Book Review

Race Against Time, by Stephens Lewis 

Stephen Lewis certainly has a way with words.  Even for this review, the best approach is to quote him, for the sheer oratory of it.  He speaks credibly as an eye-witness.  In fact, few people would be better positioned that the UN Special Envoy, to testify about “this viral contagion”.  But a witness is supposed to tell the truth, the whole truth, and nothing but the truth.  Whereas Lewis tells the truth, but not the whole truth.  Nor does he confine himself to nothing but the truth, because the book is interspersed with a generous sprinkling of socialist chutzpah. 

1.      THE TRUTH

Lewis rightly calls the HIV/AIDS pandemic “a human apocalypse”.  He quotes African presidents who have mentioned “annihilation” and a “holocaust”. 

On Third World Debt he mentions “willful inattention”.  As he puts it, “the rich got the loans and the poor got the debts.” 

On Aid (overseas development assistance) he mentions “heartless indifference”.  If this sounds like an insult, it is.  Reading the book is a bit of shock therapy. 

On Trade, he points out the disproportionate amount that is spent on subsidies in the North than on social investment in the South.  Much more is spent subsidizing every cow in Europe than on every beneficiary in the developing world. 

It was Bono who combined the above three into “DAT”.  Lewis is right that: “Increasing aid, widening debt relief and revising trade barriers are not enough.”
 

Lewis insults pretty well everyone equally.  He rightly states that the intransigent lack of action on the part of African leaders is “criminal neglect” and that “it feels like crimes against humanity.”  But he also points out that tarnishing Africa’s reputation on governance and corruption is a double standard for Canadians.  He even exposes some of the “Byzantine ways” of the United Nations, but not as much as it deserves.  It does not get its fair share of insulting, although there is some. 

On Women… “inequality is obscene” 

On Education… he points out that AIDS prevalence decreases as level of schooling increases, but that the virus is winning anyway because it is knocking out so many teachers 

Speaking of capacity shrinkage, “responding to the pandemic is undoubtedly the most dramatic example of absence of capacity.”  Just when health services should be shored up to meet the HIV/AIDS challenge, health professionals are either emigrating or dying off.

Worse yet, at a time when stable food security matters more than ever before (“ARVs don’t work on an empty stomach”), food production is dwindling due to the death or distraction of farmers caused by the pandemic.

Issues like condoms, abstinence and the stigma are there, but this book does not dwell on them.  Lewis seems to have a balanced view, and recognize that the focus has moved past Prevention to Treatment…  He notes the “slow rollout of treatment”, and relates how the “international community, including the UN, was stagnating in its response to the pandemic”.  Until WHO unleashed its 3-by-5 campaign (3 million people on ARVs by 2005).  Lewis also notes that successful Treatment acts as a turbo-charger to Prevention.

He is right that vaccines are a long way off.

He is at his peerless most when ever he mentions “the orphan deluge”… how grandmothers are taking the brunt of it, assisted by caregivers who voluntarily share the burden of care.  He notes that “armed conflicts exacerbate the impact of AIDS on children”.

If incomplete, the panorama that Lewis paints is pretty comprehensive and integrated.

2. NOT THE WHOLE TRUTH

Nevertheless there are some appalling gaps in the overview Lewis provides.  Referring to yet another UN talk shop on AIDS, he comments: “A sense of urgency was totally lacking.”  Amazingly, Lewis manages to convey a keen sense of urgency – without ever leaving his comfort zone of political correctness and suggesting that is constitutes a disaster emergency.

In spite of numerous references that Lewis makes to current events (e.g. G8 meeting at Gleneagles) – neither the Asian tsunami nor Hurricane Katrina are ever mentioned!  He is tone deaf when it comes to disaster mitigation and preparedness know-how.  The whole book is rather focussed on our probable failure to reach the Millenium Development Goals, and therefore its operating system is the development mode.  He apparently cannot function in disaster mode.  It’s as if all the relief agencies in the world served no purpose!

At one point he comes close to comparing AIDS to a disaster with the comment: “So let me tell you what Pompeii looks like…”  Speaking of food aid requirements urgently needed in Zimbabwe due in part to the pandemic, he says “Someone has to do it; the UN is best placed.”  (Say what?  The UN?  A relief agency?)  But he couches his comments in political correctness: “I’m not saying that the “right to protect” is the right to intervene.”  He is close to finding the real world when he quotes Colin Powell as saying that AIDS – not weapons of mass destruction – is the biggest threat to our planet.  And when he closes the book on the note that 20 times more is spent on military budgets than on overseas development budgets.

The point is that what the UN should do is stay out of operational relief, and conscript some one like Colin Powell to organize another grand coalition – to confront this real and present danger.

