African civil society organisations have denounced a political declaration adopted by world leaders attending a United Nations AIDS meeting in New York. At the High Level Review Meeting of the United Nations General Assembly member-states negotiated a political declaration which African activists have described as 'utterly retrogressive' and 'a sham'.

A new online resource highlights interventions for enhancing diarrheal disease control in developing countries. The Enhanced Diarrheal Disease Control Resource Center (www.EDDcontrol.org) includes documents and tools from many key health organizations including WHO, UNICEF, and PATH. The site highlights information on new interventions such as rotavirus vaccines, zinc treatment during diarrheal episodes, and low-osmolarity oral rehydration solution, while also covering time-tested interventions such as breastfeeding and improved sanitation and hygiene. The site was developed by PATH's Rotavirus Vaccine Program (www.rotavirusvaccine.org).

"ARVs can change things, but they do not change my socio-economic status. Yes, I get the ARVs; but I cannot afford to put a simple meal on the table," says a man who insists on being identified only as wa Kimani. "This is why I had to register at two treatment sites, so that I could get ARVs (anti-retroviral drugs) twice: utilise one set from one site, then sell the other batch from the second site, so that I can get something small to put in my stomach."

The Program Officer will be responsible for developing, monitoring and evaluating the Foundation's activities in the field of Sexuality and Reproductive Health (SRH) in Southern Africa (South Africa, Namibia, Mozambique and Zimbabwe) with a particular emphasis on HIV/AIDS as it affects and is addressed by local communities in the region.

Kenya and Brazil have launched a campaign aimed at making governments prioritize and fund research and development projects, which address essential and basic health needs of their people. The campaign, being undertaken under the umbrella of the Drugs for Neglected Diseases initiative (DNDi), urges governments to increase funding and policy change to support needs-driven research and development for neglected diseases.

Kenya's president has announced that fees will be removed for anti-retroviral drugs (ARVs), which combat the effects of Aids. Correspondents say the fees are one reason why only 60,000 of the 200,000 eligible Kenyans are taking ARVs. The UN has said Kenya is one of the few countries to reduce HIV prevalence, from 14% in 1997 to 4% today. But charities now say that a hunger crisis in parts of Kenya could hamper the effectiveness of ARV programmes.

Delegates at the UN summit on Aids have been hammering out the finer details of a declaration to combat HIV/Aids. Meanwhile, 40 million people worldwide are living with the disease. Severe drought across Kenya and the Horn of Africa has meant that patients on anti-retrovirals who don't get enough to eat have been unable to tolerate their medicines. So they have stopped taking them.

Genetically Modified (GM) crops are touted by some as the answer to world hunger; by others as a dangerous intervention by multi-national agri-business that will have far reaching impacts on all aspects of human life. Pambazuka News asked Mariam Mayet from the African Centre for Biodiversity for her views on the implications of GM crops for Africa.

Pambazuka News: What are the implications of GM crops for human life generally, including the human rights of populations and farmers?

Mariam Mayet: The risks posed by GM food are extremely contentious in current scientific discourse, primarily because the GM industry has failed, to date, to provide conclusive evidence that GM foods are safe. Amidst the enthusiasm for genetic engineering, there has been little space for critical reflection. Leaping into genetic engineering brings with it a wide range of biosafety issues including health and environmental risks, and broader socio-economic impacts. It requires the acceptance of intellectual property rights on living organisms, the privatisation of public research, and expensive research and development at the expense of farmer-based innovation. Amid all the complexities of the legal and scientific arguments, decisions must be made in Africa about the measures to be taken, to protect human health, agricultural biodiversity, and farming systems.

Pambazuka News: So what decisions are being taken? Have governments introduced laws to govern this area?

Mariam Mayet: Very recently, the African Centre for Biodiversity did an analysis of the draft Biosafety law of Mozambique, which is interesting to consider in answering this question. Mozambique views genetic engineering as having a role to play in agriculture, food security and human health care, but believes that the risks have to be managed by the creation of an enabling legislative environment, to this end. In other words, Mozambique will follow the route taken by South Africa and permit the entry of GM crops into its agriculture systems, after an evaluation of the risk assessment data provided by an applicant.

Currently, Mozambique's seed law prohibits the import and planting of GM seed. But Mozambique does accept genetically modified (GM) food aid, including and especially from the United States. USAID's Food for Progress (FFP) has provided 15.500 MT of PL480 (A US law relating to food aid) Title II emergency food assistance valued at $11.6 million to Mozambique through the World Food Programme. (USAID, Southern Africa-Food Insecurity, February 3 2006).

