ASSIGNMENT

Healing for a Broken World: Christian Perspectives on Public Policy (STEVEN MONSMA, 1ST EDITION COPY WRITTEN 2008)

MONSMA:CHAPTER 11

CHAPTER 11 Disease and Poverty in Africa

Three Specific Problems

At times the problems of Africa seem so overwhelming that hopelessness and despair appear to be the only rational response. But there are powerful reasons not to despair. One is that Jesus Christ is also on the move. As seen earlier, Christianity is growing by leaps and bounds in many African countries. Today there are hundreds of millions of Christians in sub-Saharan Africa. And most of these are evangelicals and Pentecostals who fully accept the basic truths of the Bible. Where the redeeming grace of God is at work, there is reason for hope.

In fact, Christ’s church is having a positive impact in many countries and areas of Africa. Take Uganda as one example. In the 1970s it was ruled by a brutal dictator, Idi Amin, who killed an estimated three hundred thousand of his own people and laid waste much of the land. But Christians resisted. Many church leaders spoke out against his regime, even at the cost of their lives. Among these was Anglican Archbishop Janani Luwum who was killed by Idi Amin’s henchmen in 1977. Out of the blood of these martyrs, the Ugandan church grew. Today two-thirds of Uganda’s population is Christian. The country is largely peaceful and is making strides. Only 12 percent of its urban population lives in poverty. It has reduced the rate of HIV infection from about 20 percent of the population in 1990 to 4.1 percent by 2003.17 It did so by way of its famous ABC program that stressed sexual Abstinence, Being faithful in marriages, and the use of Condoms as a last resort. Churches and other localized, Ugandan agencies were crucial in the success of the ABC program. As in Uganda, African Christians are making a difference in their lands.

In this section I consider three specific, especially crucial problems: HIV/AIDS, malaria, and poverty. How ought we as Christian citizens of the United States react to these problems? What policies ought we to be urging our government to pursue in light of Africa’s needs?

HIV/AIDS

This dreaded disease has reached catastrophic levels in some, but not all, African countries. As of 2005 the United Nations reports that in Swaziland 33 percent of the people are HIV positive, as are about 20 percent in Botswana, Zimbabwe, Namibia, and South Africa. Only a slightly lower14 percent are HIV positive in Malawi.19 There are other countries with infection rates as high or almost as high. As noted earlier, 26 million people are HIV positive in Africa. Many of them will die.

“O God, whose Son the Good Shepherd laid down his life for the sheep: We give you thanks for your faithful shepherd, Janani Luwum, who after his Savior’s example gave up his life for the people of Uganda. Grant us to be so inspired by his witness that we make no peace with oppression, but live as those who are sealed with the cross of Christ, who died and rose again, and now lives and reigns with you and the Holy Spirit, one God, for ever and ever. Amen.”18

—EPISCOPAL LECTIONARY PRAYER FOR THE FEAST DAY OF JANANI LUWUM, ARCHBISHOP OF UGANDA AND MARTYR

The widespread presence of HIV/AIDS raises three separate issues:stopping the spread of the disease, helping those already infected, and helping orphaned children. What actions ought we as American Christians take in our efforts to live out our solidarity with our fellow human beings in Africa at risk of or already affected by this scourge? What public policies ought we to work for our government to support?

A controversy revolves around the issue of stopping the spread of HIV/AIDS. Some believe efforts to stop the spread of HIV/AIDS ought to emphasize sexual abstinence outside of marriage and faithfulness in marriage (the A and B of Uganda’s highly effective ABC program). Others believe an equal emphasis—and perhaps even a greater emphasis—should be put on C: the distribution and frank discussion of the use of condoms. Most Christians believe abstinence and faithfulness ought to be the chief thrusts of any efforts to prevent the spread of HIV. Condoms are no absolute guarantee against the spread of the human immunodeficiency virus and, more important, urging their use implicitly sends the message that sexual activities outside of marriage are all right or, at the least, bound to happen. Many believe that emphasizing condom use sends the message that God’s standard of sexual purity is an impossibly high standard that most people cannot be expected to live by.

President Bush’s program to combat AIDS in Africa (PEPFAR) requires that at least one-third of the money spent to prevent the spread of the virus must be spent on abstinence and faithfulness education. There have been some attempts in Congress to repeal this requirement of the program, but most Christians rightly defend it.

However, Christians who fully understand that this is indeed a broken world where things are often not as they are supposed to be will also recognize that there always have been and there continue to be people who will flout God’s standard of sexual chastity. Thus one can argue, on the basis of a Christian understanding of the place of sin in the world, that the C of ABC—that is, the availability and instruction in the use of condoms—must also be a significant part of a program seeking to stop the spread of AIDS.

