Bloodborne HIV: Don't Get Stuck!

Shaming people for their alleged sexual behavior has deadly consequences for everyone infected with HIV and anyone engaged in behaviors said to result in HIV transmission, or claimed to be so engaged. Given the weight of evidence against the sexual behavior paradigm of HIV transmission (which, mysteriously, only operates in high prevalence African countries), why does the industry still use it to prop up every campaign?

When HIV was identified in several US cities in the 1980s, it was mainly found among men who had sex with men (MSM), injecting drug users (IDU) and people who received blood products or transfusions that contained the virus. Now, 40 years later, the largest proportion of people in those same US cities with HIV are MSM, with IDUs a distant second.

A few years later, when HIV started to spread rapidly in African countries, such ‘high risk groups’ did not account for the highest proportion of HIV transmissions. Rather, prevalence was higher among people who were not MSM or IDUs. Prevalence was high among a group often referred to as commercial sex workers (CSW), or just as sex workers. But it’s not clear that these were coherent groups of people who self-identified as sex workers, or if they were assumed to be sex workers by those collecting data, on the basis of their HIV status.

In fact, many of the people infected with HIV early on in the epidemic in African countries which subsequently experienced the highest prevalence rates in the world were more closely associated with healthcare than with high levels of ‘risky’ sexual behavior. Women who gave birth in health facilities, even clients of STI facilities, were infected in very large numbers. And that is still the case. Most people infected do not engage in any kind of risky behavior. Their infections are unexplained by the prevailing paradigm.

From the 1980s onwards, very high transmission rates in African countries tended to be found in cities, within the compounds of employers of large numbers of people, such as mines and other labor-intensive industries, close to well-developed infrastructures, in the vicinity of large hospitals, and in areas and countries where healthcare was accessible to all or most people. Examples of this are South Africa, Botswana, Zimbabwe, Zambia, Swaziland and Lesotho, mostly in Southern or Eastern Africa.

In contrast, most countries, even on the African continent, experienced lower transmission rates. Transmission rates in countries in the north of the continent, especially those on or overlapping with the Sahara, were, and still are, lower than in many US cities. Isolated areas, places where healthcare facilities didn’t exist, or were not used by most people, remained relatively free of HIV. Even in countries where HIV prevalence was very high in some areas, it remained low in isolated areas. Examples are Kenya, Tanzania, Uganda and others, where there are only a few high prevalence hostpots.

So why did the HIV industry play the LGBTQ and promiscuity cards in countries where neither MSM nor sexual behavior seemed to be the biggest risk for HIV transmission? If the industry wanted people in African countries to reduce transmission, they would have had more success if they had encouraged healthcare facilities to figure out why they seemed to be the source of a lot of infections, perhaps a majority. The funders of healthcare (and HIV) would have been ideally placed to insist that an appropriate proportion of funding be spent on healthcare safety, or to withdraw the funding if it was not.

Some transmission may have been a result of sexual behavior, although probably not the sexual behavior of most people, which tended to be conservative. And MSM sex does occur, despite western ‘experts’ initially claiming that it was rare in ‘African’ countries. But successive Modes of Transmission Surveys have shown that infections among these higher risk groups make up only a small proportion of total infections.

All people infected with HIV, young women, men, married or single, those engaged in sex work, or alleged to be so engaged, every MSM, including those alleged to be gay, prisoners and almost everyone else in high HIV prevalence countries suffer the consequences of the continued association of high HIV prevalence with promiscuity and with MSM.

An article in SciDev.net trots out the tired old fictoids, about homophobia threatening ‘HIV progress’, about HIV prevalence being “higher in countries with laws that criminalize homosexuality”, and the insinuation that this “could impact foreign aid to Uganda”.

The deep homophobia that we see in Uganda and other high HIV prevalence countries didn’t exist in the 1980s. The bill (the ‘Bahati Bill’) that initially proposed lengthy sentences and even the death penalty was supported by US evangelical Christians. The spite towards ‘sex workers’ and people who were perceived as being promiscuous was a continuation of long-held prejudices about ‘African’ promiscuity, dating back to the Eugenicists, and beyond.

