[stop-imf] African AIDS Activists: Open Letter to African Finance Ministers at the IMF and WORLD BANK

[Robert Weissman]

Open Letter to African Finance Ministers at the IMF and WORLD BANK
Spring Meetings from Members of the Pan-African Treatment Access
Movement (PATAM)


22 April 2004

Dear African Finance Ministers,

On 24 and 25 April, you will convene in Washington DC for the annual
International Monetary Fund (IMF) and World Bank Spring Meetings to
review the two institutions' operations. As government representatives
your mandate is to ensure that the interests of all residents in your
countries are fully met. As you are well aware, the greatest threat
facing the African continent today is the HIV/AIDS epidemic. We, the
members of an Africa-wide movement advocating for access to HIV/AIDS
treatments and other essential medicines, encourage you to consider the
HIV/AIDS as an issue affecting all other critical developmental issues
and urge you to consider initiatives that will help contain and reverse
the steady march of the epidemic. In particular, we ask that you enhance
the current efforts by the World Bank and IMF against HIV/AIDS but
reject those initiatives that hamper access to life-saving and
affordable medicines for people living with HIV/AIDS.

In the last few years, as the costs of antiretroviral therapy have
steadily declined and some misconceptions most notably on the efficacy
and safety of the drugs have been proven unfounded, treatment has become
recognised as a critical component in the response against HIV/AIDS. At
a conference of African activists held on March 3-5 in Harare, we heard
reports from representatives from countries across Southern Africa that
treatment rollout is either on the verge of starting, or has already
begun in most countries across the region.

We welcomed these reports since they send many a 'ray of hope' to those
infected and affected by HIV. However, we were also told that despite
the increased willingness by all stakeholders, whether private or
public, to provide Antiretroviral Therapy (ART), many initiatives do not
have the financial resources to respond adequately.

Currently many government-led initiatives in Africa can only meet a
fraction of the treatment needs and therefore have to rely on external
support from donors and international initiatives such as the Global
Fund for HIV/AIDS, TB and Malaria (GFTAM). This is an unsustainable
situation with potentially very serious public health consequences
should the donors withdraw support. This is not a new issue: African
Heads of States meeting in Abuja, Nigeria in April 2001 declared that
"we recognise the need to establish a sustainable source of income to
fund HIV/AIDS program."[i] We therefore ask that urgent attention is
paid towards building the internal capacity of our countries to marshal
their own resources against HIV/AIDS. We see the Spring Meetings as such
an opportunity to raise the following issues with the IMF and World Bank.


The Policy Space Occupied

While we have witnessed some movement away from the view that markets
function perfectly and governments should interfere as little as
possible, this orthodoxy still influences policy decisions and
priorities taken by the IMF and World Bank. There are numerous examples
that you are very familiar with in which as a condition for receiving
loans or other grants from these institutions, you have been compelled
to give up state responsibility in the provision of some social
services. We highlight only one.

One of these conditions that we have referred to is that you must ensure
our governments maintain fiscal discipline - in other words they do not
spend more than is budgeted for in a given financial cycle. This is on
the surface reasonable, however in practice there are situations where
it is necessary to borrow from the future to meet the urgent needs of
today and therefore spend beyond current revenue sources. The HIV/AIDS
epidemic is precisely such a case since if we are not willing to borrow
from the future, there simply will be no future. This requirement
becomes even more impractical and ludicrous when you consider cases
where you have had to contemplate declining additional donated revenues
for HIV/AIDS since it may mean breaching that spending ceiling you have
set. We ask you to reject these kinds of conditions.

Debt Cancellation

It has been widely recognised that many countries on our continent
shoulder an enormous debt burden much of it granted by the IMF and World
Bank. Given the scale, much of this debt will never be fully repaid and
furthermore much of it is "odious" having been accumulated by leaders
who were largely unaccountable to us. While efforts such as The Heavily
Indebted Poor Countries (HIPC)[ii] initiative recognise these simple
truths and wish to offer relief, it is not enough to cancel some of
these debts especially when you still find yourselves weighing whether
or how much to spend in debt servicing over social services. You should
demand full debt cancellation.

Democratising the IMF and World Bank

Finally as you yourselves recently noted at a meeting in
Johannesburg[iii], the largest recipients of aid from these two bodies -
you and other so-called developing nations contributed very little to
the decision-making processes. This must change. We therefore fully
support yours and all other efforts to shed the light of transparency,
accountability and representation into these two institutions.

We firmly believe that if these issues are sufficiently raised and
implemented, they will go a long way in freeing up our countries to
respond much more effectively and sustainably against HIV/AIDS. In the
long run, we must stop knocking at the doors of these institutions since
though we may win some gains, we are essentially beggars subject to the
goodwill of one who has more. Let us develop our own capacity.

We charge you with this responsibility and remain ready to offer any
support necessarily but also reserve the right to use all tools
available to us should we feel that you do not represent the interests
of all peoples in our countries.  Millions of lives are at stake!

Sincerely,

Members of the Pan-African Treatment Access Movement.

Email: info@patam.org

Website: www.patam.org <http://www.patam.org/>




For Further Information Contact the PATAM Steering Group


Lubna El Tabei                          Delme Cupido
                  Othoman Mellouk

Tel: +20-10-669-3346                 Tel: +264-61-223-356
             Tel: +212-66-45-28-11

Egypt                                        Namibia
                           Morocco



Moyo Matilda                            James Kamau
                 Grace Muro

Tel: +263-11-702-205                 Tel: +254-722-886-694
            Tel: + 255-22-211-7088

Zimbabwe                                 Kenya
                       Tanzania



Djueche Sylanie Laurie              Ambroise Mamona
          Ako Cyriaque

Tel: +237-775-6993                    Tel: +242-213-036
               Tel: +225-235-04927

Cameroon                                 Congo Brazzaville
                   C=F4te d'Ivoire



Rolake Nwagwu

Tel: +234-1-773-1457

Nigeria






[i] Paragraph 19 of the Abuja Declaration on HIV/AIDS, Tuberculosis and
Other Infectious Diseases
<http://www.patam.org/?download=3DABUJA%20Declaration%20full%20text.pdf> .



[ii]Even IMF Researchers in a document called "Fiscal Sustainability in
African HIPC Countries: A Policy Dilemma?" which analyzed the economic
performance of 12 African countries, including Mozambique, Tanzania,
Ghana, and Cameroon, concluded that African governments had not been
able to raise enough money to invest in social programs even after
having their debts reduced. See
http://www.imf.org/external/pubs/cat/longres.cfm?sk=3D16697.0
<http://www.imf.org/external/pubs/cat/longres.cfm?sk=3D16697.0>



[iii] Meeting of African Finance Ministers, in Sandton, Johannesburg.
See
http://www.globalpolicy.org/socecon/bwi-wto/imf/2004/0315africapartic.htm