum in Nairobi, to meet with over a hundred commercial
sex workers, all of whom are involved in a program of HIV prevention.



While everyone I met and everything I encountered was fascinating, it=92s t=
he
political leadership I=92d like to focus on for the purposes of this press
briefing.



All too often, when I report back to the media after a visit to Africa, I=
=92m
consumed by gloom and apocalyptic utterance. But not this time. This
time I
came away with a greater degree of hope and optimism than I=92ve felt for
months. It=92s hard to describe the sense of change from the previous
administration: suffice to say, where HIV/AIDS is concerned, the change is
night and day. Where before,e senior officials=92 attention to AIDS was
perfunctory, on this occasion every conversation, without
exception,  demonstrated a new leadership that is intense, committed to
confronting the pandemic, determined to put policies and programmes in
place, and consumed by the recognition that every single family in Kenya is
affected in some way by the ravages of HIV/AIDS.



I guess it=92s a trifle presumptuous to make personal comment on a
conversation with President Kibaki, but I=92m going to do so nonetheless. T=
he
President has appointed an HIV/AIDS Cabinet Committee of nine members,
which he personally chairs. He=92s providing very open and public leadershi=
p
on the issues of AIDS, and demands the same of his cabinet colleagues. What
was particularly impressive --- and unusual --- in the meeting with the
President (there were ten senior members of the bureaucracy present) was
his refusal to accept, at face value, any reassurances that his
administration has the pandemic well in hand. President  Kibaki frequently
challenged what others said, asserting --- almost by instinct ---that  the
crisis is far from under control, and insisting that the fight against the
pandemic must be intensified.



It was one of the most refreshing meetings I=92ve attended with a Head of
State. We covered prevention, particularly in the schools; anti-retroviral
drugs, financial resources, orphaned children, stigma, the role of
religious communities, the role of parliamentarians in their
constituencies, the effects on women and girls, the lifting of school fees
and the question of prevalence rates. The discussion lasted well over an
hour.



It was followed by a meeting with the Minister of Education. This is the
arena where the full force of the new Government has been felt. As most
people doubtless know, the key promise of the election campaign was the
abolition of fees for primary school. No sooner was the present Government
elected, than the promise was fulfilled. And an extraordinary thing
happened: when school reconvened in January, 1.2 million new children
poured into the educational system within one week --- an increase of over
20 per cent! --- and the numbers are still rising, expected to reach one
and a half million by June.

The implications are stunning. One million two hundred thousand children
who had not been in school turned up for school. Kenya has an estimated one
million two hundred thousand children orphaned by AIDS. Are they identical
cohorts? Of course not. Is there a significant overlap? Everyone agrees
that the overlap is large. What, then, is the situation on the rest of the
continent for millions of other children orphaned by AIDS, particularly in
the high prevalence countries? How is it possible that a campaign to
eliminate school fees has not been launched across Africa? Where is the
leadership to come from? Why should such vast numbers of children, who have
lost one or both parents to AIDS, who have little if anything to eat, who
have no guarantee of shelter, no guarantee of health or nutritional care,
no guarantee of a home or of love or of nurture =85 why on top of it all,
should they be denied the right to go to school and the prospect of a
future simply because they=92re impoverished? There=92s something truly
dreadful about all of this.



If the experience of Kenya proves anything, it proves that those who have
argued for the abolition of fees, as a way of liberating the lives of
millions of children, were right. What is so distinctive about Kenya is the
new Government=92s determination to see the lifting of fees as applicable t=
o
everything, including books, uniforms, or any extraneous levy. In the view
of the Minister of Education, the policy is driven by the guarantees
contained in the Convention on the Rights of the Child and the
internationally agreed principles of "Education for All".



In one instance, in an urban slum community many miles from Nairobi, the
population of the primary school, after the fee announcement, jumped from
one thousand to five thousand students. But when the Headmistress insisted
that every child must come to school in a uniform, the numbers dropped to
2,600 --- a major revelation in itself. The Ministry of Education asserted
that absolutely nothing, including uniforms, was to stand in the way of
school attendance, and the numbers are moving back up.