Without dwelling on the politics of hunger and food aid, it's worth pointing out that the opening or maintaining of markets is a key objective of Public Law 480 (PL 480). PL 480 clearly asserts that the purpose of US food aid programmes is to “develop and expand export markets for United States agricultural commodities”. [1] A position repeatedly pronounced by US government officials is that the opening of new markets is immensely important for the future of US agriculture. [2] Moreover, US agribusiness have been the main beneficiaries of US food aid programmes.

Therefore, in considering the Mozambique law, its worth warning that countries should not be pushed into believing that GM food aid is the only alternative to consider during emergencies and that countries should be careful when developing legislation that their laws will not be used as a conduit to push GM food aid into the rest of Africa.

Pambazuka News: So there's definitely some vested interests operating in the trade in GM crops. What role does the World Trade Organisation (WTO) play?

Mariam Mayet: The United States, the world's largest producer of GM crops, has effectively used the threat of WTO sanctions against developing countries such as Sri Lanka, Bolivia, South Korea and Thailand when these countries tried to ban or restrict imports of GM crops in adopting biosafety measures.

Countries in Africa have also been the target of US style pressure: one of the main reasons given for Egypt's initial support of the US, Argentina and Canada WTO complaint against the EU (On May 13, 2003 the US, along with Canada, Argentina and Egypt, filed a complaint in the WTO against the EU's de facto moratorium on GMOs.), was that Egypt would be rewarded with a Free Trade Agreement in 2004; an offer retracted with indecent speed when Egypt subsequently withdrew from the complaint, stating that their decision was in recognition of “the need to preserve adequate and effective consumer and environmental protection.” [3]

Similarly, in May 2003, when Sudan banned the import of GM food aid, it was forced to issue a series of temporary waivers enabling food aid shipments to the country to continue while alternatives were found. The US response was to suspend food aid shipments to Sudan and exert enormous pressure on the government to rescind the ban. The government relented, and ended up extending the waiver for six months, allowing the distribution of GM food aid to continue.

Hence, the extent to which African countries and indeed, developing countries, will be given opportunities to take biosafety measures aimed at banning or severely restricting the trade in GM crops will be greatly influenced by the outcome of the complaint submitted during May 2003, by the United States, Canada and Argentina to the WTO against the European Union's Measures Affecting the Approval and Marketing of Biotech Products (EC-Biotech) [4]. For those of us in Africa, reliant on trade and aid from the US, the WTO challenge most certainly has conveyed a lasting message that either we open our markets for GM food and seeds, or face reprisals.

Pambazuka News: You mention GM food aid. Shouldn't food aid be welcomed?

Mariam Mayet: The most frequent criticism of food aid is that it impacts on local food security. Food aid acts as a disincentive to local production by driving down domestic prices. Local farmers may withdraw from producing a surplus, forcing governments to import the growing deficit. Alternatively, it may lead a government to neglect its own agricultural sector, relying on aid or imports rather than facilitating local agricultural development. It may also introduce a taste for a particular food, which is not produced locally, therefore undermining the long-term potential for self-sufficiency. Crucially, the provision of food aid is intimately tied to the disposal of highly subsidised surplus food on the planet's poorest and most vulnerable people.

Already, controversy over the shipment of GM food aid has erupted twice in Africa. During the Southern African food crisis in 2001/2002, Zambia imposed a ban on the acceptance of GM food aid, and several other Southern African countries imposed various restrictions. Last year, Angola and Sudan introduced restrictions on GM food aid. These countries are almost always presented with a false choice between accepting GM food or facing dire consequences, whereas non-GM alternatives almost always exist at the national, regional and international level.

Pambazuka News: What has been the role of civil society in Africa - do they have a say in any parts of the decision making process about GM crops? Has civil society been active in opposing GM crops coming into Africa?

Mariam Mayet: Civil society in Africa is active - alive and kicking - quietly. The fact that Africa (except for South Africa) has not taken any decisions on biosafety grounds, to permit the commercial import and growing of GMOs, is a huge victory for us. Whereas in the rest of Africa, over the last five years, only eight other countries have conducted field trials of GM crops: Burkina Faso, Egypt, Kenya, Morocco, Senegal, Tanzania, Zambia and Zimbabwe, on small plots of land.

The key target countries for USAID, the World Bank and the gene giants are the cotton markets in West Africa. However, already the farmers have rejected GM crops. Recently, in an unprecedented move, farmers in Mali voted not to grow GM crops on their land. In a "farmers' jury", cotton growers and other farmers debated the issue and came to the conclusion that their government should reject GM crops. The citizens' jury was hosted by the regional government (Assemblee Regionale de Sikasso) and was designed and facilitated by the London-based International Institute for Environment and Development and RIBios, the University of Geneva's Biosafety Interdisciplinary Network, together with a wide range of local partners in Mali.