The worst HIV epidemic in the world is in South Africa, where as much as 20% of the global population of HIV positive people live. Yet, homosexuality is not criminalized there. In contrast, HIV prevalence in most North African countries is lower than that found in many western countries and in US cities where HIV prevalence has been high since the 1980s, although homosexuality is criminalized in most North African countries. Many countries where homosexuality is criminalized are also countries with low or very low HIV prevalence, such as those in the Middle East, Central Asia and elsewhere.

Numerous Aids Indicator Surveys and Demographic and Health Surveys show that most people in all countries, on every continent, engage in relatively low levels of sex, ‘risky’ or otherwise. Some people engage in high levels of sex, sometimes ‘risky’ sex, in every country. Among MSM, only some are ‘promiscuous’ and many take precautions to avoid infecting others or being infected with HIV. Outside of sub-Saharan Africa, people engaged in sex work are unlikely to be infected with HIV unless they are also IDUs or have some other, non-sexual risk.

Playing the promiscuity and LBGTQ cards is what drives the increasing homophobia seen in countries like Uganda. Obama and Cameron threatened to reconsider HIV funding after the Bahati Bill was proposed and Museveni, predictably, said they could keep their funding. This SciDev.net article seems to be reiterating that threat. It was the HIV industry that built itself up around prejudices and issues that the legacy and trade media will always report assiduously.

If SciDev.net and the HIV industry in general are genuinely interested in addressing HIV transmission, after dithering for 4 decades, they could start asking some of these questions that have long demanded an answer. If only some HIV transmission is accounted for by sexual behavior, including MSM sex, how is the rest to be accounted for? If that question is not answered then HIV transmission will continue through the industry’s next ‘target’, 2030. 

Winnie Byanyima, head of UNAIDS, wrings her hands about racism and stigma, and the title of the article points the finger at ‘Big pharma’. But that’s not quite accurate. Big pharma will take money from anyone, not just people in sub-Saharan Africa (SSA). The characterization of HIV as a primarily sexually transmitted virus in sub-Saharan Africa is one of the main sources of stigma. The consequent grouping of HIV positive people according to their assumed or alleged sexual behavior is one of the main sources of racism and sexism. The source of the prejudice is institutions, the UN, development finance, academia and others. 

The executive summary of the 2022 Global Aids Update claims (in a pie chart, page 15) that 97% of all HIV positive people in SSA were infected through sexual contact. Over 40% are said to be infected through sex work, either because they are (alleged) sex workers or (alleged) clients of sex workers. And a whopping 49% are part of the ‘remaining population’. Which means, if they were infected sexually, they must engage in extraordinary levels of ‘risky’ sex (although it looks as if UNAIDS can’t convincingly explain how they were infected, they just publish data attributing it to some kind of sex). 

The population of HIV positive people in SSA is 1.94%, overall (23,500,000 people living with HIV; 1.21b people). Many HIV positive people are either not sexually active, not engaging in any kind of sexual contact with a HIV positive person, or only engage in ‘safe’ sex. A relatively difficult to transmit virus, at least sexually, infects about 23,500,000 people, mostly in a few parts of several countries, the vast majority of those being in about 10 countries in eastern and southern Africa. So why target the entire 1.18b people in SSA when you could target these ‘hyperendemic’ hotspots? (Of course, 1.18b is a much bigger market than just 2% of that, so that’s a good reason.) 

But UNAIDS (and therefore Big pharma, BINGOs, funding, healthcare, and anyone else with a share in the industry) target those who are infected with HIV, regardless of whether they are ‘key populations’. (In case this is beginning to sound like a circular argument, I can assure you that it is.) Being HIV positive is used as a proxy for ‘engaging in some kind of risky sex’; and engaging in sex of any kind, or being assumed to do so, attracts the blanket behavior change communications and other finger-wagging interventions that many people in SSA have grown up with. That means the entire sexually active population of SSA is considered to be ‘at risk’. 

