Sunday, October 23, 2005

Stephen Lewis: Massey Lecture #1

I went to to see Stephen Lewis, the UN Special Envoy for AIDS in Africa, give the first of his CBC Massey lectures, at the Chan centre at UBC this week. He is one of my heros. In some ways he reminds me of Martin Luther King -- his combination of intellect, passion, and compassion. I met him when he signed my book afterward -- it was actually the second time I've met him -- and just being in his presence, I feel that the man exudes compassion and kindness. He greets everyone he meets with dignity and respect, even those with whom he sharply disagrees. He is what I aspire to be as a human being.

The title of his lectures is "the race against time," and it is fitting. The plight of Africa, which continues to be ravaged by AIDS and poverty, continues to eat away at him. The solutions are there and they are simple, yet governments and authorities continue to refrain from acting.

Here is a piece from Michael Valpy on the Globe and Mail on him:

The scene is the junior common room of the University of Toronto's Massey College. Stephen Lewis, the United Nations Secretary-General's special envoy to Africa for AIDS, is there to launch his book, Race Against Time, the text of the Massey Lectures he now is delivering in cities across Canada, which subsequently will be broadcast on CBC Radio.

The common room on a mid-October's late afternoon is packed and loud with talk. It is a come-and-be-seen event commensurate with Mr. Lewis's acquired celebrity status, filled with academics, writers, broadcasters, publishers, a thick slice of Toronto intellectual society jammed shoulder-to-shoulder over wine and canap├ęs.

You can't see Stephen Lewis, but you instantly know where he is. He is at the far end of the room behind a wall of students, three, four and five deep, hanging on his every word, all of them holding his book, gazing at him reverentially.

If the bureaucratic establishments of the UN and the World Bank and the International Monetary Fund and the U.S. State Department could see this scene -- this man many of them would love to see ousted from his job, being idolized -- it would, as Mr. Lewis might say with his trademark flawless diction, "upset them immensely."

Indeed, there is growing speculation that Mr. Lewis -- African AIDS envoy since 2001 and, before that, deputy executive director of UNICEF, Canada's ambassador to the UN and leader of the Ontario NDP -- has upset too many important people immensely, and is on the edge of being sacked.

He himself alludes to that possibility in his book, speculating that some of the things he has said may lead high-level UN officials and politicians to "exact retribution."

He has strongly criticized the U.S. administration and a number of Western and African governments by name -- the equivalent in UN bureaucratic etiquette to being flatulent at a garden party.

He has baldly trashed the policies of the World Bank and the International Monetary Fund.

He has verbally lashed some of the UN's top executives (Secretary-General Kofi Annan included, again by name) for being variously duplicitous and do-nothing while the HIV-AIDS pandemic destroys much of sub-Saharan African society.

He may, in fact, deny his critics the pleasure of seeing him fired -- by quitting.

In a conversation three days after his book launch, he talks of feeling emotionally beaten down by the hideousness of the pandemic he has witnessed over the past four years, and he wonders aloud if he is strong enough to remain at his job.

In the comfortably cluttered living room of the house in Toronto's leafy Forest Hill where Mr. Lewis, 67, lives with his wife, journalist and social activist Michele Landsberg, he struggles to make sense of the horror he sees on every visit to the continent.

He whispers statistics: The 40 million people infected worldwide -- 26 million in Africa. The millions, mainly young women, without access to treatment because the world won't pay for it. The 14 million children now orphaned by AIDS. The third of all children in Zambia who soon will be AIDS orphans. The half a million children who die each year, and yet not until a few months ago -- 25 years after the pandemic began in 1981 -- was the first pediatric treatment formulation finally worked out.

"I've often thought to myself that it's possible" -- he pauses for a long time -- "that you need a sturdier emotional psyche than I have. I mean, you know, I just can't take what I see on the ground. I just cannot take it. I am only one person.

"But I defy anybody to be able to take it over the long term. Because, you know, it's all so unnecessary."

His voice drops again to a whisper: "And they're all young women, they're all in their 20s and 30s. You go into a hospice, 25 beds, 23 of them filled by women in their 20s. You can't get the drugs to them in time. You know they're going to die in a matter of months. They all have children. You feel as though everything is out of kilter."