* Interview conducted by email. Please send comments to or comment online at www.pambazuka.org

References

[1] United States Department of Agriculture, US Food Aid Programs Description: Public Law 480, Food For Progress And Section 416(B) http://www.fas.usda.gov/excredits/pl480/pl480brief.html

[2] Hembree Brandon, 'Veneman says more farm aid likely', Southwest Farm Press, Jun 21, 2001 http://southwestfarmpress.com/ar/farming_veneman_says_farm/

[3] Letter by the Egyptian Ambassador to the EU, Suleiman Awaad, Cited in Al Amrani.: Egypt follows EU line on GM, Middle East Times, June 6, 2003.

[4] European Communities-Measures Affecting the Approval and Marketing of Biotech Products (EC-Biotech), WT/DS291

Compared to 20 years ago in Kenya, people live for ten years less on average, more children die in infancy and a greater proportion of those who survive face stunting. Why? Soren Ambrose makes a case for holding the International Monetary Fund (IMF) responsible, arguing that the institution's obsession with low inflation rates - one of the foundations of trade liberalization - starves economies and hurts the poor.

On March 6, Kenya's Assistant Minister for Health, Enock Kibunguchy, told the press that Kenya urgently needs to hire 10,000 additional professionals in the public health sector, blurting out: “We have to put our foot down and employ. We can tell the International Monetary Fund and the World Bank to go to hell.” [1]

These are strong words for a high-ranking government official to put on record regarding the most powerful international financial institutions (IFIs), and in particular the IMF, a body whose power extends to being able to call for the withdrawal of virtually all external assistance to a country.

Minister of Health Charity Ngilu had in fact been rumored to have made similar accusations in meetings with IMF officials and civil society representatives; since Kibunguchy's declaration she has confirmed she shares his view. Similar allegations have also been made by several civil society organizations focused on the IMF and on health rights. Indeed, in the last two years a number of organizations have identified IMF restrictions as a serious disincentive to hiring desperately-needed health professionals not only in Kenya, but in many other African and Global South countries as well.

Specific IMF policies, in particular the low ceilings it sets for inflation rates and wage expenditures in borrowing countries, are demonstrably illogical and detrimental. Together with the dubious defense the IMF mounts for maintaining such restrictions, cases like Kenya's provide a strong argument that those controlling the IMF should re-examine the restrictions it places on borrowing governments. The logic of demanding continual decreases in public wage bills is likewise suspect, as are the IMF's routine inflation targets. With increased funding from new sources, improved standards of living are within reach of even the most impoverished countries, if only the IMF would allow it.

The Health Care Crisis

Kenya's health care crisis has been 20 years in the making. Its dimensions are spelled out in the 2004 Poverty Reduction Strategy Paper (PRSP) - a government document written in consultation with the IMF and World Bank and approved by both bodies' boards. Life expectancy declined from 57 in 1986 to 47 in 2000; infant mortality increased from 62 per thousand in 1993 to 78 per thousand in 2003; and under-five mortality rose from 96 per thousand births to 114 per thousand in the same period. The percentage of children with stunted growth increased from 29% in 1993 to 31% in 2003, and the percentage of Kenya's children who are fully-vaccinated dropped from 79% in 1993 to 52% in 2003.[2]

Why this deterioration? As in most African countries, Kenya's health care system was hit hard by the “structural adjustment” policies imposed by the IMF and World Bank as conditions on loans and as prerequisites for getting IFI approval of the country's economic policies. Those policies were introduced in the 1980s, and have left a lasting mark on Kenya's health. As usual with such programs, the emphasis was on cutting budget expenditures. As a result, local health clinics and dispensaries had fewer supplies and medicines, and user fees became more common. The public hospitals saw their standard of care deteriorate, increasing pressure on the largest public facility, Kenyatta National Hospital in Nairobi. As a consequence, that hospital, once the leading health facility in East Africa, began, like so many other African hospitals, to ask patients' families to provide outside food, medicine, and medical supplies. Most beds at Kenyatta and the regional and local hospitals accommodated two patients. Professional staff have taken jobs - some part-time, some full-time, at private healthcare facilities, or migrated to Europe or North America in search of better pay.

An October 2005 communication from an NGO coalition to the November 2005 “High Level Forum on Health MDGs (Millennium Development Goals)” notes that “between 1991 and 2003, the [Kenyan] government reduced its work force by 30%” - cuts that hit the health sector particularly hard.[3] For the period between 2000 and 2002 alone, the government was scheduled to lay off 5,300 health staff.

