DIGGING HEALTH MATTERS: Walking on Borrowed Legs – to end AIDS

One of my favourite African proverbs comes from the Wolof Speaking people of Senegal. It says “If you borrow a man’s legs, you will go where he directs you.” I quote this proverb extensively when I speak publicly or privately as an advocate/activist, or write about Zambia’s HIV Response and whether we shall be able to see the end of AIDS in Zambia in 2030. I say that we shall not – as long as we continue to respond to the Zambian HIV and AIDS epidemics with other people’s legs.

It is not a secret that the largest portion of funding for Zambia’s HIV Response, is by foreign governments, chiefly the United States of America through the President’s Emergency Plan for AIDS Relief (PEPFAR). Everything in HIV and AIDS – from prevention with so-called key sustaining commodities such as HIV Test Kits; Laboratory reagents; male and female condoms; kits for Voluntary Male Medical Circumcision (VMMC) to lifesaving antiretroviral drugs (ARVs) – are all being funded through the goodwill of our ‘cooperating partners’ the United States and Europe.
As Dr Katele Kalumba used to say in the early 90s when he was Deputy Health Minister, “the people and governments from these donor countries do not owe the people of Zambia a living!” Unfortunately there are now close to a million Zambians who owe their lives and living with HIV to our donors. If donors stop ‘donating’ ARVs, many of our people on HIV treatment will die.

For the last 10 years or more, I have advocated at every opportunity for the Zambian Government, and our kind donors to be cognizant of this grave danger to people lives posed by our total dependence on other governments to keep our people alive. I always said that if a new President replaced Barak Obama, we could face the possibility of withdrawal of PEPFAR assistance. The owners of the proverbial borrowed legs we have depended on for so long could claim them back and withdraw them!

The answer I got was the same, “No American President can withdraw PEPFAR and let Zambian people die!”

In 2013, I was invited to speak on a panel during a Child Survival Summit in Washington DC. Two members of the panel were senior officials from USAID. I said then that rather than the USG continuing to let us walk indefinitely with borrowed legs, if I was USAID, I would insist that Zambia uses the borrowed USG legs for a stipulated limited time to strengthen our own legs, until we can walk on our own. My favourite proverb went down very well, but that was all!
In January 2017, I made a submission during a sitting of the Parliamentary Committee on Health, Community Development and Social Services in which I implored them to open and spearhead the debate in Parliament, about the urgent need for sustainable Zambian domestic funding of the Zambian HIV Response. I submitted that unless Zambia moved to take complete ‘ownership’ of our HIV and AIDS epidemic and its response, ending AIDS in Zambia by 2030 would remain a mere slogan.

With a new administration in the White House, it is anyone’s guess how long we can rely on borrowed legs to fight HIV in Zambia, and more importantly to keep HIV infected Zambians on ARVs alive.

Dr Mannasseh Phiri
reflectingaids@yahoo.com

         

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