Is Debt Relief the Cure for AIDS?

By Jerad Morey on 01 April 2005

The World Bank/IMF meeting April 15-17 should be treated by Christians as an international weekend of prayer. At this meeting the powerful financial institutions will consider the February 5th meeting of G-7 nations, wherein the world's most powerful countries agreed in principle to provide as much as 100 percent debt relief to impoverished nations. Christians should pray and act in support of debt relief, not only because of the deleterious long-term effects of high indebtedness on economic development and security, but also the specific effects it has on an urgent contemporary crisis — the HIV/AIDS pandemic. Liberating poor nations from slavery to both debt and disease fits everything we know of the Gospel.

The connection between debt relief and the struggle against global AIDS has been largely ignored by American Christians. This is due to bad theology, a theology that stigmatizes AIDS as a product of sin from a continent of pagans, and that uses popular aphorisms such as "God helps those who help themselves" as faux-Scriptural loopholes to ignore Christ's repeated intercessions with the poor. Churches desperately need the facts.

HIV/AIDS, Economics, and Security

The scourge of HIV is advancing so quickly that it is seriously threatening the stability of effected states, especially in Africa, due to its ravaging effects on populations. The African continent accounts for 70 percent of all HIV/AIDS cases in the world, although it represents only 10 percent of the global population.¹ These disproportionate numbers indicate how one region is bearing the brunt of a global plague. The United States Institute of Peace (USIP) predicts that "on its current trajectory, by 2010 the disease will decrease life expectancy on the continent [of Africa] to levels found at the beginning of the last century."²

The pandemic's effects have been even worse than predictions from a few years ago. Two years after the USIP report (which declared that "these most recent data far surpass the most pessimistic predictions about the effects of the disease in Africa made just five years ago"³), the Heritage Foundation released a backgrounder stating that in Sub-Saharan Africa, "average life expectancy is only 48 years. In addition, an estimated 30 million Africans are infected with HIV/AIDS."⁴ By 2010, the CIA predicts that as many as 100 million people will be infected-a staggering number.⁵ The projected trend leaves us with 40 million AIDS orphans in southern Africa by that same year — almost three times as many children as all the high school students in the United States.⁶

Furthermore, as the USIP notes, the disease "strikes at the most productive members of society…. teachers and other wage earners that are critical to the development of the African states and the stability of the African family."⁷ Nor is the civilian economy the only affected sector. In South Africa, 40 percent of the military is HIV-positive. In Angola and the Democratic Republic of the Congo, that number jumps to 60 percent. This poses a dual threat, as soldiers tend to be both very mobile populations capable of spreading the disease to new areas and also necessary for the state to maintain its monopoly on violence.

HIV is connected to state failure. President Bill Clinton observed that it "can ruin economies and threaten the very survival of societies."⁸ The CIA published a report testifying that "new and re-emerging infectious diseases will pose a rising global health threat and will complicate U.S. and global security over the next 20 years." Sub-Saharan African countries devastated by AIDS have suffered net losses in their Gross Domestic Product and, as the USIP report succinctly states, AIDS causes a "spiral of destabilization":

Families become impoverished as breadwinners sicken and die. With the spread of disease and death, social bonds within and between families are weakened. The disease leaves in its wake an explosion of the orphan population. This and the shortage of teachers due to AIDS contribute to the disruption of education patterns and increase the likelihood that children will leave school early. Erosion of all the elements of civil society is inevitable in the face of the epidemic, weakening one of the main brakes on governmental excesses in Africa. With the loss of population, the economy languishes and growth becomes impossible. Finally, power struggles over the state's limited resources increase the likelihood of violent conflict.⁹

States weakened by the AIDS scourge are not just potential breeding grounds for internal conflict — they are also at risk of becoming what the Heritage Foundation dubs "slacker states," or "nations with lax laws or poor law enforcement, which unintentionally allow transnational terrorist groups to operate within their borders or permit state or non-state groups to obtain weapons or support illicitly from the private sector."¹⁰ Obviously, a state that has lost its monopoly on violence is in no position to police itself from terrorists — look at Iraq. This deterioration is why former Secretary of State Colin Powell proclaimed the fight against AIDS the "most important struggle on the face of the earth."¹¹

HIV/AIDS and the Church

Churches have largely been silent in the face of this struggle. The early theological attitude largely equated AIDS with immorality. Christian Aid, a human rights organization, has evaluated the early response and concluded: "AIDS was [seen as] a punishment from God, akin to the plagues which God inflicted on disobedient communities in Old Testament times."¹² This created an underclass of people in the Church, wherein there is supposedly neither Jew nor Greek and "all are one in Christ Jesus."¹³ Stigmatization prevented people from being tested and hindered education and prevention efforts.