Those requirements were externally imposed. A World Bank Group document from November 2003, written to justify waiving a loan condition calling for a workforce reduction, notes: “This condition required retrenching 32,000 personnel from civil service over a period of two years. In practice, 23,448 civil servants were retrenched in 2000/01 before the program was interrupted by lawsuits. […] A specific commitment in the updated [agreement] is to reduce the size of the civil service by 5,000 per year through natural attrition.” [4] The very same document supports Assistant Minister Kibunguchy's assessment of the sector's current needs - “the health sector currently experiences a staff shortage of about 10,000 health workers.” The document, however, draws no connection between the shortage and the insistence on cutting more workers.

The impact of the layoffs and budget slashing in the health sector over the last 15 years was cited recently by Member of Parliament Alfred Nderitu as the primary motivation for his motion of censure against the IMF and World Bank in the Kenyan Parliament. His initiative would insist that any future loans from the institutions get Parliamentary approval. [5]

Clinics Without Nurses

Many African countries have shortages of medical staff because of lack of training capacity; in Kenya this is not the case. Thousands are unemployed or underemployed, eager to take up full time positions.

Both the Kenyan government and the IFIs regularly announce that health spending will increase substantially. [6, 7] With all these promises of increased resources for health care, with the World Bank's acknowledgement of a staff shortage, and with all those unemployed nurses, one might expect that the government would waste no time in hiring the thousands of nurses Kenya so desperately needs. And indeed, frequent promises are made by government officials to that effect. But the promises are almost never kept.

According to the Chief Economist in the Ministry of Health, S.N. Muchiri, the reason is that while the IFIs support increased expenditures on health, they forbid spending that money to pay staff wages. This is accomplished through insisting on a ceiling on wage expenditures; in Kenya, the targets are 8.5% of GDP in 2006 and 7.2% by 2008. [8] The IMF doesn't specify that hiring in the health sector specifically must be limited, but when the entire wage bill must be suppressed, the chances of hiring the personnel needed are slim indeed.

So when IFI staffers call for more funding for clinics, as they do in their critique of the government's draft PRSP, they mean buildings, equipment, and medicine. [9] Unfortunately, personnel are required to run the clinics. It is the choice by those institutions to prioritize targets for reduced spending on public salaries and on inflation, says Muchiri, that prevents Kenya from hiring health workers. [10]

Muchiri provides valuable “inside” confirmation of charges made with increasing intensity by civil society organizations over the last two years. Advocates point out that while recent funding initiatives like the Global Fund for AIDS, Tuberculosis & Malaria and PEPFAR have made stemming the most critical health crises in Africa more possible, the IMF's power over borrowers' economic policy and its narrow focus on keeping inflation and payrolls as low as possible is actively discouraging governments from putting the available funds to use.

Numbers, Not People

On one level, it seems like commonsense for an organization like the IMF to seek out ways in which governments can reduce the amount spent on salaries, especially in countries like Kenya, which have had troubles with “ghost employees” on public payrolls in the past. But the self-defeating nature of this quest quickly becomes apparent. If the government were simply expected to identify and eliminate ghost employees, that would obviously lighten the government's burden and enable it to target its resources more wisely.

But the IMF's conditions deal with bottom-line expenditures, not with going to the root of the problem. Kenya's PRSP spells out the implications: “…achieving the 8.5 percent target by 2005/06 will require that any awards to be provided to the civil servants or any additional awards […] will be matched by a proportionate downsizing of the civil service.” [11] Any hiring of nurses, for example, would require that some other public employees be eliminated - regardless of how much the nurses may be needed, or how vital the other positions may be. Indiscriminate targeting like this only demonstrates the prioritizing of abstract economic statistical standards over real-life outcomes, including those most likely to have a positive material impact on poverty and on contributing to the overall health of both Kenya's population and the economy.

So if the health budget is to rise - as both the IFIs and the government repeat often - then the PRSP must remind us that: “The fiscal strategy assumes that these health expenditures will be focused on non-wage non-transfer expenditures and will thus enable the rapid increase in basic health services.” [12] Indeed, Muchiri reports that funds are often available for facilities or supplies, but not for staff. The result is that more people may seek out health services, but the ministry will actually be less able to provide them because of lack of personnel to administer the drugs or operate the machinery.

Inflation, Inflation, Inflation

But why does the IMF, with its power to exclude a country from the global economy by declaring it “off-track,” insist on reducing government payrolls? Adding employees to the government payroll, especially if accomplished with aid money, is considered by orthodox economists like those at the IMF to increase inflationary pressures in a developing country. And an increase in inflation is anathema to the IMF.

