| July 15, 2002 | Monday | Jamadi-ul-Awwal 4, 1423 |
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Combating AIDS globally
THE recent World Bank assistance amounting to over 236 million dollars is welcome primarily on two counts. On the one hand, it will make it possible for the government to press on with its on-going reforms with a degree of confidence as the resources required to launch specific reform projects have been assured. On the other, it will significantly add to the record seven billion foreign exchange reserves the country already has. What is special about this assistance is that these resources are coming from the WB’s highly concessional International Development Assistance (IDA) window having a 35-year maturity with a 10-year grace period and bearing a paltry 0.75 per cent interest. Besides, unlike the usual method of routing assistance through the federal government even for projects falling within the provincial and regional sphere of responsibility and leaving the distribution aspect to Islamabad’s discretion, the WB this time has very rightly specified the province for which each allocation has been made. This is how it should be.
The normal practice of the multilateral aid agencies to provide funds meant for provincial projects through the federal government has proved to be largely counterproductive. For one thing, the federal government has been known to charge very heavy rates on these highly concessional resources while allocating them to the provinces, thus unnecessarily burdening them with debts. Secondly, experience has shown that more often than not such assistance meant specifically for provincial projects have been diverted by the federal government to other projects, mostly non-developmental, thereby depriving the provinces of the benefit of concessional foreign assistance. Thirdly, since the diversion of such assistance is normally made from social sectors, the hardest hit are usually those people who need this form of assistance the most.
It is encouraging that the federal government had lately allowed Sindh and the NWFP to directly seek WB assistance to push forward the work they had already begun for reforming their fiscal and economic systems as well as improving their public finances, governance and financial regulatory frameworks. In the NWFP, the concessional World Bank assistance had already been budgeted for to raise the spending in the social sector from 27 per cent in the outgoing year to 35 per cent in the current year. In Azad Kashmir, the WB credit is to be used to improve the lot of the low-income communities through the expansion and improvement of small infrastructure and services schemes. One only hopes that the executing agencies would make full use of these resources efficiently and honestly so as to improve the conditions of the impoverished sections in these areas by ensuring that basic services like the supply of drinking water, sanitation, health care and solid waste management reach the people at the grassroots level. One also expects these agencies to ensure that capacities and institutions are built at the district and lower levels of government so as to make development at the grassroots levels a self-sustaining process.
To ensure that the process becomes so, the WB-financed projects have been appropriately designed to fully involve communities in the process of identifying, designing, implementing, maintaining and owning these schemes. The provinces would require adequate counterpart rupee funds to utilize the entire amount of assistance. One hopes that the federal government, while redesigning the new centre-province financial relations, would provide the provinces enough room to widen and improve their resource generating capacities in order for them to be able to mobilize enough resources of their own to match the foreign assistance they would now be receiving directly from the multilateral and bilateral donors.
THE largest ever international AIDS conference attended by nearly 15,000 delegates from around the world concluded after five days of heated deliberations in Barcelona, Spain, last week. As expected, there were only well-meaning promises without any concrete financial commitments made by the developed countries amid fears about AIDS threatening to destroy millions of lives globally in the coming years. The statistics emanating from the conference are alarming: some 40 million people around the world are infected with HIV, the infection that causes AIDS. Ninety per cent of all those infected live in developing countries, 75 per cent of them in sub-Saharan Africa. The Asia-Pacific region is home to over eight million infected people, Latin America to nearly two million, while the epidemic is spreading at an alarming rate in Europe, Russia, China, Indonesia, Thailand and India.
Among the good tidings offered by the conference was the news that a vaccine has been developed to partially prevent HIV. The vaccine is set to begin a five-year trial test on some 16,000 Thai volunteers before any concrete conclusions as to its efficacy or otherwise could be reached. The bad news that reverberated through the conference was that the existing drugs needed to treat those infected with HIV are extremely expensive and thus out of the reach for most of the suffering poor populations. Human rights groups and activists used the issue to demand that the developed countries subsidize all such drugs and make these available on a humanitarian basis to the millions of poor patients suffering from HIV and AIDS in poor countries. Pushing the argument, one delegate stated that it was the apathy on the part of the rich countries that resulted in the death of some 48,000 AIDS-infected men, women and children during the five days of the conference, while only promises were being made to combat the deadly scourge. Mercifully, the point was not lost on the wider audience, and a debate is now under way in the western media about the role of the multinational pharmaceutical companies making these expensive drugs.
Pakistan, along with the rest of the developing countries, finds itself in the same situation, though, mercifully, the disease has not assumed epidemic proportions here yet. The challenges faced by the developing countries are multifaceted when it comes to combating the deadly affliction. Controlling the spread of AIDS would not be possible in isolation, as any progress in the public health sector would have to be part of the overall progress that needs to be made to reach the goals of sustainable development over a period of time. The social stigma attached to AIDS necessitates aiming at achieving a parallel level of progress in the social sector, as rightly stated by the declaration of the Barcelona conference. This means creating gender equality and strengthening civil society in countries like Pakistan. Also, raising awareness about the disease itself and instituting safety procedures and practices at the health care and blood transfusion facilities are the obvious measures that would need to be taken.
All of this requires both professional and financial resources, which the developing countries seriously lack. Therefore, the need for the developed countries to chip in to bear this burden as a collective social and humanitarian responsibility cannot be overemphasized. Promises aside, the world now needs to think as one global village which is under a dreadful threat from an epidemic that has already assumed pandemic proportions in Africa, for instance. As Nelson Mandela said at the closing session of the Barcelona conference, “Unless we do something practical, eloquence is less than useless”.