When it comes to financial resources for HIV and AIDS the challenges are many. This is true all over the world and perhaps more profoundly in Zimbabwe. For example, the World Bank recently released a report entitled The World Bank’s Commitment to HIV and AIDS in Africa: Our Agenda for Action, 2007-2011
If you look in Appendix 8 entitled HIV Prevalence and Global Financing (for 44 African countries), you see that Zimbabwe has the fourth highest adult HIV prevalence rate (20.1%). However, when you look at total funds received from the Global Fund, PEPFAR, and the World Bank, Zimbabwe ranks 26th. Dating back to 2001, Zimbabwe has received US$50 Million from the Global Fund and no funding from either PEPFAR or the World Bank. Ethiopia has received the most funding from these three donors (US$1.1 billion), followed by Kenya, South Africa, Nigeria, Uganda, Tanzania, Zambia, Mozambique, Rwanda, and Namibia is 10th with US$429 million.
One can surmise that there is politics behind Zimbabwe’s significantly lower funding; particularly when it comes to PEPFAR. Launched by George Bush in 2003, PEPFAR funds only 12 of the 44 countries listed in Appendix 8. In order of most money received these 12 countries are: South Africa, Kenya, Nigeria, Uganda, Zambia, Tanzania, Ethiopia, Mozambique, Rwanda, Namibia, Botswana, Cote D’Ivoire (the range is US$857 million to US$200 million). Despite these funding limitations, adult HIV prevalence rates in Zimbabwe have declined in the last few years.
As often is the case, it’s difficult to understand why prevalence declines. Behaviour change is usually the answer, but which behaviours? How do you document and measure behaviour change? More condoms? Less sex? Increased monogamy? Are self-reported changes accurate? Or do they capture intentions perhaps not actually fulfilled? All solid questions for investigation, yet, in my view, one of the most important questions involves reactions to death; that watching loved ones die potentially prompts behaviour change. Deaths also go beyond pinpointing reasons for behaviour change. I wonder how many dollars go to helping Zimbabweans cope with deaths? And I mean cope emotionally. Even if a figure were available, larger questions resonate: It is socially and culturally acceptable to speak about death? To discuss loss and pain? To express and share the complex process of grieving? The saying goes that everyone grieves in different ways; I get a sense more often than not, Zimbabweans grieve in silence. Only time will reveal the longer-term impacts of HIV and AIDS-related deaths (as well those related to political violence). Again, I mean emotional impacts.
When there are hesitancies to speak openly about death, I wonder too if there are hesitancies to speak openly about life. Natasha’s recent blog Desocialising the self touches on a discussion forum organised by the Musasa Project where people spoke about life’s challenges, largely in relation to lobola, patriarchy, and marriage/relationships in general. I attended the forum as well and a particular comment has been on my mind, one which seems to highlight hesitancies among Zimbabweans to delve into potentially emotionally-charged topics of why, specifically: Why something in life is the way it is?
A woman asked one of the men in attendance: If you had a car that didn’t work, what would you do? Without batting an eye, the man answered: Buy a new one. The woman followed up with: Really, you wouldn’t investigate why the car didn’t work? And then continued with an analogy. Seems then perhaps if your wife didn’t want to have sex you might be inclined to get a new one (wife) and not think to ask your wife why she didn’t want to have sex. The man didn’t disagree. Perhaps he felt on the spot, but still, true to the poignancy of the analogy, the man said nothing. After some laughter that the analogy (unintentionally) equated women to non-functioning cars, the discussion continued following a line of thinking about both desocialising you self away from harmful practices and the importance of resocialising your self to better confront the many why questions life entails, including the complex and emotionally-charged ones.