The IMF quite openly prioritizes inflation targeting over almost any other factor in the countries where it works. Pressed on the question, as they have been in the debate over health spending, its officials will invariably respond that inflation is a “tax” that hits the poor the hardest.

But is that true? Anis Chowdhury points out that:

“The poor have very limited financial assets; they are largely net financial debtors. Thus inflation can benefit the poor by reducing the real value of their financial debt. Meanwhile, the IMF's cure for inflation - raising interest rates - can actually harm the poor because this increases the servicing costs of their current debts. […] The poor fare worse when unemployment rises and persists, especially when there is no adequate safety net or social security system. At the same time, the real value of their household debt rises with falling inflation rates. Hence the poor have more reason to be averse to unemployment and less averse to inflation than the elite in society." [13]

After this seemingly obvious point is made, it seems only too easy to point out that those who stand to lose the most from inflation are those who hold large amounts of money - financiers, investors, bankers. Yes, there are risks to the poor in high and/or persistent inflation, but increases in inflation below a certain point are far more likely to cause pain to those whose incomes depend on relatively minor fluctuations in currency values. For the impoverished, as Chowdhury explains, such increases in inflation are likely to be more beneficial than harmful.

As is so often the case, it is easiest to discern the interests of policy-makers not from their rhetoric, but from whose interests are most vigorously protected by their policies - by who “wins” as a result. The IMF's longtime prioritization of inflation over all else lends weight to those who accuse it of using its powers to protect the interests of the wealthy over those of the impoverished, regardless of their rhetoric that maintains the reverse.

IMF official Andy Berg recently admitted as much: “Higher inflation […] tax[es] people who hold cash or whose nominal incomes are fixed.” But Berg's next sentence restores IMF ideology, and at the same time exposes its flimsiness: “And this tax discourages private investment and tends to fall on those least able to adapt - in other words the poor.” [14] Berg relocates the pain from the rich to the poor, but offers no logic for that move.

Drawing a Reasonable Line on Inflation

To challenge the IMF, the question must be where to draw the line - at what point, to use Berg's phrase, is “inflation out of control,” or at risk of spinning out of control? Berg says “in poor countries the danger point is somewhere between 5 and 10 percent.” The good news is that this figure is actually less conservative than the standard used in most IMF programs. In most countries with IMF loans, the conditions call for inflation to decline and stay below five percent. [15]

Few economists outside the IMF opt for a level as low even as 10% in defining a healthy rate of inflation for a growing economy in a developing country. Terry McKinley, an economist with the United Nations Development Program (UNDP), declares: “As long as current revenue covers current expenditures, governments can usefully borrow to finance [social] investment. […] Fiscal deficits should remain sustainable as ensuing growth boosts revenue collection. The resultant growth of productive capacities will keep inflation moderate - namely, within a 15 percent rate per year.” [16]

There is no room for neutrality in this debate. Adhering to IMF standards in order to avoid trouble will, according to McKinley, likely sabotage any hope of genuine development:

“Moderate inflation can, in fact, be compatible with growth. But low inflation can be as harmful as high inflation. When low-inflation policies keep the economy mired in stagnation or drive it into recession, the poor lose out, often for years thereafter, as their meager stocks of wealth are wiped out or their human capabilities seriously impaired. […] Without jobs and income, people cannot benefit from price stability.” [17]

Tactfully avoiding mentioning the IMF by name, McKinley argues: “The new 'politically correct' justification for minimizing inflation is that it hurts the poor. However, this misreads the facts: very high, destabilizing inflation (above 40 per cent) definitely hurts the poor; and very low inflation (below 5 per cent) can also harm their interests when it impedes growth and employment.” [18]

Rick Rowden points out that Latin American countries and “East Asian tigers” like South Korea grew rapidly despite inflation rates of around 20%. [19] But that was before the IMF moved into the development world in the 1980s, and re-wrote the rules - without any definitive evidence to support their claim that doing so was advantageous to the poor.

The IMF appears to be caught in a classic case of “fighting the last battle.” When the IMF started lending to developing countries in the early 1980s, they were afflicted with astronomical, runaway inflation. It still apparently believes that hyperinflation is the most dangerous threat. But hyperinflation has been eliminated almost everywhere (apart from crisis or pariah countries like Zimbabwe); indeed most developing countries now have inflation rates well below 10%, and many below 5%. [20] This is largely as a result of the IMF's hyper-vigilance over the last 25 years. The problem today is not hyperinflation, but IMF-induced stagnation.

