Norbert Mao Speaks to Irish Parliament on HIV/AIDS

"AIDS REMAINS AFRICA'S BIGGEST CHALLENGE"

Speech by Norbert Mao MP to the gathering of EU Chairs of Foreign Affairs Committees in the Irish Parliament. Reprinted from the Hansard of the Irish Parliament

Mr. Norbert Mao:

"The previous speakers Father Lambert, the Ambassador and Ms Marika Fahlen, our friend from UNAIDS, seem to read from the Book of Lamentations. I will read from the Book of Genesis: when God caught Adam and Eve violating his commandment he decided the time had come to distribute some punishment across the board. The harshest punishment was given to the snake whose right to cry out was withdrawn. In our culture anyone who sees a snake assumes it is fleeing a death sentence and has the right to execute that sentence. The snake does not have the power to cry out even when one beats it.

As human beings we have that right and capacity to cry out. That is why this gathering is particularly important because political will could be renamed political capital. We are trying to mobilise the political capital of the individuals here who have power in their various parliaments to raise this alarm. They have the information about Nkosi Johnson,Uganda etc., but ultimately they must commit themselves as individuals and write to the chairmen of the largest pharmaceutical companies in their countries asking them to commit at an individual level. Those are things they can do, whether or not their committees are with them. If at its next board meeting the International Federation of Pharmaceutical Manufacturersreceived a one page letter signed by these chairmen it might regard it as a nuisance but it would put the matter on the agenda. The federation knows these people can affect their contracts and who wins tenders, and that they meet the board members of the World Bank which spends over $1 billion on pharmaceutical products. In this roundabout the chairmen can act and all the stories we tell are designed to commit them to doing so.

The Ugandan case is world renowned. Our Government decided we were too poor to treat people who fell sick and that it was the best thing to prevent them from being infected. There was a political commitment at the highest level to speak openly about HIV and AIDS. As a university student in 1991 I saw Government officials visiting an emaciated popular musician, a Ugandan who was based in Sweden but came home to die in Uganda. The officials visited him and touched him, saying one cannot catch AIDS by embracing someone. Our president spoke about AIDS in every speech. He might attend an Independence Day dinner gala but would “spoil” the speech by saying he knew people would have fun and get drunk but they should remember they could also get AIDS in the excitement. It became his characteristic approach. People knew when he was making a speech that the phrase “and now before I sit down” signalled a reference to AIDS. At first many of us young people regarded him as a nuisance and as impolite and discourteous but eventually that is what saved people’s lives.

He then mounted a campaign to tell young people to get married as quickly as possible. He warned them not to think they could test drive for marriage by dating many people to find the best one. They should make up their minds, commit themselves and get married. He gave the example of a person who goes drinking in various pubs and gets drunk before finding the best wine and is too besotted to make a proper judgment. That person will collapse on the street whereas somebody who has sought expert advice on the best drink will make a beeline and get the best drink. I recall those early lessons learnt. Donor funds are not necessary for a prime minister to speak about AIDS or to activate our national self interest. Once we saw the effectiveness of this at presidential level we decided at parliamentary level to go to our constituencies and talk about AIDS. I also attend large youth parties and at the end of my speeches warn people about AIDS. They probably think I am a nuisance but that was the beginning of the Ugandan miracle.

There was a public campaign about traditions which can promote AIDS, for example, female genital mutilation. The Government published a policy saying it would not tolerate this criminal practice which violates human rights and it passed a strict law against defilement. In some of our cultures people want to marry off their daughters at the ages of 12 and 13 so we passed a law making it illegal for any sexual relations to take place with a person under 18 years of age, with a death sentence as a punishment. That scared off many who were fond of defilement. No one has yet been hanged but the fear of the punishment has saved the lives of many young people who would otherwise be victims of defilement. The number of teenage marriages is also dropping. The policy of universal primary education, which many of the governments represented here have supported in Uganda, has also helped. Parents used child marriages as a means to acquiring more money by marrying their daughters to wealthy men but now with the option of education many young girls postpone marriage and plan to do more than simply be wives. That has worked and Uganda’s universal primary education is a significant policy tool in the fight against AIDS.

The campaign against domestic violence has also helped. The Government set up a family protection unit in every police department and any young girl, abused mother or wife can report a case at the special desk called the family protection force. The force is not very diplomatic and it assumes that the suspect is guilty but at least it empowers women. If a woman threatens to report a man to the family protection unit he knows that he will be kicked around first and asked questions later. It is a draconian response but it has helped to show women that the law protects them also. We continue with the ABC, in that order. AIDS is still on the offensive in Uganda. Scientists say that only when the incidence falls below 5% can one say that it is on the retreat. As long as it is 5% or more it is a losing battle. The situation in Uganda may look good, but seen from that perspective, it is clear that efforts must continue. In our case, the testing stigma must be removed. Many people get tested so that they know their status. Testing in Uganda is simple, with results given within half an hour.
There is an issue regarding the utilisation of civil society organisations. We have an organisation started by a lady who is now in Geneva. Her husband died of AIDS but she was not infected and she survived. She then set up the AIDS support organisation called TASSO. Its work could be copied all over Africa. It is not a Government organisation. Those running it are highly accountable. They visit families and monitor cases of infection. They can detect the viral load. They call themselves not AIDS victims but AIDS victors. They have given a boost to people who thought they were helpless victims of this epidemic. Suddenly, people are fighting back. This is helpful.

