AIDS aid for Africa

A program aims at increasing cooperation between Israel and African countries on tackling the scourge of AIDS.

By JENNA HANSON
aids (photo credit: courtesy msr, sheba)
aids
(photo credit: courtesy msr, sheba)
ON A HOT OCTOBER MORNING, A DOZEN OR SO people gather at the Sheba Medical Center at Tel Hashomer, just outside Tel Aviv. They all appear to be somewhere in the very early to later stages of middle age, many are wearing short-sleeved shirts, some sporting baseball hats. Most of them are men, with only a few women. Huddled in a small hospital room, they crowd around a bed watching a medical simulation being performed on a lifesized dummy.
Comprised of medical experts in the field of AIDS from various African countries, including Uganda, Tanzania, Kenya, Rwanda and Zambia, this group is taking part in an intensive, week-long conference, which participants hope will lead to increased cooperation between Israel and African countries on tackling the scourge of AIDS.
The conference has been organized as a cooperative effort between the Israeli Consortium on AIDS Medicine in Africa (ICAMiA), composed of physicians from Hadassah Medical Center in Jerusalem, the Tel Aviv Sourasky Medical Center and the Sheba Medical Center, Project Interchange, an educational institute of the American Jewish Committee that brings experts from around the world to Israel for high-level seminars in their field and MASHAV, the Foreign Ministry’s Center for International Cooperation.
While most of Project Interchange’s seminars bring people from many corners of the globe and function as one-time events, this conference concentrated specifically on Africa with the goal of using the week as a kickoff for increased long-term Israel-Africa cooperation on AIDS work. The seminar was financed by the Paul and Balbina Schifter Memorial Fund, named for a couple who perished in the Holocaust and contributed by their grandson.
THE CONSORTIUM HAS ORGANIZED VISITS BY groups of Ethiopian health professionals to Israel for threeweek training sessions for the past five years. With representatives from six other African countries attending the latest seminar, the consortium plans to use it as a starting point for similar projects in many other parts of the continent. The participants come from countries suffering from severe AIDS crises and which are critically short of trained health professionals and health facilities. Israel has offered to assist with the training of additional personnel and to help expand existing healthcare facilities.
“We have been working on a project with Ethiopia for a long time,” Professor Shlomo Ma’ayan, director of Hadassah’s AIDS Center and founding member of the ICAMiA, tells The Report. “It started when we began to have a large number of Ethiopian immigrants in our clinic. We realized that we were accumulating experience…Though the Ethiopian population in Israel lives in a different environment and faces different issues, they do share many cultural norms with the population in Ethiopia. Thus we felt that we could offer health professionals in Ethiopia additional training from which they could greatly benefit.”
In 2005, Ma’ayan and three other doctors founded ICAMiA, with the intention of providing African academic institutions with assistance in the battle against the pandemic. The idea was to combine their medical experience and access to first-rate training and treatment with their cultural experience with Ethiopian-Israeli AIDS patients and their family members and develop training programs specifically fashioned for students and health professionals in Ethiopia who work in the field of AIDS.
Dan Turner, director of the Tel Aviv AIDS Center and another founding member of the ICAMiA, is in charge of sending Israeli medical professionals to Africa and bringing African professionals here for the training sessions. “The first AIDS outbreak in Israel occurred in the Ethiopian community,” he explains, adding, “The creation of the consortium was very natural. It just slowly developed over the years as our experience and knowledge increased.”
Those who founded the consortium, Turner says, did so because they understood that despite the differences between Israel and Ethiopia, much of their experience working with Ethiopian AIDS patients in Israel could be transferred back to Ethiopia. Ma’ayan concurs, saying that once their ability to help became clear, the natural next step was to begin trying to do just that. “When we were able to get funding for the Ethiopian project,” he tells The Report, “we began. The funding comes mainly from PEPFAR, the US President’s Emergency Plan for AIDS Relief, and the project is university- based, making it easy to recruit trainees and share research.”
SOBBIE MULINDI, DEPUTY DIRECTOR OF THE National AIDS Control Council in Kenya, is one of the seminar participants. Looking out from behind his rectangular rimmed glasses, he speaks intently in a soft, paced rhythm. “In Kenya, we have 1.4 million people infected with AIDS and 1.5 million people who have already died of the disease,” he states somberly. “There are 2.8 million Kenyan children who are AIDS orphans. The situation is dire. Israel is in a position to help us. Israel has a very high number of doctors – 20,000 for a population of 7 million, while in Kenya, we have only 2,000 doctors for a population of 40 million,” he tells The Report.
Mulindi continues, “Israeli doctors are helping us with treatment and dealing with the catastrophe. The visit here is for establishing links, it is just the beginning. We are being exposed to all kinds of research that is being carried out here, and it is very impressive. These are things that can really make a difference for us.”
Mulindi feels that if large numbers of Kenya’s health professionals have the opportunity to learn firsthand how treatment is carried out in Israel, it will greatly improve their capabilities to deal with the disease. In addition, he would like to see Kenyan students benefiting from Israeli training, which Kenyan institutions do not have the money to finance.