He says the HIV-AIDS assault on women has no parallel in history. "Women are the pillars of family and community -- the mothers, the caregivers, the farmers. The pandemic is preying on them relentlessly, threatening them in a way that the world has never yet witnessed. The virus threatens the very existence of women in some countries. I can barely talk about [the gender inequality] with equanimity."

He talks about the children.

"You go into a little community center for kids . . . and I remember this . . . you have a whole group of kids sitting in a little room. They look as though they're 4 or 5, they're all stunted, and they're really 8, 9, 10 years old, all HIV-positive, and there are no drugs. And you know these kids are measuring their lives in minutes. And you just wonder . . . why is this? How long can it happen? How long does it have to go on incrementally?

"It's just so bad. It's so awful. How do you get people to understand? How do you get things mobilized?"

Thus, Stephen Lewis -- who has established his own charitable foundation to fund AIDS projects in Africa, mainly for infected women, orphans and AIDS sufferers who have created their own support and education programs -- talks now about quitting.

Nothing, he says, is fixed. But he thinks maybe it will be next year after the biennial global AIDS summit is held in Toronto.

He says he is running out of steam -- those are his words. And when he is asked what the indices are of "running out of steam," he has a ready list:

"Crying too easily on public platforms.

"Awake at night with images in my mind.

"Tired." (No one who knows Mr. Lewis likely has heard him before say publicly that he is tired.)

"Apprehensive now about going to Africa and knowing what I'm going to encounter. . . . You meet people with AIDS, you make friendships . . . and then you come back six months later and they're gone."

He says: "I want to be around for the breakthrough. I want to feel this pandemic is going to come to an end at some point and I want to have been a part of that, of subduing it. But I'm not kidding myself. I think eventually" -- and then the words again -- "you run out of steam."

If steam is what Stephen Lewis is running out of, it is not happening quickly. Or even visibly.

His close friend and alter ego of nearly 50 years, Gerald Caplan, says: "It's no secret that the job takes an enormous toll. But for Stephen, it's not acceptable to give up. It's not acceptable to show despair or resignation. It's only acceptable to continue to inspire others to carry on the fight. Other than for his grandkids, that's why he exists. And that's what he does. True, too, though, every day is a test."

In the past few months Mr. Lewis has all but called the U.S. government recklessly negligent for tying its AIDS assistance money to Uganda to a condition that the country's public-health authorities de-emphasize condoms in their AIDS education programs.

When the Americans denied Mr. Lewis's accusations, he came within a hair's breadth of calling them liars -- something UN officials just don't do. There are persistent rumors out of Washington that the U.S. State Department wants Mr. Lewis removed from his post.

He has excoriated the World Bank and the IMF for imposing structural adjustment programs -- dictating how much African governments can allocate to social programs in exchange for loans from the two institutions -- that he says have crippled many countries' health and education resources.

He says the programs have resulted in one of the greatest wrongs in the fragile global South, the imposition of user fees for public education, with a resulting double penalty for the children of AIDS, orphaned by their parents' deaths and left in the darkness of ignorance by their financial inability to afford school.

In his book, Mr. Lewis writes that the World Bank and the IMF should pay the cost associated with abolishing school fees as "reparations" for the damage their policies have caused: "This is not some negotiable item. I am writing and speaking passionately about it because, every time I travel to Africa, I encounter orphan children who are desperate to be in school, who need friends and teachers and attention, who need one meal a day that could come from a school feeding program, who need the sense of self-worth that education could bring, who want so much to learn, and who are denied all of it because the costs of schooling are prohibitive."

He has criticized present and former UN officials -- for example, Carol Bellamy, former executive director of UNICEF and someone close to the U.S. Administration -- for publicly pledging to eradicate education user fees and then doing nothing.

He has accused UN executives, including Mr. Annan, of pledging to right the gender imbalance among UN senior staff, and the gender inequality in many UN programs and, most of all, in the impact of the AIDS pandemic -- but injecting virtually no substance into their promises.

He accuses the Canadian government of inexplicable hypocrisy in pledging to raise the level of its official development assistance to 0.7 per cent of the gross national product (it currently is less than 0.25 per cent), but refusing to declare a timetable for its accomplishment.