We emphasise sexual abstinence, though not for ever. We emphasise it for people who are not in a recognised relationship. Whether people look at it from a traditional or religious perspective, it is a way of staying away from trouble. If you are not on the highway, no car will run over you. When we were young we were told that if we sat on the roadside our mothers would die. We were told this so that we ourselves would not be run over by cars. No-one wanted to be motherless, so we decided not to cross the road alone.

Urging faithfulness is simply a way of emphasising a traditional value. We need to retain space for that kind of message, even if many people think it impracticable because of all the video shows featuring young men going about with tarty women. When a man chooses one we say he is devaluing the family. There is still a place for people to talk about faithfulness. Regarding the use of condoms, the churches understand the situation. In the Ugandan Parliament we have a way of explaining it by saying that there is a difference between decisions made by an army in the war room and the decisions made on the battlefield. We leave people with the option to make battlefield decisions. One can make a plan in the war room and promise to be faithful, to abstain — but one never knows: after a Guinness or two, a condom in one’s wallet may save one’s life. Those are field decisions and the right to decide must not be taken away from people. The churches seem to understand that.

I emphasise the relationship between AIDS and armed conflict. In Uganda there is an armed conflict in the north of the country, a part one does not usually hear about. One hears more about the economic boom and so on. The conflict is the underbelly which spoils a good story. All our development partners in the World Bank have been under great pressure with demonstrations in various places. They need a good story, and Uganda is one such story, so people seldom talk of the aspect which spoils the story. We need to face up squarely to that which undermines our capacity to fight AIDS, namely armed conflict.

There is a peculiar relationship between armed conflict and AIDS. I have made some notes about the infection rate. Among the Ugandan armed forces the infection rate is 66%. The rate in Zimbabwe, at 80%, is worse. In Malawi, the rate is 75%. Experts have been studying this. A colonel in the UK’s Royal Army Medical Corps published a report and said that history is littered with examples or armies falling apart for health reasons. When an army is infected to such an extent, and the country’s President is not particularly democratic, one becomes paranoid. The world AIDS epidemic has affected our armies in Africa. In northern Uganda, pregnant women were tested in a hospital run by Italian missionaries. The infection rate was found to be 30%. That is not the Ugandan percentage. In Uganda we do not want to hear of any AIDS percentage figure above 6%. There is an explanation.
I call on Uganda’s partners to invest more in conflict resolution. That is one way of fighting back against HIV-AIDS. Experts have asked why the infection rates among soldiers seem to be so high. A few reasons have been given. Soldiers are among the most sexually active age groups. That goes without saying. They are also posted away from their home areas and uprooted from the social sanctions. There is nobody around the barracks to suggest to a solider that the woman he is with is not his wife, and ask what he is doing with her. The soldiers are so far away from home. Imagine being in Baghdad. Nobody will ask whose hand one is holding. Soldiers are also among the most lonely and stressed individuals and their sexual over-activity seems to be a way of responding to that stress and loneliness. Soldiers are almost among the most highly paid in a deprived community where there is a war. Because they have a great deal of money to spend, they get into all these relationships. Consigning people in a barracks also attracts people such as prostitutes and drug dealers. Studies have also found that military culture seems to glorify risk-taking. I have heard Ugandan soldiers say they detest using condoms. They ask if one would eat a sweet without removing the wrapper. That is the attitude. They say they have survived so many wars, and have so many scars, and still have not died, so they believe AIDS will not get them. That is the culture.
We need to invest much more in conflict resolution. We do not have the statistics from the Congo, but when they arrive they will shock everybody. We have had seven recognised armies and four quasi-armies like UNITA, the SPLA and various militias. If we are now saying this is an epidemic, we need focus. I call upon those present, dear friends, to join Africa’s efforts in conflict resolution. I know that the UN Secretary General, Kofi Annan, has convened a three-year process under the UN auspices to take an original approach to conflict resolution, similar to the one used to calm down the Balkan regions. I call upon delegates to give that effort all support possible. Indirectly, when the conflict ceases, intervention can be made. While there is war, all the retroviral treatments will never reach people. If food convoys are being ambushed, then what of convoys taking anti-retroviral drugs or the various anti-AIDS drugs cocktails? Peace is a major prerequisite for any intervention effort. Economists have said that by 2012, AIDS will reduce Africa’s GDP by as much as 20%. That should incite us to act even more urgently. It is not just about resources. It is about applying the resources correctly.

I will end by revealing that $200 billion was spent on fighting the millennium or Y2K bug. I do not know how much will be used for this. Many say there was never a millennium bug but somehow we were all so scared of it that €200 billion was spent worldwide. It was called “an imaginary epidemic”. How much more should we spend on a real epidemic such as the HIV-AIDS epidemic?"