TCS Daily


How Stripping Spreads AIDS

By Peter F. Schaefer - August 23, 2007 12:00 AM

At the most recent G-8, one of the few substantive outcomes was the commitment to increase funding for AIDS to $60 billion. Before the Summit, President Bush announced his plans for a doubling of AIDS funding for, mainly, Africa. His plan - called PEPFAR - will be increased to $30 billion. Although criticism has come from AIDS activists who want more, both houses of Congress and both sides of the aisle are praising this initiative so it looks like a done deal.

However no one in the US government and few in the anti-AIDS community are dealing with a major issue in the transmission of AIDS called "property stripping." Since the cure for property stripping is cheap, technically quite easy and would have an enormous secondary impact on economic growth (poverty is a hidden vector of AIDS) it would seem like a sure thing for attention. But it is virtually ignored.

The Problem of AIDS

One of the most successful pediatric AIDS programs in a poor country has been created in Romania by Michael W. Kline at Childrens Hospital in Boston. He reports that medicine is not the real issue. His biggest problem is the nearly non-existent medical infrastructure; no personnel, equipment, clinics, and hospitals. Yet the headlines are about medications and the denial of patent rights of drug manufacturers. The head of World Health Organization's HIV Division, Kevin De Cock, is quoted as saying "It is very obvious that the elephant in the room is not the current price of drugs. The real obstacle is the fragility of the health systems. You have health infrastructure that is dilapidated, and supply chains that don't exist."

On World AIDS Day two years earlier Dr. Jim Yong Kim - De Cock's predecessor - said,

"In sub-Saharan Africa almost 60 percent of AIDS sufferers are women [and] in some settings ... we are finding ... that the number one risk factor for women in becoming infected with HIV is marriage. [And] married women have the highest rates of HIV infection. We have to take on some of the most fundamental and difficult cultural and social issues that are definitely affecting the way this epidemic is spreading. And ... if we can take on things like for example, property rights [so] women can inherit the property of their husband if [he] dies, that really reduces the likelihood of them getting into sex work for example. If we can ... change laws, change fundamental beliefs and culture by [getting] people the right kinds of prevention messages we will have done a lot not just for HIV AIDS but for issues like gender equity that have been with us forever."

In the scholarly literature, the traditional practice of the husband's family inheriting all his property after he dies is called "property stripping." In normal times, this had some logic; the husband's family had responsibility for the widow and her children, a brother often taking her as a second wife and so assuming responsibility for his nieces and nephews.

But things have changed. In the time of AIDS, the widow is likely also infected with the HIV virus, though not yet sick since her husband often gets it first and the disease is less advanced in her when her husband dies. So even if her brother-in-law hasn't died from AIDS himself, he is not willing to marry someone infected with HIV. And often the brother-in-law himself is sick or dead. Nevertheless, the family often still follows custom and seizes her house and farm and so she has no recourse but to turn to menial jobs, begging or prostitution. And since she was infected later, she may have years to spread her illness to her sex partners which are commonly many a day.

In a Washington Post editorial by Richard Holbrooke, published after Dr. Kim's NPR interview, he noted that increased testing and detection efforts was the "only effective prevention strategies can stop the spread of AIDS." He goes on to point out that "...monogamous women [are] thrown out of their homes for a disease they got from their husbands."

The Strategy

Last summer the 16th International AIDS Conference was held in Toronto. It will be interesting to see how the people attending World AIDS Day annual meeting in December will react to the President's announcement. In addition to the US contribution, there are billions more public and private dollars coming into HIV research and AIDS treatment. What strategy will the AIDS community employ in the coming year to spend those billions? Knowing their strategy will tell us a lot about how this money will be spent. Will they, for instance, craft a global strategy to help support the Dr. Klines who are battling AIDS successfully? Or will they support the recent decision of Brazil and Thailand to cancel patent protection for AIDS drugs? As an article in the Wall Street Journal notes; "...the thing that mattered most [is] the state of the Thai health-care system, which was suffering from hospital closures and staffing shortages. Without hospitals and doctors, cheap drugs will do little good."

Legislation was recently introduced in the EU parliament aimed at allowing governments to issue "compulsory licenses" for drugs and if history is any guide, the AIDS community will support efforts to suspend patent protection but do absolutely nothing about property stripping, not even discuss it.

Solutions from the AIDS Establishment

As someone working in the property rights area, learning of Dr. Kim's recognition that property was a major problem was very exciting. It gave me and my colleagues an opening to help with a problem as profound as AIDS. So I began researching the medical literature and monitoring AIDS conferences looking for details of the AIDS community's response to the terrible problem of property stripping.

At the Toronto Conference, there were 16,000 attendees, 4,500 peer-reviewed papers, 16 plenary sessions, 24 formal meetings and hundreds of smaller sessions. But if you had attended it you would think the only options are education, testing and pressuring drug companies to give up their property rights to medical patents. But since property stripping is recognized by the WHO as a major problem, surely it would be an important focus of the conference. Well, searching the main website with the word "property" I came up with one hit which was guidelines for protesters about their treatment of the conference property. Searching abstracts of conference papers concerning "property" going all the way back to 2000 conference, I came up with 16 hits, 14 of which were about the intellectual property of drug companies, not the property of infected widows. And the two papers that were about tangible property did not mention property stripping at all but, rather, addressed the issue of orphans whose parents died without a legal will.