I don=92t want to pretend for a moment that there isn=92t a very tough, har=
d
slog ahead. The new government and the voters understood that abolishing
school fees would be costly in financial terms, but the free education
campaign slogan said it all:  "If you think education is expensive, try
ignorance." The Ministry is scrambling to put together the dollars to
finance the policy (a government task force announced in March that it
would cost $97.1 million through June, and another $137.1 million through
the 2003-2004 school year)" a major portion of it from the Kenyan national
treasury, part of it from the World Bank, part of it from bilateral donors.
And there are still areas of the country, particularly the nomadic
North-East, where school attendance remains unacceptably low. Moreover, the
urgent need physically to expand the school system, and to replenish the
teaching profession, shredded by AIDS, is obviously overwhelming. But the
Government is single-minded in its determination to guarantee the rights of
every Kenyan child to education, and to prove, in the process, that the
goal can be accomplished without sacrificing quality.



For the orphaned children of Kenya, the policy is a salvation. Why, then,
is it not in place across the continent? The time has more than come to
champion this cause with every Government, and to champion it with
unrelenting tenacity. No one should forget that all of the governments in
question have ratified the Convention on the Rights of the Child, article
28 of which reads, in part: "Make primary education compulsory and
available free to all".

Let me now move to the Minister of Health. Again the conversation was
illustrative of a Government determined to break the grip of the pandemic
on Kenyan society.  This Minister speaks with passionate clarity, knowledge
and resolve about the need to proceed simultaneously on care, prevention
and treatment. More, in a fashion with few parallels, this is a Minister
who understands the appalling toll being taken on the women of her country,
and the need to address their extreme vulnerability.



The Government of Kenya has just received money from the Global Fund. The
$56 million allocated to the next two years will help to provide
anti-retroviral treatment for another three thousand Kenyans. There are
roughly seven thousand in treatment now, mostly in the private sector, so
that will bring the total to ten thousand. Already the new Government has
set a target of 40,000 in treatment by the year 2005.



How will they achieve it? In four ways. First, the Government is examining
legislation to introduce a National Health Insurance Plan. It is the
intention of the Ministry of Health that treatment for opportunistic
infections, and for full-blown AIDS, be covered, at least in part, by the
Plan. In my respectful view, that=92s an astonishingly enlightened and
courageous position, worthy of international support. Second, the
Government hopes to persuade the private sector to further expand its
coverage. Third, the Government has set aside, in this fiscal year, with
increased recurrent funding in mind, the sum of $4 million for laboratory
infrastructure to address HIV/AIDS, and it is hoped that, inevitably, some
of the money will be directed to treatment. Fourth, the Government is even
now preparing its next proposal for the Global Fund, which will include
financing for the treatment of another ten thousand people. In that regard,
it should be added that the Government will wish to purchase generic drugs,
from the WHO list of approved anti-retrovirals, probably from India, in
order to keep the prices down. This, then, emphasizes yet again the
desperate urgency of adequate resources for the Global Fund.



While all of these intentions are truly exciting, and a dramatic departure
from the previous administration, it must be pointed out that over two
million people are living with the virus in Kenya, and it is estimated that
two hundred thousand would qualify for immediate treatment. As always, the
gap between need and reality is measured in the  appalling foreshortening
of hundreds of thousands of lives. With additional resources, Kenya could
treat thousands more. With additional resources and a transfer of
technology, Kenya could establish an indigenous capacity to manufacture
anti-retroviral drugs. When will the resources come? When will the needless
carnage end?



Finally, a word about the Minister of Information. He=92s about to take a
very unusual step. Using the authority granted to him under the
Broadcasting legislation, he will direct that a certain limited percentage
of air time, on all radio and television stations, be devoted to
programming on AIDS prevention. It=92s a move that will undoubtedly attract
criticism, but just as in the case of his colleagues, the Minister is
unshakeable.



It=92s hard to convey the startlingly changed atmosphere in the political
precincts of Nairobi and by extension, in the population overall. If ever
there was a time to turn the pandemic around in Kenya, that time is now.
There is no reason in the world, given the commitment of the new Government
to tackle HIV/AIDS, why Kenya cannot become the next Uganda. But they=92ll
need lots of help: they must get it.