More and more economists - outside the IMF - are taking a more complex view of growth and inflation. Rather than insisting that a country have a demonstrated “absorptive capacity” before increasing the flow of revenues, they look at the likely impact of increased flows. In the case of increased spending on health care, not only is employment created (if wage ceilings are set aside), but the population's overall economic capacity improves, and private-sector activity, rather than being discouraged by public funds, is spurred by the increasing availability of resources.

Muchiri, in Kenya's Health Ministry, concurs with McKinley's positions on inflation targeting, and with the view that public spending, especially on healthcare, will encourage growth. He acknowledges that his government has committed to a low inflation target - its “Letter of Intent” to the IMF states: “The monetary program for 2004/05 is designed to reduce underlying inflation to 3.5 percent.” [21] And thus far Kenya seems to be meeting that goal.

But, says Muchiri: “3.5 percent is too low for an economy that is supposed to grow by 5 percent. A certain level of inflation is healthy - you can't grow otherwise.” This recognition moves Muchiri to criticize officials of a nearby country who have told him they must limit expenditures on health care - even refusing funds from the GFTAM - in order to prevent any risk of inflation rising. That line of thinking is clearly reflected in the recent statements by Kibunguchy and Ngilu.

But Finance Ministers who have committed to the IMF's inflation targets, and in many cases made those targets the centerpiece of their macroeconomic policy, are deeply reluctant to do anything that might raise that rate. Not only would doing so risk IMF disapproval and blacklisting, but it would also be seen as reversing a position they have publicly, and politically, committed to. Until this logjam is broken, a higher quality of life - even life itself - will continue to elude many thousands.

Muchiri counts as a significant victory the recent concession made by the IMF, after substantial negotiations, that Kenya could hire more health professionals if it could find donors willing to provide extra funds who themselves were comfortable with the impacts - economic and otherwise - that hiring additional health staff might have. It is this concession that recently allowed Kenya to announce that it will use funds from the Clinton Foundation, PEPFAR, and the GFATM to hire upwards of two thousand new nurses and other health professionals. [22] Unlike with previous pledges, advertisements for the positions are now appearing in newspapers.

But the very existence of these policies, and the fact that he must invest so much in winning exceptions to them, cause Muchiri to reflect on his experiences of watching mothers and children die in hospitals for lack of surgeons or a lack of capacity to offer preventive care, and speculate that the IMF and World Bank could reasonably be charged with genocide. “The only difference from what happened in Rwanda is they don't use pangas [machetes]. They use policies.”

* Soren Ambrose is Coordinator, Solidarity Africa Network, Nairobi, Kenya. He is also associated with the Washington-based 50 Years Is Enough Network, which in April convened a meeting to launch an international campaign to shrink or eliminate the IMF (for more information write [email][email protected]; see related commentary, by Ambrose and Walden Bello, at [email protected] or comment online at www.pambazuka.org

References:

[1] Elizabeth Mwai, “Ignore the World Bank on health, says minister,” The Standard (Nairobi), March 7, 2006.

[2] Republic of Kenya, “Investment Programme for the Economic Recovery Strategy for Wealth and Employment Creation, 2003-2007 - March 12, 2004 - Revised.” Published by International Monetary Fund as “Kenya: Poverty Reduction Strategy Paper,” IMF Country Report #05/11 - January 2005, p. 9. Subsequent citations as “PRSP.”

[3] “A joint NGO statement to the High Level Forum on Health MDGs,” October 2005, p. 3.

[4] International Development Association (World Bank Group), “Kenya - Economic and Public Sector Reform Credit - Release of Second Tranche - Waiver of Two Conditions and Amendment of Development Credit Agreement,” November 20, 2003, para. 33, p. 10.

[5] “Plans to Censure WB, IMF,” Kenya Times, March 14, 2006.

[6] PRSP, p. 18

[7] PRSP, p. 21

[8] PRSP, p. 19.

[9] International Monetary Fund, “Kenya: Joint Staff Assessment of the Poverty Reduction Strategy Paper,” Country Report #05/10, January 2005, para. 33, p. 10.

[10] S.N. Muchiri, Chief Economist, Ministry of Health, Republic of Kenya: Interview with author, March 21, 2006, Nairobi, Kenya. All of Muchiri's quote come from this interview.

[11] PRSP, p. 20.

[12] PRSP, p. 21.

