2) What is the United States doing about HIV/AIDS in Africa?
The following answer is the opinion of Nathaniel Calhoun.
You ask what the United States is doing to combat HIV/AIDS in Africa. There are two positions from which somebody could provide a comprehensive and objective answer to that question.
The first would consider how much the United States is doing relative to its budget and relative to its abilities—this is the way that people outside the U.S. tend to judge our contributions. They are asking, in other words, if we are doing "enough." (Is it fair to expect that your wealthier friends give you nicer gifts on your birthday?) On the Internet, you can learn how the government allots the money it receives from taxation and investment. You can compare how much money is spent on military and espionage with how much money is used to pay your teachers, launch spaceships, pay for the incarceration of small-time drug offenders, fix roads in low-income neighborhoods, offer subsidies to U.S. farmers or "help Africa." Most people outside the U.S. consider our financial contribution, as a percentage of our wealth, to be a shameful sum about which we have no right to brag.*
The second position from which one could attempt to deliver an objective or somewhat factual answer to your question doesn't exist in reality. Someone would need to follow all of the donated money through the millions of hands and bank accounts that it travels and judge whether or not it has arrived in a good place. (It is expensive to follow aid money around; that may be why there are so many scandals about its misuse and theft.) In any case, nobody has followed all of our given money. Some people have followed some chunks of it and discovered cushy jobs and second houses. Others have seen evidence of hard work and saved lives.
(Discussion: What do you think are the relative advantages and disadvantages of answering the question in the first and second ways? From whose perspective should we try to answer this question in the first place?)
USAID is the principle organization that distributes American money (your tax dollars) to foreign peoples for humanitarian purposes. Sometimes they offer partial funding to large and successful international organizations, sometimes they give directly to foreign governments with instructions of varying clarity and sometimes they single-handedly pay for whole projects. They don't generally have staff on the ground who work directly with local populations. They are an enormous and wealthy entity that distributes much sought after cash to groups all around the world. The questions are, do they choose their beneficiaries carefully, do they give them the appropriate amount of assistance and do they impose conditions on their money that are troublesome or helpful?** Again, you could look on the Internet to discover who USAID supports and what those groups are doing. Decide if you think they are helping people to do good work.
Eventually, our team hopes to have a solid base of experience and observation from which to make general statements about our government's generosity; but we have only visited five countries so far and only focused on U.S. money in a few of them. With that limited knowledge, let me tell you what we've seen.
In both Mali and Burkina Faso, we focused on the work of Population Services International (PSI), something created by the U.S. government several decades ago to promote family planning and slow population growth. (Are there currently any foreign companies in the U.S. that try to influence how many children you or your friends hope to raise?) This organization has developed tremendously since its inception and has become one of the biggest players in global health and wellness education. Their work is called "Social Marketing." This means that they seek to market or make popular products and behavior that are good for the health of society. Think about commercials against drug use or cigarette smoking, advertisements against forest fires or drunk driving: that is social marketing.
Sometimes PSI is funded entirely by the U.S. government, and sometimes they are funded by other wealthy governments or donor organizations. In either case, they are often working in the most high-profile manner to bring information about HIV/AIDS to underinformed peoples in Africa. They develop radio dramas, television advertisements, low literacy pamphlets and peer education events to teach people about AIDS (as well as other problems like malaria or spousal abuse). They do a considerable amount of survey work to discover exactly what sort of message the people need to hear and which people are most vulnerable. For instance, by conducting regular street interviews, they hope to learn when their urban populations have absorbed the basic information about AIDS and need to learn about more specific issues like the asymptomatic carrier (the healthy-looking person with AIDS) or the way to increase pleasure through condom use (avoiding stress and anxiety about infection after the fact). They also discover the most vulnerable people—typically young rurally raised women transplanted to cities and men working far away from their families as, say, drivers or miners—and work on special ways of communicating directly with them. This means, in Africa, that PSI can be as likely to beam a television commercial to your home as they are to send someone to discuss with your bus driver how and why to use a condom. It is difficult to quantify how effective their messages are. But it does seem obvious that they are beneficial and it is easy to find people who admit to being informed by their efforts. (For more information about the efforts of PSI, check the feature article "Population Services International: Social Marketing in Mali and Burkina Faso".)
(Interestingly, President G.W. Bush recently diminished funding to organizations that stress the use of condoms and discuss family planning—leaving undamaged the budgets of groups that stress abstinence and fidelity. In Mali, this meant that PSI's well-planned and carefully researched initiative to promote "protector plus" condoms could not be advertised on television or with any intensity—despite the high prevalence of unprotected sex in this very well sexed country. Supporters of Bush's decision would emphasize the value in changing the sexual morality of these cultures. (Discussion: Any thoughts?)
The other global attempt of the U.S. to deal with AIDS is related to its Peace Corps volunteers, some of whom work specifically on this problem for their two years of service—usually in cooperation with various NGOs who have taken interest in the issue. The usefulness of this program is another question entirely. Any questions you might have about Peace Corps, you should address to Sean.
Lastly, this answer is not discussing the actions of independent Americans and American organizations who have found their own funding. There are many universities, churches, entrepreneurs and individuals from our country that are making their own plans and contributions here.
* Possible Internet Research Project #1: Search the Internet for statistics about what percentage of its Gross Domestic Product (GDP) the U.S. government devotes to different domestic and international causes. Find two allocations to criticize and two to affirm.
** Possible Internet Research Project #2: Find the home page of USAID. How do they choose who to help and how to help them? Are there any projects you are unhappy to support with your tax dollars? Are there any projects you are particularly happy to support? (On USAID signboards in Africa there is often the inscription, "From the People of the United States of America"—that's speaking for you.)
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