When Jesus and the disciples met a blind man on the road, the disciples attempted to stigmatize his blindness, assuming it to be the result of sin. "Who sinned, this man or his parents, that he was born blind?"¹⁴ Jesus changed the old paradigm by answering "neither" before restoring the man's sight. Job's sufferings in the Hebrew Bible were not caused by unrighteousness. Certainly there are immoral behaviors, such as promiscuity, that put one at risk of contracting AIDS. However AIDS is also transmitted to faithful partners in covenanted relationships, and from mothers to children through the process of childbirth.

The Church must look with a forgiving eye and realize what it means to be the body of Christ — "If one member suffers, all suffer together with it."¹⁵ The Church has AIDS.

HIV/AIDS and Debt Relief

What does any of this have to do with the April 15-17 meeting of the World Bank/IMF? There is a connection between AIDS, poverty, and debt.

At the International AIDS conference in Durban in 2000, South Africa's President Thabo Mbeki famously attributed AIDS not to HIV but to poverty. His argument was mistaken by many in the West as ignorance of basic medical facts. In reality, Mbeki was pointing to a more systemic cause of the pandemic's spread. Both Louis Pasteur, who created vaccination, and Jonathan Mann, who founded the World Health Organization's Global Program on AIDS, noted that the social environment plays a significant role in the spread of disease.

[T]he environment in which any infection is transmitted is bound to be strongly influenced by crucial societal factors such as the levels of poverty, sanitation, malnutrition, environmental degradation, and access to preventive and curative case-to mention but a few In other words, pre-existing socio-environmental conditions play a key role in people's susceptibility to disease.¹⁶

Certainly there are behavioral factors that contribute to the spread of AIDS — that is not in dispute. However, HIV-positive people who live in poverty are unable to withstand opportunistic infections. People living in poverty are often illiterate and have little access to educational resources. In other words, AIDS is not spreading in Africa because there is something about African cultures or genetics that make Africans less able to control their sex drives.¹⁷ It is spreading because the conditions of poverty have always encouraged the spread of disease, and much of the African continent is very poor. "Today Africans account for one out of every four poor persons in the world — with four out of every ten Africans living in conditions of absolute poverty."¹⁸

It follows that in order to do justice in the struggle against AIDS, churches must stand against poverty. This is in keeping with God's will; never in the Bible are God's children given permission to be complacent about poverty. In Deuteronomy 15 we are told that there will never even be poor among us if we fully obey God's commands. The fact that some are poor is proof of our fallen state. Though we are fallen, we are not allowed to give up: God still tells us to give generously and be openhanded toward our brothers and sisters.¹⁹

In Christ, God gives us a model life of generosity and relationship with the poor. Often misconstrued are Christ's words to Judas: "The poor you will always have with you."²⁰ Jesus was not making a statement of fatalistic apathy, but quoting God's condemnation from Deuteronomy that allowing our brothers and sisters in Christ to be poor is a key indicator of our disobedience to the Father. In Luke Jesus begins his public ministry by quoting from Isaiah 61 that he has come to "preach good news to the poor."

This good news should come from today's body of Christ in two words: debt relief. Consider Zambia, which currently pays 30 percent more in debt repayments than on health. And Zambia's is not the only similarly burdened budget. Debt relief will enable AIDS-afflicted nations to more completely address the crisis within their borders by spending more on prevention/education and treatment. Behavior modification strategies are marginally successful and are only part of a comprehensive strategy — a strategy that must have aggressive debt relief as a central pillar.

Last updated 12 January 2009