Has Disease Posed a Greater Threat to the Survival of Post-Colonial African States than Foreign Debt?
Thesis
In 1957, Ghana became the first sub-Saharan African state to gain independence from European colonisation in the twentieth century. This emancipation paved the way for many other once colonised African states over the next four decades. Celebrations for this newfound hope of development were limited as it was soon revealed that there was a rising foreign debt crisis occurring in post-colonial Africa, specifically between the 1970s and 1990s. Equally, the world’s first HIV/Aids epidemic left a staggering impact on Africa’s populace at this time. Arguments about the severity of the conditions that diseases and foreign debt have left Africa in, are invariably centred around two different definitions of state. This essay will explore the threat that diseases, more specifically HIV/AIDs, posed to the survival of post-colonial Africa as a populace. It will also discuss how this differentiated from the threat that foreign debt posed on post-colonial African states as a governance and populace.
By examining the effects of diseases and foreign debt, this essay also explores the inevitability of viruses such as HIV and AIDs. Contrary to popular beliefs that have been influenced by the media, Africa did not experience the worst case of HIV/AIDs epidemic because it was a “poor continent”. However, this is not to say that the continent’s broken economy did not aggravate the epidemic. Foreign debt posed a considerably greater threat to the survival rates due to the effects it had on the economy, which ultimately resulted in poverty in African nations such as Swaziland. Once the government and healthcare providers were aware of the severity of HIV/AIDS, it was their delay in taking action that exacerbated the speed at which the diseases would kill the populace. Foreign debt ultimately played a significant role in the epidemic that would dominate Africa, because, as historian John Iliffe said, “poverty… did not give birth to HIV, but it was an effective incubator.”
Introduction
The HIV-1 epidemic took a moderate 10 years process to hit Kapita Bila in Kinshasa, city of Democratic Republic of the Congo. When the epidemic eventually hit the town, it visibly spread to three corners of Africa, these being Ethiopia, South Africa and Senegal. The initial invisibility of HIV and AIDs contributed to the threat it posed to the survival rates of post-colonial African states’ populace. This invisibility, combined with the medical advances in the 20th century, led political leaders such as President Mbeki (of South Africa) to question why Africa had the world’s most terrible HIV/AIDs epidemic.
As Iliffe echoes, the epidemic would have spread rapidly regardless of which part of the world it hit first. This essay seeks to evaluate the role that transport mobility played in shaping the origins and nature of the HIV/AIDs virus. In addition, the impact of persistent and somewhat narrowed arguments that sexual behaviours aggravated the spread of the disease amongst Africans was considered to be a key factor when researchers of HIV/AIDs were discerning the threat of these viruses to post-colonial African nations. This was an idea that dominated how healthcare providers, the government and the general public would approach matters when it came to combating HIV/AIDs.
The lack of preparation for African nations (for example, Zambia) transitioning into independence is one of the pivotal reasons behind the external debt that many governing states experienced. Furthermore, Swaziland, a country that possessed one of the highest rates of HIV infection in Africa (let alone the world) in the 1990s, is a case study that strengthens my argument that foreign debt posed a greater threat to the survival rates of African states because it aggravated the poverty line. Consequently, making the aggressiveness of HIV/AIDs a product of foreign debt in this light. Secondly, undisbursed loans by multilateral organisations affected the economy of post-colonial African countries like Zambia. Hence, I will explore how these organisations stagnated Africa as a nation, consequently crushing their hope for development even further.
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The severity of the HIV/AIDs epidemic that was quickly infecting and threatening the populace was seldom in question. Rather, in the case of Swaziland, Adelaide Mkhonza (Swaziland’s minister of health and social welfare) revealed the shocking statistics that 18 people died of AIDS in Mbabane Government Hospital on one day alone in March 2000. Although the virus is unique from other epidemics that have dominated African nations, for example: smallpox, influenza and tuberculosis, the main connection between each of these epidemics was transport mobility. To debrief, people having to cramp together in famine or drought was often a key factor behind the smallpox outbreaks. Meanwhile, the movement of returning soldiers along railway lines would spread influenza. Finally, southern African mineworkers would carry tuberculosis to their rural homes when they went along their migration routes. These examples collectively support Iliffe’s thesis that HIV, in spite of the unclear origin, merely followed the “pattern of past epidemics”. As a result of this, the chances of this infection becoming widespread were inevitable. Once it became an epidemic, HIV/AIDs were destined to be a threat to the survival of post-colonial African states.