[13] Chowdhury, Anis. “Poverty Reduction and the 'Stabilisation Trap' - The Role of Monetary Policy,” University of Western Sydney draft available from [email][email protected] Cited in Rick Rowden, “Changing Course: Alternative Approaches to Achieve the Millennium Development Goals and Fight HIV/AIDS,” ActionAid International USA, September 2005, p. 30. www.actionaidusa.org/pdf/Changing%20Course%20Report.pdf

[14] Berg, Andy. “An interview with Andy Berg on the macroeconomics of managing increased aid inflows,” IMF Civil Society Newsletter, February 2006.

[15] Rowden, p. 30.

[16] Terry McKinley, “MDG-Based PRSPs Need More Ambitious Economic Policies,” United Nations Development Programme - Policy Discussion Paper, p. 4.

[17] McKinley, pp. 14-15.

[18] McKinley, p. 16.

[19] Rowden, p. 31.

[20] Rowden, p. 21.

[21] Republic of Kenya, letter to Rodrigo de Rato, Managing Director of the IMF, December 6, 2004. Published by the IMF as “Kenya-Letter of Intent, Memorandum of Economic and Financial Policies and Technical Memorandum of Understanding.”

[22] See Lucas Barasa, “2,210 jobs lined up for nurses,” Daily Nation, August 9, 2005, and Francis Openda, “State to Hire 1,420 More Health Workers,” The Standard (Nairobi), October 12, 2005 - http://allafrica.com/stories/200510110915.html

"Livelihood insecurity in Manica is growing both in terms of the number of people affected and in its impact, particularly in certain areas where erratic rainfall and ill health and deaths from AIDS have occurred. Growing numbers of people are taking up ever more risky livelihood strategies such as unsustainable livestock sales or the removal of children from school in order to release them for household duties requiring labour or to relieve costs associated with school attendance."

This is the second of a two-part article that addresses plagiarism in the context of social justice in Africa. It was sparked by the discovery that an article I wrote for this column was plagiarized by the Kenya Times. Part 1, published last week, looked at the dimensions of plagiarism, through several recent prominent cases, both on and off the African continent. Part 2, this week, will explore why it is relevant to social justice.

When I was in primary and high school in Nairobi, our English compositions were peopled by white European characters, with English names. We set them in European or American cities and schools, and inserted ourselves into those landscapes. Our plots were imitations or direct copies of what we read in Nancy Drew mystery novels or Enid Blyton boarding school tales. Or we stole freely from American TV imports – Good Times, Dallas. One of my classmates, in an essay on “The Dangers of Hitchhiking” reproduced, blow by blow, an episode of the American sitcom, “Diff’rent Strokes” which had run the previous night on Kenyan TV. She didn’t even change the names of the characters – she simply cast herself in the starring role. The English teacher commented: “You should use your own ideas in future!” – and gave her a mark of 75%.

In all those years, only one teacher ever challenged this slavish postcolonial erasure of our own lives. Ironically, he was a British expatriate. He asked my Standard Seven class why we used English and American names, locations and plots in our compositions, instead of Kenyan ones. We stared at him, confused, a classroom of 11 year olds, who had never been told that our reality had any place in literature. Finally, one girl raised her hand: “That’s what is in the books we read.”

Generations of Africans have grown up consuming media and culture from which they are absent. Believing that “real” writing, “real” music, “real” art must imitate, or even better, reproduce, what is imported. That the language spoken on the streets of Harare or Lagos has no place in newsprint. The dramas enacted daily in Nairobi matatus scrums, Cairo markets, Freetown suburbs, do not belong on our TV and movie screens. Is it any wonder then, that journalists on the continent routinely plagiarize work from multiple sources? That editors run it without question?

There is a political dimension to this trend. Authentic voices are also voices that question and challenge the status quo. Threaten those in power. Growing up, I watched several original TV dramas, piloted in Nairobi, shot down at birth by protests in Parliament that they were “immoral” and would “corrupt our youth.” Their crime was to deal honestly with the economic, social and sexual realities of a generation facing 70% unemployment in a country ruled by oligarchs. I never heard similar protests raised about the soft-porn American films that certain Nairobi cinemas specialized in. Or the imported soap operas that were the most exciting offering of the state-monopoly TV station.

So many journalists, aspiring writers and artists, never learned how to report the world through their own eyes. To trust their own perceptions and the language available to them. A perfect demonstration of the fear that authentic voices induce in the establishment was the reaction to Kwani?. Kenya’s first journal of homegrown writing broke new ground by carrying pieces in Sheng, the street language of Nairobi. A University of Nairobi literature professor actually tried to ban his students from reading Kwani?. One can only speculate on the source of his unbearable discomfort with an idiom outside his academic authority being presented as valid living literature.