Also, in male-dominated cultures—as is the case in most African countries—women and girls can be infected with HIV not by sexual promiscuity, but due to the pressures of situations that give them few choices. Husbands who are HIV infected due to their sexual promiscuity often infect their wives. A majority of HIV-infected people in Africa are women, and in some countries married women have higher HIV-infection rates than single women. Girls often enter the sex industry in response to economic and other pressures that seem overwhelming to them. These conditions not only bear witness to the brokenness of our world, but also argue against an abstinence or faithfulness-only approach to stopping the spread of AIDS.

Nevertheless, equally sincere Christians may have differing opinions on how much emphasis to put on abstinence and faithfulness education over and against condom distribution and education. Here we need to be guided by trusted African churches and non-governmental organizations with direct, local experience. The correct balance may vary from one country or region to another.

The HIV/AIDS crisis in Africa raises a second issue: how best to care for those who are already infected with HIV or already are suffering from AIDS. In the United States and other Western countries the lives of people with HIV have been extended—in some cases seemingly indefinitely—by a battery of anti retroviral drugs. Until recently many people had concluded that problems in making these drugs available to most HIV-infected Africans could not be overcome. These drugs were extremely expensive, and they need to be taken in exact dosage levels every day without any interruptions. This requires strong education and distribution systems that were not in place.

But it is becoming clear that anti retroviral drugs can be used in Africa to save thousands, perhaps millions, of lives. The costs of the drugs have come down, as some of them are now available in generic form, and as some drug companies have reduced the price they charge for their drugs going to Africa. Programs treating HIV/AIDS sufferers with anti retroviral drugs in several African countries have demonstrated that the needed educational and distribution networks can be developed. Some 20 percent of Africans in need of anti retroviral drugs are now receiving them20 But this also means 80 percent are not. People are dying every day who, if they lived in North America or Europe, would not die.

What can we do to help get the needed drugs to those in Africa in desperate need of them? A massive effort is needed. Part of that effort is needed funding. Billions, not millions, of dollars are called for. This is where the American government and those of other Western countries can help. But more than money is needed. Elaborate distribution and education networks are also essential.

Here is where churches and Christian and other nonprofit organizations—both African and American—come into play. They are often the ones that have the trust of the local populace and already have networks extending into even remote villages. Thus they—and we who support them—have a key role to play. This is an especially clear case of the point I made earlier: both civil society and national governments are crucial if needs are to be met and lives saved.

A third issue concerns the millions of African children being orphaned by AIDS. There are more than a million AIDS orphans in each of these countries: South Africa, Tanzania, Zimbabwe, Kenya, and Uganda.

One response is to redouble efforts to expand anti retroviral drug programs. By extending lives, the number of orphans will be reduced, as HIV-infected parents will be able to continue to care for their own children. But in spite of such efforts, there are already millions of AIDS orphans, and there will be more in the future. Some can be cared for by the extended families of the AIDS victims. But often the extended family has also been ravaged by AIDS. Or it may be so poor that it simply does not have the shelter and food for additional children.

African churches are responding to this crisis through adoptions and orphanages. For example, in Malawi a pastor, T. J. Chipteta, and his wife have started an orphanage called the Home of Hope. With the support of Malawian Christians, it is now serving three hundred orphans. But in a country such as Malawi, which has a per person annual income of only about $16022 and an estimated 550,000 orphans out of a population of 13 million,23 it is extremely difficult, if not impossible, for our fellow Christians to meet on their own all the needs of the AIDS orphans. In fact, the Home of Hope orphanage is only surviving with financial support by Christians in the United States and Canada. It is doing good work, but it is nowhere near adequate to the needs. States and Canada. It is doing good work, but it is nowhere near adequate to the needs.

“The millions upon millions of orphans have now become a heartrending reality. These are individuals whom God personally loves, and we simply cannot abandon them.”21

—MARK GALLI, MANAGING EDITOR OF CHRISTIANITY TODAY

Again we face the question of what should be our response as American Christians. The needs are so great that both government assistance programs and the work of individual churches and relief agencies, faith-based and secular, are required. The both-and approach again seems best.

Malaria

Malaria continues to cause hundreds of thousands of deaths each year in Africa. Children under five years of age and expectant mothers are the most vulnerable. As noted earlier, one African child dies from malaria every thirty seconds. Adding to the tragedy is the fact that malaria is preventable. Keys to defeating malaria are insecticide-treated mosquito nets for use while sleeping at night, spraying with insecticides, and treatment with drugs for those who have been infected. None of these poses the problem of prohibitively high costs. A dose of anti malaria drugs costs about one dollar. An insecticide-treated mosquito net costs about ten dollars and can make a huge difference in lives saved. When the United States distributed mosquito nets for every pregnant woman and every child under five years of age in one of the Spice Islands of Zanzibar, the number of malaria cases plunged 90 percent.24

In the case of malaria, the problem is not the lack of solutions or of resources with which to implement them. Instead, the problem is one of overcoming indifference and figuring out how to make use of grassroots networks generally already in place. Again, we should look to the relief and development agencies, churches, and other institutions that make up civil society—and to our government with its superior financial resources.