After noting the success of the Israeli- Ethiopian partnership in Ethiopia, Mulindi, who was put in touch with the Israeli team through PEPFAR, hopes a similar kind of cooperation will develop between Israel and Kenya. “We need expertise and highlevel training in AIDS research and care,” he says. “We are hoping to send students and doctors for training at the universities and laboratories in Israel. We are also hoping that at some point Israeli researchers will come to Kenya. Another area we would like to collaborate on is disaster medicine. We have seen Israel help with disaster relief in other parts of the world, and we can use this kind of assistance as well.”
Though most organizations that receive funds from PEPFAR are based in the United States, ICAMiA has been able to continuously renew its funding, and even hopes to receive significantly more money from the fund in order to finance the planned expansion of cooperation into additional countries in Africa. The next step is for the Israeli and African teams to work together on formulating specific requests for funding for programs that fit PEPFAR’s requirements. This will also determine the amount of money that they request.
The consortium was connected to PEPFAR by an American friend with ties to the fund. “It was Richard Schifter’s idea to expand the project,” says Turner, referring to the former US deputy secretary of state under Jimmy Carter. Schifter, an American Jew who is now a Capitol Hill lobbyist, works with the American Jewish Committee and is Chairman of the Board of Directors of the American Jewish International Relations Institute.
“This goes back to 2003, when the PEPFAR program was first announced,” says Schifter, 87, from his home in Washington, DC. His crisp, youthful voice gives no hint of his age. “At that time it occurred to me that this would be an opportunity for Israel to play an important role in dealing with the HIV/AIDS problem in sub- Saharan Africa. As the program was getting underway, I went to various agencies to discuss the possibility of Israel becoming involved. I then shopped around for someone in Israel who might be interested in the matter, and finally got to Shlomo Ma’ayan. We connected and agreed that given the fact that Israel has experience in dealing with HIV/AIDS in the Ethiopian population, we should start there.”
Since then, the consortium was established and the Ethiopian project begun. Two years ago, the consortium, along with Schifter, began to think about ways of expanding the project into other African countries. At the time, their ideas did not match PEPFAR’s requirements and nothing materialized. According to Schifter, PEPFAR is now looking specifically to fund projects that will help build medical institutions and introduce policies that will reduce the incidence of AIDS in sub-Saharan African countries.
“The PEPFAR program is now under specific instructions to train 140,000 health personnel over the next ten years,” explains Schifter. “So we wanted to develop programs that would fit into their new approach. After we realized that this is what the emphasis should be, we suggested an exchange of ideas between the Israeli group and high-level health professionals in Africa in order to discuss the possibility of adding to health institutions and programs in these countries.”
This is not the first time that Israeli health professionals have worked on AIDS-related matters with African countries. Aside from the consortium’s project, which has brought Ethiopian health personnel to Israel for training for the past five years, Dr. Dan Engelhard, director of the Paediatric Department at Hadassah and another founder of the ICAMiA, started a program with Ethiopian children living with HIV/AIDS. Through this program Israeli volunteers travel to Ethiopia to help treat these children and provide mentoring for Ethiopian professionals who work with them.
Last year a group of Senegalese doctors spent a week in Israel learning about adult male circumcision, a procedure which studies have found to significantly reduce the chances of HIV contraction through sexual intercourse. This is also a procedure in which Israel has had to develop expertise due to the conversion process, involving adult circumcision of large numbers of immigrants from the former Soviet Union to Israel. In 2007, Israel also sent a team of doctors to Swaziland in southern Africa to train local doctors in circumcision procedures.
PRIOR TO THEIR VISIT TO THE SHEBA MEDICAL Center at Tel Hashomer, the group toured holy sites around the Sea of Galilee. Earlier they spent several days in Jerusalem, where their time was divided between lectures by health experts at the Hadassah Medical Center, tours of the city and talks on the political situation by politicians, journalists and academics. The Project Interchange schedule provides the participants with professional training as well as a taste of the complexities of Israeli society.
Some may see this cooperation as an opportunity to highlight Israel’s positive side. Turner observes, “Some people promote the project because it shows that Israel also does good things in the world.”
But Haim Divon, the Foreign Ministry’s Ambassador At Large for International Cooperation, says this is not the case. “Most people in the world don’t know about this work that we do, so it does not help our reputation,” he asserts, adding that Israel has been involved in aid work of one type or another since the 1950s. “Much of the aid goes to Africa, though we send aid and teams to places all over the world where help is needed. It started with agriculture, with our solution to water shortage problems,” continues Divon. “Our work on dealing with water shortages is the real agricultural revolution of our time, and the methods we developed to deal with such problems have helped many other countries with similar issues.”
Schifter agrees, saying that there are two main reasons for Israel to partake in such work. “Number one, this accomplishes the provision of significant humanitarian assistance, keeping in mind that Israel is unusually well-qualified to perform this particular role. The other aspect is developing improved relations with countries in sub-Saharan Africa, which is a continuation of the efforts being undertaken by MASHAV, much of which are in agriculture.”
