The hospital’s program manager, Nii Akwei Addo, extends his welcome: “We started 10 years ago from zero, and all we used to do was counsel and talk and watch people die. Now we have 72,000 people on anti-retroviral treatment all with support from the Global Fund. We have spread the money as far as we can spread it.”
The Global Fund is due a US$15 billion replenishment in the coming weeks of which 10 percent should come from Britain. Progress has been spectacular; in Ghana alone the crucial rate of mother-to-child transmission of HIV has been reduced by 75 percent since the advent of the fund.
Still, spend some time speaking to Adane Nsure who has lived with HIV for 14 years, and whose third, healthy child, a daughter, Happy, is asleep on her lap, is to believe it is money well spent.
The commitment to combat HIV/AIDS was one of the original Millennium Development Goals (MDG), envisaged 13 years ago now, by then UN secretary-general Kofi Annan as a blueprint for a new relationship between the developed and the developing world. The targets were to be achieved within 15 years, that is to say, by Dec. 31, 2015, a date which, particularly when viewed from Accra, now seems very close.
It has long been the fashionable cynic’s view that the goals — “the eradication of extreme poverty and hunger,” and so on — were hopelessly resistant to scrutiny.
Jamie Drummond, who was an architect of the Drop the Debt and Make Poverty History campaigns, and who is now director of ONE would not subscribe to that argument. Along with ONE Africa director Sipho Moyo, who is with us in Accra, he is quick to reel off some of the statistics about Ghana to back up his point; among them that life expectancy has risen by six years to 64 since 2000, child mortality has fallen by 22 percent and Ghana has more than halved extreme poverty levels.
Still, as both Drummond and Moyo accept, one of the valid criticisms of the original MDGs was that they gave the impression of being the imposed solution of rich countries on this part of the world. A new post-2015 framework, which is currently being debated, should clearly be more representative of the demands of Africans. To this end, Moyo, based in Johannesburg for ONE, has developed an initiative called Your Voice that has canvassed 200,000 Africans in the south of the continent and invited them to outline their priorities.
The answers emphasized jobs, inclusive growth, in particular measures to keep a bigger proportion of wealth from the extractive industries — of the US$2 billion earned from Ghana’s gold mines annually, for example, only US$38 million stays in Ghana — , more open accountability of corporations and government and donors, and an end to corruption.
If the original MDGs asked for an “aid revolution” this time around, therefore, they may well demand a “transparency revolution.”
ONE, along with many other organizations, has lately been working to understand and nurture what that revolution might involve. Having lobbied, successfully, over the last two years for legislation that requires US and European mining and oil companies to publish their contracts for concessions in Africa — the secrecy of which was previously the source of enormous corruption — Drummond and Moyo are in Ghana to examine the progress of the other half of that transparency compact. That’s the one which demands African governments be transparent democracies, open both about the money they receive from all sources, and accountable for where it is spent. Hence the importance of “factivists” such as Kamara, people who are slowly building and reinforcing the idea of civil society, demanding more robust and well-scrutinized institutions.