However, people who are able to make legal wills are only that very small percentage of elites' families with formal property holdings. This class of people who can write wills - in fact who even have formal property subject to law - is nearly always less than ten percent of the total population and applies to virtually no poor families, who are those most affected by this disease.

I then went to the WHO website and put "property stripping" into the search engine. I got back one hit; a UNAIDS/WHO paper which mentioned property stripping but mainly in passing. In 2006 Oxfam's website "Land Rights in Africa" (which no longer exists) listed fifteen papers. Most were not about property stripping, a few mentioned it in passing and only one or two did substantial analysis. Although these few papers acknowledge the seriousness of this issue in sub-Saharan Africa ("the worst-hit part of the world") it had no actionable recommendations ("protect women's inheritance and property rights...raise awareness and sensitivity...educate..."). Okay, we agree it's a good idea but how do you do it?

So I expanded my screen and just asked for "property." Success, 6540 hits. But after going through the first 400 citations it seemed clear that this, too, was all about intellectual property rights, not real property rights. How do you take property rights away from drug companies, not how you give property rights to the poor.

Lack of Solutions

If it is such a large problem how can it be ignored year after year? By the end of 2007 the US will have committed $30 billion to combating AIDS, mostly in Africa. Surely the importance of property rights is not some abstraction to US policy-makers.

The least critical explanation is that no one can figure out a solution and so they can't discuss doing something that can't be done. But, in fact, there are credible solutions and both Dr. Kim and his broadcast partner, AIDS expert Frank De Palomo, had a key part of the solution subsequently explained to them but showed little interest.

I believe that the actual explanation for this omission is less benign than short attention spans and misplaced priorities. Correcting property stripping is a political solution and most activists operate on the sufferance of governments that are mainly authoritarian. So they stay away from politics (the Government of South Africa only recently acknowledged that AIDS even existed in their country, so obviously the disease itself is highly political).

However, the AIDS movement itself is very political and with tens of billions of dollars at stake it is even more likely that the whole AIDS problem has become politicized within the movement as researchers and activists carve up the pie for their own particular interest, and property issues don't fit into the calculus of its leaders. Moreover, it is politically correct to attack large pharmaceutical companies, in part because private property in general has been somewhat malodorous to progressives since Marx poisoned that well nearly two centuries ago. The papers reviewed talked more about land reform (read "redistribution") that protecting existing property rights.

The AIDS community talks endlessly about women's rights so why are they so silent one a problem which the community itself identifies as vitally important? The real irony is that solving this problem is politically correct in every aspect. A solution for property stripping will help widows and orphans and expand women's rights for every woman, whether affected by AIDS or healthy widows. Money is power and having control of their homes is a source of personal, social, political leverage that African women sorely lack today.

Despite his own identification of the gravity of this problem Dr. Kim and WHO seem to have done nothing at all to deal with it, while the leading global expert on property rights could not get a meeting with the former AID Administrator Randall Tobias when he headed up the AIDS office in USAID. Another inconvenient truth, perhaps?

Outlines of a Solution

One of the papers in the WHO archive was prepared by the World Bank. It is a discussion of property in the Palestinian Territories. Though not about property stripping, the paper notes, "in many areas of the developing world, land and property....is a common means of storing wealth," and so titling and land administration is critical.

Much of the effort of the AIDS community is expended on taking away intellectual property rights, while ignoring the property rights of truly poor, destitute women whose survival strategies have become a major vector of the HIV virus. The donor nations have enormous leverage and American leverage has just been doubled.

Creating property systems based on law - titling and registries - is technically simple and requires very little money. There are dozens of large US firms who do this kind of work all over the world and the systems need not be funded by aid but can be self-financing. Changing laws requires political capital not cash. But as with much of Western aid, writing a check is far simpler than actually effecting change.

Peter F. Schaefer is a businessman and business consultant who has worked in over 50 countries and in the US government from time to time since 1970.


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4 Comments

property stripping
Good article pointing out a problem that many of us have been talking about for decades; no property rights in africa. But the left wingers in the NGOs, UN, etc don't really like property rights, so why would they bother about this? I should say, they're only concerned with their own property, but with regards to the populations there, they are more interested in control, and victimizing them. So what africa needs is not another trillion or so in free aid, but actual capitalism, property rights, free markets, rule of law.

Wealth, Property and Freedom
The accumulation of property is the acumulation of wealth and thus Freedom and Security. Like it or not without the ability to own property and thus create wealth we have no ability to govern our destinies.

Take note for there are people in the US whom would also take out wealth and property. Not for some tribal tradition but for the "common" good. Thus we would be mere slaves to the state. The reasoning may differ but the outcome is the same. Wealth is power.

Shared society anyone?

Property
The NYT had an interesting article on Niger and property rights some time ago. In Niger, Trees and Crops Turn Back the Desert. Trees are technically the property of the state and as such were supposed to be cared for by the state forresters. However, about twenty years ago a group of farmers started treating the trees as if they owned them. They started to preserve the trees and harvest the leaves and fruits as a crop. Widows even took this on themselves to earn a living. The article shows that property rights have led to the greening of parts of Niger.

good e.g.
Good example, although I'm surprised the left wing NYT would even publish anything that supports capitalism. Another good source on this topic are the books of Hernando de Soto. But most governments don't really like it that people own everything; even in the US. Thus you see gross distrotions like the government getting into the slumlord business and creating those filthy ghettoes they quaintly called 'projects'.

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