The theft implicit in plagiarism impoverishes us all. It is no secret that how we receive any message is shaped by the perceived source. The voices most likely to be silenced through plagiarism in Africa are those of marginalized groups – women, youth, ethnic minorities, those outside the formal education system. Several African women writers have shared stories with me of submitting their work to national magazines and newspapers, receiving no response, then seeing it turn up a few months later under the byline of a male staff journalist. Each time this happens, it feeds the myth that women, or African Asians, or youth in the informal sector, are not a part of the public discourse, have nothing to contribute to the cultural and political life of our societies.

In “Purple Hibiscus”, the brilliant debut novel by Chimamanda Ngozi Adichie, a teenage Nigerian girl refuses to take the customary English name for her Confirmation into the Catholic Church. She argues cogently that English names are no more Christian than Nigerian ones, and her spiritual coming of age is not an occasion to disown her own identity.

There is a way in which all of us who came of age on the African continent in the last three decades have been taught to disavow our creative identities. To be ashamed of our own thoughts and language. To hold them up against the BBC, the New York Times, CNN, and find them lacking. The shame is reinforced by editors who will not take risks on original writing, by repressive political regimes that allow only parroted sycophancy in the place of real writing.

In my article plagiarized by the Kenya Times, I wrote:

“What can poetry do, right now, in Kenya? […] Inspire us to trust our own intelligence and passion, our hunger for art that is real and hard and truthful; messy and complex and bloody. Above all, art that is ours. Trust that our own voices are the thick grain, the juicy greens, we have been hungry for.”

It’s time for us all to refuse to be robbed further by unchallenged plagiarism.

* Shailja Patel is a Kenyan poet, writer and theater artist. Visit her at

* Please send comments to [email protected] or comment online at www.pambazuka.org

The AIDS epidemic, described by the United Nations as the "most destructive in human history" and accounting for more than 25 million deaths so far, is still a growing threat to global progress and stability. "AIDS is one of the greatest leadership challenges of our time," says U.N. Secretary-General in a new report released in advance of a U.N. special session on AIDS. "Without urgent and long-term action," he warned, "the epidemic will continue to take an unacceptable toll of death and suffering in countries and communities throughout the world."

Armed Somali fighters have occupied a major hospital that offers surgical services to civilians who have been wounded in recent clashes in northern Mogadishu, according to reports by the International Committee of the Red Cross (ICRC) and the Somali Red Crescent Society (SRCS). The occupation of the Keysaney Hospital has reduced medical services in the capital city and prompted relatives to move patients away hastily.

At least fourteen children have reportedly died from diarrhea in southern Somalia. Doctors and other health activists in the District have started community awareness raising.

ActionAid is looking to appoint an International HIV/AIDS Programme Coordinator to join its international team.

A ban on smoking in Kenya's public places has come into force, to reduce the number of tobacco-related deaths. From Monday, anyone smoking in offices, bus stations, airports and sports venue faces a fine of 50,000 Kenya shillings ($700; £375) or six months in prison. Bars and restaurants without separate smoking areas are also affected.
*Updated News:
Kenya suspends public smoking ban
Kenya's High Court has suspended a controversial ban on smoking in public places which began on Monday. It ordered the suspension for 30 days after tobacco companies challenged the health minister's authority to impose the restriction.

A British-based charity has called for international donors to give specific long-term support to African nations in providing free healthcare. The charity, Save the Children, says in a new report that almost 800 children die in Africa daily because they cannot afford to pay for medical treatment. It says greater access to health services could make a huge difference. It also points out that only limited progress has been made in abolishing health charges in Africa.

Dr. Lee Jong Wook, the head of the World Health Organization whose gamble to greatly expand AIDS treatment to the poor around the world helped give new life to hundreds of thousands of people, died suddenly Monday, two days after emergency surgery to remove a blood clot on his brain. He was 61. Dr. Lee had served less than three years of a five-year term as WHO director general, where he faced challenges including SARS, avian influenza, preparation for a possible human influenza pandemic, tobacco control and childhood immunization.

"Shelve the abiding fiction that disasters do not discriminate -- that they flatten everything in their path with "democratic" disregard. Plagues zero in on the dispossessed, on those forced to build their lives in the path of danger. Aids is no different," argues this commentary from the Mail and Guardian.

The number of new HIV infections in Uganda has increased from 70,000 in 2003 to about 130,000 in 2005, Uganda AIDS Commission Director-General Kihumuro Apuuli said Thursday, the Monitor/AllAfrica.com reports. Apuuli, speaking on HIV/AIDS Vaccine Awareness Day, said that despite financial support from donors, the incidence of new HIV cases in Uganda still is increasing.