Clearly, there were Swazi HIV/AIDs healthcare providers (for example Mkhonza) and educational advocates who were committed to their fight against this epidemic, however, this was not enough. A large part of this is to do with the fact that many Africans were initially unwilling to acknowledge the epidemic in the continent, regardless of the “powerful evidence” that illustrated the existence of the infections.
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As a result of its uniqueness, the epidemic received national and global attention overtime. The magnitude of the HIV/AIDs epidemic was unlike any other epidemic that had affected not just Africa, but the rest of the world. Unfortunately, global awareness of the disease exacerbated the speed at which the epidemic spread across African states for two reasons, these being the delayed intervention by the authorities and the stigmatisation of sexual behaviours.
Firstly, on a national scale, the African governments did not intervene with the epidemic soon enough. This primarily goes back to the invisibility of HIV/AIDs. Although HIV/AIDs do not entirely fit the subjective definition of an invisible disease, especially given the possibility of symptoms showing after a long incubation period, these symptoms only showed in the later stage of the infection. Hence, the Prime Minister of Swaziland at the time, Barnabus Sibusiso Diamini, referred to the unique disease as a “catastrophe in slow motion” in 1999. Diamini’s description conveys that the authorities were aware that action needed to be taken, which leaves the question of what was being done to combat this epidemic? More importantly, whose job was it to provide healthcare treatment for the disease? With these two questions in mind, I will explore how the government and multilateral organisations were indifferent when it came to fighting the epidemic. This is an issue in itself, especially given the fact that research on the viruses had begun by the late 1990s.
Going back to the two questions presented in this essay: what was being done to combat the epidemic and who was taking responsibility, it is important to note that Swazi healthcare providers and educational advocates who specialised in HIV/AIDs did work “tirelessly” against this epidemic. Nevertheless, this was ineffective because national awareness of HIV/AIDs did not occur until February 1999. Therefore, the virus continued to spread because it was not perceived to be ‘anyone’s’ responsibility to fix. As long as many Africans continued to live in denial about the existence of the virus, the pace at which treatment could occur would be slow. Nonetheless, this laissez-faire approach is somewhat understanding when we consider the commentators who referred to the infection as a racial slur, thus stigmatising the epidemic and influencing the African population’s approach to HIV/AIDs. It is such ignorance that led the virus to pose a significant threat on the populace.
In February 1999, UNICEF published a report in the Times of Swaziland that centred on the long-term impact that the epidemic would have on the number of children who would be orphaned. The second event was the acknowledgement of this report by King Mswati of Swaziland, who admitted that the HIV/AIDS epidemic was a national disaster. Therefore, the virus was finally recognised as a national problem by the citizenry. The government was also inspired to intervene “more aggressively” to create and implement relevant public policies that would help contain the spread of the disease. The survival of the post-colonial African [populace] state, was finally on the path to becoming salvaged, at least in Swaziland.
Unfortunately, early observers of HIV/AIDs were fixated on connecting the scale of infection in African nations, to high levels of sexual promiscuity. It is this obsessive stigmatisation of sexual behaviours that contributed to how diseases threatened the post-colonial African populate state. It did so by hindering further research on HIV/AIDs. Once the viruses were taken seriously, the direction of the research conducted was flawed. Between 1989 and 1990, a survey was carried out using examples of 8 mainland African countries and 3 Asian countries (including Thailand and Sri Lanka) to illustrate how the fixation on HIV/Aids and sexual behaviours was actually a “more complicated situation”. The evidence in place only reveals that, when HIV/AIDs did begin to be acknowledged as a national problem, the misunderstanding of how it came to spread, and the stereotypes that the diseases held stagnated researches on HIV/AIDs treatments.
For example, the survey itself exhibited that only a small percentage of African men had 5 or more casual partners, yet overall, non-marital sex was a “relatively rare event for a majority of men and women”. It is no surprise that the fight against how pugnaciously the viruses spread, continued to vegetate when Africans too believed that sexual behaviours factored into the epidemic.
Going back to Dimini’s statement in 1993, this survey (released in 1990) confirms that Thai men, despite being as sexually active as African men, chose to concentrate their non-marital sex on commercial sex workers. This is telling given the fact that such activity was only common in African states such as: Rwanda, Burundi, urban Ethiopia, Senegal and Nairobi, Kenya. In light of this, this essay will concede that diseases became a product of the neglection of post-colonial Africa’s governing state. With legitimate funding and a more focused research, it is possible that the death rates caused by HIV/AIDs would have decreased.