Bird flu has now spread from China to Turkey.  When southern Africa’s summer ends in May 2006, the birds will migrate north – to the Middle East and Eastern Europe.  When they return at the end of Turkey’s summer, they could be bringing with them a disease that kills 1 out of 2 people under normal conditions – to a context which has AIDS prevalence rates as high as 43 per cent.  A military scale response may be needed sooner than it will take Lewis to get over his political correctness.  And on his watch!

In his middle chapter on Women, Lewis says: “Gender mainstreaming is a pox for women.  The worst thing you can do for women is to fold their concerns into the mandates of UN agencies, or bury them under the activities of government ministries.”  Precisely!  The same applies to HIV/AIDS.  As a “cross-cutting” issue, it is everyone’s problem – and as such, no one’s. 

Another thing that Lewis fails to say is that the “teething problems” at the Global Fund are one reason why so many good intervention “never get to scale”.  From personal experience in 2005, I can attest to the phrase “bury them under the activities of government ministries.”  The CCM (country coordination mechanism) structure that the Global Fund has adopted is useless as a mechanism for disaster management.  The SWAPS approach (sector-wide approaches) was designed for development.  Furthermore, it constitutes a throwback to nationalism.  The CCMs refresh all the excesses of protectionism.  And they strengthen government’s hand – at the expense of the other sectors.  Even when a disproportionate amount of AIDS response is falling on actors in civil society – like grandmothers and volunteers who are about as far from government as you can get (in more ways than one).  The Global Fund’s apparatus is reactionary, and I speak from first hand, fresh (Round 5) experience. 

Increasing resource flows to the Global Fund will have the effect of slowing down – not of speeding up – AIDS responses.  Whereas an operational coalition – as military experts know – can accomplish a lot more severally than jointly. 

1.      NOTHING BUT THE TRUTH – AND A LITTLE CHUTZPAH! 

Lewis is an unapologetic socialist, and his whole analysis must be seen in this light.  So he is terribly hard on structural adjustment policies, to the point of calling them “capitalist Stalinism”.  While there is certainly a lot of “rethinking conditionality” going on, hey, don’t forget that the guys who brought you SAPs are the same ones who brought us the end of the Cold War, the defeat of Communism and of a divided world (Africa included).  The domino effect of this was the end of Apartheid… The closest that Lewis comes to admitting that Africa has changed in some ways for the better (without forgetting that in many ways it IS worse off), is his tribute to Jeffery Sachs.  But on the whole he goes beyond the truth and into full-fledged electioneering when it comes to “the Bank” (WB) and “the Fund” (IMF). 

On the campaign trail for international socialism, Lewis also advocates for: 

1.     free education for all, that it, the elimination of school fees
  (He  quotes a strong phrase: “ration access to school through
  fees”)

2.      A new UN agency for Women (yet another layer of government,
  albeit at multilateral level)

3.     Ramping up the Global Fund (centralization)

But whose pork barrel is he doling these goodies out of?  Taxpayers in the North are going to pay more if their governments (as they should) live up to the 0.7 per cent of GNP standard. 

Lewis’ romanticism starts in his recollection of Africa in the 1950s and 60s (“it never felt like Armageddon”) and ends in challenging corporate donors to contribute generously to the Global Fund.  In his dreams!  Why should those who are self-aggrandizing and protectionist be rewarded, in a world where empowerment and regionalization are the order of the day? 

Africa is truly facing a crisis of Biblical proportions.  Its health, education and food security institutions are shrinking at the very moment that they should be fortified.  The AIDS infection rate is peaking at around 43 percent, we are told.  Immunologists also say that the death rate peaks seven years later than the infection rate.  Apocalypse, Pompeii and Armageddon indeed.  

A hazard like Bird Flu could put these dreadful scenarios into fast-forward, but as we learned from the Tsunami and Katrina, these are “unexpected” to everyone except those who operate in the disaster mode. 

Africa needs an army of health professionals, educators and food producers/processors to shore up its sagging systems.  A grand coalition of such forces needs to be raised.  Not of soldiers and tanks, but of volunteers and technicians.  Blessed are the peacemakers.  Isaiah envisioned a day when “foreigners will shepherd our flocks”.  This is upon Africa – politically correct or otherwise.  The “right to protect” is leading in a very different direction that either Lewis or the UN would prescribe… for we have the right to protect our grandchildren as of yet unborn, not just ourselves, and not just in Africa but in Canada too. 

Cuba already has medical technicians in every Africa country – who would have thought that it would be the vanguard?  If other countries would follow suit, proportionally, a grand coalition could be raised - not against WMD but against AIDS.  Maybe if Colin Powell is not available, Fidel Castro could lead this coalition?  That would surely make Stephen Lewis smile!