Speaking Up

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Wed Apr 13, 2011

Winstone Zulu Speaks Up: Unkindest Cuts

By Winstone Zulu

The hunter had carefully laid out his trap deep inside the cassava leaves. It was made of the bark of the strong mfundanzinzi tree. If a bush pig got caught in the trap, it would be almost impossible for it to break off and go free. The trap, called msampha in the Chewa language spoken in eastern Zambia and Malawi, is set to catch bush pigs locally called ngulube, and other animals that cause a lot of devastation to cassava and other tuber-producing plants such as sweet potatoes.

Having thus set the msampha, the hunter went to wait at a distance for a lucky catch. In no time a large boar arrived, foraging through the plant, digging up its nutritious tubers and eating voraciously as only a hog knows how. After a while it noticed that it could not move its hind leg either forwards or backwards and realized with dread that it was caught up in a trap. Being an old wizened-up animal, it decided to fight quietly to avoid attracting the hunter, who was busy tending to his crops a short distance away. It silently rubbed the rope made of bark against a stone to weaken it. It kept at for a long time and courageously fought wave after wave of despair. The boar knew that eventually the trap would have to give, and he would escape the sure death that would come should he scream now. But after several hours of working, it lost hope and gave a howl of anguish and despondency. It felt the fight was not taking it anywhere; that this was a hopeless case, and that its fate was sealed.

The hunter heard the yelling animal and rushed there. It only took one big blow from his axe to kill the pig. He then started to disentangle it from the trap. He suddenly stopped and said, “Look, this is my lucky day. This animal was almost free. If only he had kept on another minute he would have escaped. My family will have such great pork stew this evening.”

In Chewa the story is summarized in the saying “Ngulube inalila msampha utaning’a kale” — literally, “the bush pig screamed when the trap was almost broken.”

The cuts being proposed and made by countries that had promised to keep funding the fight against AIDS, tuberculosis and malaria do not make sense at all. In the first place, the servings are so small that they will hardly make a dent on the recession. However, the loss to the gains made by PEPFAR and Global Fund interventions of the past eight years will be immense. As a result of these investments, there is evidence that more people are now on treatment than ever before, which translates into better prospects for human development.

The money that has been put into PEPFAR and the Global Fund has had a huge impact on prevention, as more people have chosen to come forward to seek services such as being tested for HIV early and starting treatment if found with the virus. Now more than ever before, there are people living with HIV walking around with undetectable viral loads, which is great news for prevention.

Apart from that, study after study shows that it makes much more economic sense to keep people with HIV healthy than to deny them access to treatment and let them occupy hospital beds.

According to the March 2011 issue of POZ magazine, Kelly Gebo, MD, a researcher at Johns Hopkins University School of Medicine in Baltimore, found an economic correlation between CD4 cell counts and costs of care. Gebo's team examined data from almost 15,000 HIV-positive adults who used high-volume HIV clinics in the United States in 2006. They found that the average annual cost of HIV was $19,912, but for people with CD4s under 50, the average yearly cost was $40,678. In other words, POZ concludes, a more compromised immune system leads to more expensive medical care.

Great strides have been made in preventing vertical transmission of HIV and many programs supporting pediatric HIV depend on the G8 leaders’ promises made at Gleneagles in 2005.

We do not even need to imagine what will happen if the proposed cuts are implemented. People will die. We have been there before; we have known how this disease behaves in the absence of therapy. There is no justification for going back to doomsday scenes of the 90s, where life expectancy in Zambia, for example, plummeted from 56 to a mere 37.

These are deadly cuts and there is no economic or other justification for them.