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It became clear that the threatening HIV/AIDs virus was a product of foreign debt, when the state of the economy only hindered the pace that research and treatments against the epidemic could flourish in Africa in the post-colonial period. As established earlier in this essay, this is not solely because of the delayed intervention by the African government. Rather, the medical history of Africa exhibits that the epidemic followed immediately during a time that was allegedly the continent’s “greatest medical improvement”. Although the constraints that had been placed on medical innovations before the 20th century, were removed during the post-colonial period, the population growth peaked. Once the medical innovations had removed Africa’s hostile disease environment, the 1980s saw the sub- Saharan African population grow at about 3.1% a year. With these clear correlations in mind, Iliffe strengthens the argument that HIV became an epidemic at the same time the demographic growth reach its peak, thereby exacerbating the poverty line.
It was also somewhat redundant that the “heavily indebted regimes” that sought international help were forced to accept structural adjustment programmes, which included demands of set fees at medical institutions that did less to raise money than to deter the poor from using them. Consequently, the HIV/AIDs epidemic continued to pose a threat on the populace because patients who had contracted the virus felt that they could not visit the medical clinics in place by the government. This is exemplified by the fact that the utilisation of urban health centres in Zambia alone, fell by 80%. Meanwhile, the average patient would turn to indigenous healers, because biomedical doctors and their wealthier patients had retreated to private practice. With all this in mind, it comes as no surprise that HIV/AIDs continued to rapidly infect the post-colonial African state, even after research had been conducted on the virus. In light of this, more weight can be added to the argument that this specific disease was a product of foreign debt and the neglection of medical care.
Despite the fact that there were some significant economic growth and medical advances in most regions that had continued 30 years after WW2, the 1970s’ global depression reversed the fortunes of a new and emerging Africa. There is clear evidence of economic growth as provided by John Iliffe, who concedes that the depression only exposed African regimes that had been “over-extended, over-staffed and over-borrowed.” This argument is founded on the fact that between 1965 and 1980, the sub-Saharan Africa’s GDP had grown at 4.2% a year. The gradual decline in economy is displayed by statistics between 1980 and 1990 which shows that the GDP had decreased by 50% and now only grew at 2.1% a year. Thus demonstrating another reason why foreign debt would pose a greater threat to the economic and popular state of post-colonial Africa.
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Foreign debt inevitably posed a greater threat on the economic and political state of post- colonial Africa when it became habitual for the countries to rely on the exports of raw materials for their foreign exchange earnings. This essay will focus on the Zambian economy which declined drastically in the 1970s after seeming to be an emblem of African urbanisation, back when the country gained independence in 1964. The social transformation that had sparked in the 1920s in the Copperbelt province revealed that copper is central to the Zambian economy, since this is the most effective way that the country made its income.
However, the nationalisation of copper mining by 1973 (which occurred at the hands of the Zambian Industrial Mining Corporation) proved to do more harm than good to the economy. This, in turn led to a rapid rise in wage, which had “adverse consequences” on the economy. The Zambian economy would not have survived in this post-colonial period as long as the government’s role remained political rather than educational. In addition to this, the oil crises combined with the demands of the Vietnam War, which lasted from November 1955 until April 1975, called for a devaluation of copper. This damaged the economy as food prices rose, which in turn increased the poverty line and ultimately threatened the survival rate of the populace. This devaluation of copper raised concerns amongst the Zambian union workers, who had expected the country’s independence to bring about a change in their work and living conditions. This was evidently not the case as the strike actions that occurred between 1964 and 1965 illustrate. These local disputes brought the union workers into conflict with the government as there were commotions and concerns about the dependency of the Zambian government on mine revenue, which was now devalued thanks to the Vietnam war. Finally, this all caused the [former] President Kenneth Kaunda to go to the International Monetary Fundy (IMF- which is confounded of China, USSR, US, and Britain) and essentially ask for a loan, which he was granted on a conditional basis. The system that such loans were built on, caused more harm than good to African economies.