“One million last year alone died on the African continent because of malaria. And in the overwhelming majority of cases, the victims are less than 5 years old, their lives suddenly ended by nothing more than a mosquito bite. The toll of malaria is even more tragic because the disease is highly treatable and preventable . . . the world must take action.”25

—GEORGE W. BUSH, PRESIDENT OF THE UNITED STATES

Poverty

As seen earlier, poverty is present in overwhelming numbers in Africa. Colonialism, corrupt governments, wars, Western nations’ trade policies and their exploitation of Africa’s natural resources, disease, a lack of education, and other factors keep many Africans living in deep poverty in spite of their personal hard-working nature and their nations’ many natural resources.

We need to be aware of two public-policy issues directly related to poverty in Africa, the first being the trade policies of the United States and other Western nations. It is not so much that we impose high tariffs on goods coming to us from African countries. Instead, it is a matter of the subsidies that our government pays to our farmers. Whenever the American government subsidizes crops such as sugar cane or cotton, it makes it harder for African farmers to compete on the world market with American farm products. The United States spends about $40 billion a year subsidizing American farm products. These subsidies result in lower prices for American farm products—prices that African farmers without the same subsidies have a hard time matching.26

There is no neat, obvious, “Christian” answer for the extent to which our government should assist American farmers. Public policy should treat them with justice and enable them to support themselves and their families. But for the Christian citizen, the issue of farm subsidies ought never to be merely a matter of the American farmers’ self-interest and the subsidies’ impact on our government’s budget. We must think how our actions affect African farmers, most of whom are desperately trying to earn a living with which to support themselves and their families. We should also keep in mind that many of them are our fellow believers and that in almost all cases they are much poorer and have fewer options than American farmers.

A second public-policy issue concerns the heavy debt carried by many African governments, resulting from loans granted years ago—often to corrupt dictators—by Western governments, the World Bank, and the International Monetary Fund. Just paying the interest on these loans takes large portions of some countries’ budgets, leaving little money for health clinics, schools, and economic development initiatives. For example, in 2005–2006 Kenya spent as much on debt repayments as it spent for water, health, agriculture, roads, transport, and finance combined.27

In 2000 the debts of some impoverished countries were cancelled by industrialized countries, but other impoverished countries are still struggling under huge debt burdens.

Many Christians in the United States and in Europe are calling for a “Year of Jubilee,” which will result in Western governments and international banking institutions cancelling the debts of poor nations in Africa and elsewhere. These Christians point to Leviticus 25 and the year of jubilee the Israelites were instructed to observe, when all the land that had been sold would be returned to their original owners and all debts cancelled. There is a biblical basis for forgiving loans. But others have argued that simply forgiving the debts of nations will encourage irresponsible rulers to enter into new debts, hoping they too will never need to be paid. Forgiving debts, they point out, is a bad precedent that rewards irresponsible behavior.

It seems to me that the right thing to do is to forgive a nation’s debts that were entered into by irresponsible rulers years ago, often with the overly quick and easy approval of the lending nation, and that are now imposing a crushing burden on the debtor countries. But others will disagree. No matter what position we take, it should be motivated by a genuine, heartfelt concern for the peoples of these countries. We ought not merely insist—as did the ungrateful servant in Christ’s parable in Matthew 18: 23–35—that what is legally owed must be paid irrespective of the dire circumstances of the debtor.

“The world’s most impoverished countries are forced to pay over $100 million EVERY DAY to the rich world in debt repayments, while poverty kills millions of their people.”28

—JUBILEE DEBT CAMPAIGN

Conclusion

A final word: The biggest danger in regard to Africa and its needs is not that Americans as a whole, the news media, or members of Congress will come out forcefully against aiding orphans, fighting against malaria, or stopping the spread of AIDS. The real danger is that the American population’s and Congress’s attention will drift elsewhere, and programs of assistance will languish. We who hold the lives of all people as being precious in God’s sight—no matter what their race, no matter where they live—need to continue to press for action by our churches and our overseas relief and development agencies. And by our government. This is not a one- or two-year battle against disease and poverty; a major, long-term, year-in and year-out effort is needed. Africa must not be the “fad” for a year or two. Consistent, sustained acts of love and concern are needed, undertaken by individual Christians and their churches, Christian relief and development agencies, and—encouraged and spurred on by Christian citizens—our government’s policies toward Africa.