The doctors involved in the consortium also deny any motives other than simply helping those in need. “I don’t think about those things,” Turner insists. “I identified a need and an opportunity to help, so I decided to act on it. To tell you the truth, it may sound stupid, but we do it out of Zionism. It takes a lot of time and effort on our part and we do it because we want to do well, simply because we believe in it,” he continues earnestly. “We believe that if we have something to give, we should give it. Call it Zionism or call it humanitarianism. We have no other reason to be involved in these projects.”
Ma’ayan explains his motives with the simple statement that it is his “duty” to help where he can. Like Turner, he sees this cooperation from the point of view of an individual person with something to give. “We hope to train 4,000 African health workers in the coming years, to assist them with making their hospitals more efficient, and we want to deal not only with the disease itself, but also with issues that are related to AIDS. For example, things like prevention are very important when dealing with AIDS,” Ma’ayan asserts.
Yet he does say that his clinic also stands to benefit from the cooperation, and sees it as more of a barter than a gift. “They gain training that really helps them,” he says, “and we gain a reputation and a name in the field of AIDS work. These are things that can really help us too.”
Mulindi says that the political situation and conflict in Israel do not matter when it comes to the work he hopes to do with his Israeli colleagues. “I have no reservations about working with Israel,” he explains. “As physicians, we are above politics. Our job is to help people with disease and suffering. That is all. This work goes beyond political conflicts.”
YET WITH THE INCREASING INTERNATIONAL CRITIcism of Israel, the question of whether Israel is looking to Africa in order to augment dwindling relations with other countries remains. Dr. Arye Oded, professor of African Studies, researcher at the Hebrew University’s Harry S. Truman Institute for the Advancement of Peace and former ambassador to several African countries, says that relations with Africa have always been important to Israel.
“We have had strong relations with African countries since the state’s early years,” he explains to The Report, “as we were among the first to give them major assistance with agricultural issues. Relations with Africa are very important not because of recent political developments but because of the attempt by Arab countries to isolate Israel. The more countries with which we have diplomatic relations, the better we can fight against such isolation attempts. This is nothing new. These relations do not replace any others. They have always been important to Israel.”
According to Oded, Israel’s ties to Africa faltered after the 1967 Six Day War, and took a drastic dive after the 1973 Yom Kippur War, when pressure by Arab states in the Organization of African Unity caused most African countries to sever diplomatic ties with Israel. “Yet they began to look to Israel again in 1982,” he recalls. “Zaire was the first country to restore diplomatic relations with Israel, after the return of the Sinai to Egypt, and many other countries followed suit. They had hoped for much more help from the Arab oil countries,” he continues, “and their disillusionment brought them to look back towards Israel.” Today, almost all African countries apart from Arab North Africa have re-established ties with Israel and bilateral relations with most of them are quite strong. Trade between Israel and Africa is increasing, especially in the high-tech and construction sectors. Despite this, on a multilateral level the African bloc largely continues to vote against Israel in the United Nations. However, says Oded, “Israel’s policy is generally that the aid we give is not dependent on voting. We hope to work out this issue over time, but we do not tie the aid to the voting patterns of the African bloc.”
Thus Israel continues to cultivate its relations with many African countries despite their voting tendencies. As Oded explains, “these relations have simply always been important to Israel as a way to neutralize the ostracizing of Israel in the international community.
Oded further alludes to the more complex nature of Israeli aid to Africa. “Unlike some Western countries,” he says, “most African countries put themselves first when making foreign policy decisions. Thus, they continue their relations with Israel – and the Arab countries – without looking into the politics of the conflict. They make pragmatic decisions and continue to cultivate all relations from which they benefit. So while European countries may feel they need to take a stand, most African countries are happy to do business with us and with the Arab bloc, as long as this business helps their development.”
Divon also notes that Israel is under some pressure to give more aid since being accepted into the OECD, the Organization for Economic Cooperation and Development, which brings together most of the world’s most developed nations for the purpose of economic cooperation and the promotion of democracy. “The goal for OECD countries is 0.7 percent of the country’s GDP. We are not there, but we are trying to get closer.”
In fact, Israel is very far from that target figure. According to a Foreign Ministry Situation Assessment from 2009, Israeli foreign aid comprised only 0.068 percent of its GNP in 2007, while the average for OECD nations in the same year was 0.46 percent of GNP. For Israel to match the OECD average, it would need to increase its foreign aid expenditure sevenfold. Furthermore, since the AIDS project is funded by PEPFAR, the money is coming from abroad and not from Israeli funding.
AIDS in Israel
◆There are approximately 5,100 people suffering from AIDS in Israel.◆ The prevalence of AIDS in the adult population aged 15-49 is: 0.1% (compared to 0.6% in the United States).◆ There are approximately 350 new infections every year.◆ First Israeli to die of AIDS: 1983.◆ So far less than 200 Israelis have died of AIDS.◆ AIDS first affected the Ethiopian immigrant population and is prevelent among the male homosexual population.◆ Most complex population to treat: foreign workers who do not have health care coverage.
J.H.