"The irony is that on an issue like HIV-AIDS in the developing world, Canada's record is excellent. The reality is that our initiatives on the pandemic are completely eclipsed by our failure on foreign aid."

He declares that there is no chance -- none, not a hope in hell -- that the much-touted Millennium Development Goals (which include reversing the spread of HIV-AIDS by 2015) will be attained unless all the world's wealthy countries raise their levels of official development assistance to 0.7 per cent. Which he increasingly doubts they will do.

He says the Group of Eight countries' pledge of $50-billion in aid to Africa by 2010 simply is not enough -- when the conservative estimate of the cost of sustaining and introducing new AIDS programs in Africa by that year will alone be $30-billion. The result, he says, will be as certain as night follows day: millions of people denied treatment; millions needlessly dying.

Time and time again in his book and in conversation, he returns to the theme of women bearing the brunt of the pandemic -- having no control over the sex they must submit to from "predatory" men, usually their husbands, who are HIV-positive; experiencing the frightfulness not only of becoming infected themselves but of infecting their children; being denied treatment by the hundreds of thousands, and finally dying at a young age and knowing their children will be left motherless.

Only 5 to 8 per cent of pregnant women in sub-Saharan Africa have access to PMTCT (Prevention of Mother-to-Child Transmission) programs, Mr. Lewis says. "This is a terrible deficiency. There is no excuse for this state of affairs" -- except the parsimony of the wealthy world and the empty pledges of its leaders.

"Because of the low access rates," he writes, "thousands upon thousands of babies are born HIV-positive who need not be infected; most of them die -- helplessly, pathetically -- before the age of 2. But for those HIV-positive women who have access to PMTCT, the program is a godsend.

"One tablet of the drug nevirapine during the birthing process, and the liquid equivalent within 72 hours of birth, and the infection rate is cut by 53 per cent."

He writes: "My own view is that the horrendous toll is yet to come. Countries will be fighting for survival 10 and 15 years down the road. It's simply impossible to tear the productive generations out of the heart of a country without facing an incomparable crisis."

He says: "I'm not some sweet innocent. I'm 67 years old. I've learned something about politics, diplomacy and multilateralism. I thought I understood the way the world works. I don't.

"I'll devote every fiber of my body to defeating this viral contagion, but I cannot abide the willful inattention of so much of the international community. I cannot expunge from my mind the heartless indifference, the criminal neglect of the last decade, during which time countless people have gone to their graves -- people who should still be walking the open savannah of Africa."

Will he get fired for his outspokenness?

Kofi Annan is believed to have come to Mr. Lewis's defense against the Americans over Uganda. A Canadian knowledgeable about the workings of the UN but speaking only on condition of anonymity, says the agency would not dare get rid of him.

"Everybody else [in the organization], including the Secretary-General, has criticized the UN recently, and then failed to introduce [Mr. Annan's] reforms. How could they pretend [if they went after Mr. Lewis] that they weren't just getting even because he named some names?

"I also think they know fully well how much personal support Stephen has throughout the world and how much trouble they'd be making for themselves if they turfed him."

As the conversation draws to a close in his living room, Mr. Lewis recalls the Massey College students clustered around him at his book launch. "They were sweet," he says.

Last year, 30 students from University of Toronto's law school approached him with an offer to do research on everything from women's property rights in countries with high AIDS death rates to intellectual-property rights in pharmaceuticals to the impact of user fees for health and education in AIDS-infected countries. Some of the papers were 50 to 80 pages long, Mr. Lewis says, and the quality was "so good, it's startling."

This year, there were many more law students volunteering to help than Mr. Lewis and his staff could use. And he cannot meet the demands from universities and high schools to have him come and speak.

Three weeks ago, he stepped onto an elevator in a Winnipeg hotel to go to the top floor. Halfway up, the elevator stopped, the doors opened, a man got on. The man looked closely at him. He asked: "Are you Stephen Lewis?"

Mr. Lewis nodded, smiled pleasantly. "Yes, I am," he said.

The man snapped at him: "My son is in Ethiopia because of you and I don't like it."

Young Canadians -- and likely young people elsewhere in the world -- have found a hero. Anyone who messes with Stephen Lewis better know that.