A key reason for this is the existence of undisbursed loans, also known as: the amount of funds that the creditor had committed to the borrower, but the borrower had not yet used them. Africa was $50,000,000,000 US dollars deep in undisbursed loans. As politician George Chipumbu emphasised, this posed a threat to the socioeconomic development of Africa. This is because it was “bad lending practice” since multilateral institutions such as IMF and World Bank, were essentially underfunding projects across Africa, whilst still expecting full and consistent repayments from these borrowing nations. What more, the delays with depositing these undisbursed loans damaged the economy, which simultaneously hindered the development of African countries. In the long run, Africa suffers the most and its countries struggle to survive, despite the fact that, as Chipumbu asserts, it is the multilateral institutions that are the “main culprits”. Their failure to distribute “timely disbursements” for the project to be completed on time, along with their failure to closely supervise the borrowing countries revealed the flaw in these lending arrangements. A ‘good’ lender would have been able to gauge whether or not repayment due dates could be met, more importantly, they would have placed a stronger system that did not put African countries at risk of increasing foreign debt.
With that being said, it is merely the system that is flawed; borrowing money to finance development is not necessarily a bad economic policy, this is providing that the system is managed effectively. For example, Chipumbu notes that one of the benefits of borrowing money (when done properly) is that it can help the pace at which the economy develops, which in turn could improve the welfare of the populace. Although, the risks of borrowing money arise when the borrowing fails to coordinate with the needs of the country. Many, if not all African countries do not enjoy this opportunity of lending arrangement that benefits the country.
The lack of preparation of African countries to transition into independence contributed largely to the foreign debt crisis that the continent experienced in its post-colonial period. The basis of this is the neglection of western colonies, who would once have arranged for political members of African governments to travel to European countries and become educated in appropriating skills such as negotiating. However, this practice did not continue into post- colonialism, because African politicians were forced to trial and error their way through the debt crisis. It was this very lack of preparation that revealed that many African countries did not take the necessary steps to monitor the increase in external debt. If the countries had prioritised a management of foreign debt perhaps the crises would not have become so extortionate. Chipumbu suggests that the best way to resolve this issue, is for each African nation to set up technical negotiating committees that would be responsible for analysing each agreement and prioritising projects. More importantly, a negotiating committee would be able to intercept the debt difficulties that the sources they analysed would reveal, and also come up with solutions for problematic domestic policies such as fiscal deficits, which left the countries vulnerable.
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In conclusion, the high death rates provoked by HIV/AIDs highlights that the disease statistically posed a greater threat on the popular state. However, the governing states’ delays in intervening with providing funding to treat the disease once they understood the nature of it, was far more threatening to the survival of the post-colonial African states. As this essay has conceded, although foreign debt did not cause HIV/AIDs, it did exacerbate the pace at which the diseases spread, which also resulted in a rise in orphaned children, the privatisation of medical care and an 80% fall in the utilisation of urban health centres.
Furthermore, foreign debt damaged post-colonial African in the long term because the countries continued to be indebted to European powers such as USSR, USA and the UK. African economies have been controlled for “far too long” by developing countries, as long as this continued, foreign debt will pose a threat to the economic and populace state of post-colonial Africa.
Bibliography
Cedric De Beer, The South African Disease: Apartheid Health and Health Services (London: Africa World Press, 1986),
George M. Chipumbu, The Impact of External Debt on African Economies, International Journal on World Peace, Vol. 10, №1 (Paragon House, 1993)
John L. Daly, ‘Aids in Swaziland: The Battle from within’, African Studies Review, Vol 44, №1 (Cambridge University Press, 2001),
James Ferguson, Expectations of Modernity: Myths and Meanings of Urban Life on the Zambian Copperbelt, (Berkeley: University of California Press, 1999)
John Iliffe, The African AIDS Epidemic: A History (Cambridge: Cambridge University Press, 2006)
Miles Larmer, ‘Unrealistic Expectations? Zambia’s Mineworkers from Independence to the One-Party State, 1964–1972’, Journal of Historical Sociology, 18, 4, (2005)
Robert Lorway, Namibia’s Rainbow Project: Gay Rights in an African Nation (Bloomington: Indiana University Press, 2014)
Kenneth Kaunda, Zambia Shall be Free, (London: Heinemann, 1962)
United Nation’s Children’s Fund (UNICEF), “Children and HIV/AIDS: Government and Community Response in a Multisectoral Context.” (1999)
Note
This is a essay that I wrote in March 2019 for my module on ‘Freedom and Nation: The State in postcolonial Africa’, I got a first on this essay at the time, however, I have since edited it slightly for the purpose of publishing it onto my medium account.