When Big pharma came up with their ‘Pre-exposure prophylaxis’, (PrEP, the use of antiretrovirals by HIV negative people to reduce the risk of being infected), they targeted anyone engaging in sex, or alleged to be engaging in sex. PrEP was designed for people who identified themselves as belonging to a group that faced a higher risk of HIV transmission. It was developed in wealthy countries, where the behaviors involved are not as deeply stigmatized as they are in many parts of SSA. Big healthcare came up with mass male circumcision because the US believes it is ‘hygienic’ (with all the racist overtones of that word). Big NGOs were already deeply involved in ‘behavior change’ programs, which date back to a time when eugenics was openly referred to as science. 

But there is something very simple that Byanyima, UNAIDS and others in the industry can do: they can target the places or broader environments where all the bigger sub-epidemics can be found. They can consider the circumstances in which people live that may make them more susceptible to infection with HIV or other serious diseases. HIV positive people in the worst hit hotspots have things in common that have nothing to do with their individual sexual behavior. Cities, places with relatively good infrastructure, accessible and widely accessed healthcare facilities, high population density areas, big employers and various other factors have been closely associated with some of the highest rates of HIV transmission. 

In contrast, most people in most countries engage in some kind of sexual behavior, some in high levels of sexual behavior, and some in high levels of ‘risky’ sexual behavior. But there is little evidence that sexual behavior patterns are unprecedented in SSA, even less so in HIV hotspots. Pointing the finger at sex and implying that being HIV positive strongly suggests that people’s HIV status is a result of their individual sexual behavior is the source of the stigma associated with HIV. Big pharma and other players in the industry merely adopted UNAIDS’s and academia’s scattergun approach. If you brand the entire population of a sub-continent as promiscuous, you can’t then qualify your actions by adding that you do so in a completely non-stigmatizing way. 

More women than men are infected with HIV in SSA (although far more men than women are infected outside SSA). So, the pie chart claiming that 97% of HIV positive people were infected through their own individual sexual behavior reflects the anti-woman and institutionally sexist strategy of UNAIDS and the industry. African men are stigmatized as predatory. Some men may be, but predatory behavior is not confined to SSA, nor to high HIV prevalence hotspots. UNAIDS and the rest of the industry, including academia, and legacy media who depict HIV as a predominantly sexually transmitted virus, but only in SSA, are upholders of this stigma, institutionalized sexism and racism. 

UNAIDS has been around for nearly thirty years and was set up by people who had already worked with HIV for the 10 years since it was identified. The groups most affected by HIV in the 1980s in SSA were often self-identified as sex workers, sex worker clients, and the like. These are groups that had been targeted by healthcare practitioners for decades to address sexually transmitted infection and contraception. Other groups that were infected with HIV early on include women giving birth in healthcare facilities, antenatal care clinics and similar. Some of the biggest outbreaks of the mid to late 80s and early 90s are the hyperendemic hotspots of today. 

UNAIDS and other institutions that have been working with HIV in SSA from early on, or from the very beginning, know better than anyone how misplaced the stigma is. They know more than most about the conditions people live in, and what their health determinants are. They collect the figures showing that individual sexual behavior cannot account for any of the massive rates of HIV transmission that occurred after HIV was identified (not before). If anyone knows what happened, UNAIDS and all the other institutions working in the epicenters of HIV in SSA should, because they were there. A lot of these epicenters are healthcare facilities. They are still operating and can still be investigated. 

If there was an outbreak of a potentially deadly virus, one that has been a headline ‘pandemic’ in the past, you’d expect to see it emblazoned across the mainstream media. Their health correspondents would be drooling over exotic offerings from the usual experts, Drs Piot, Ferguson, Fauci, people from WHO, CDC, SAGE and others.

There would be dire predictions based on complex (but highly mysterious) ‘models’, all ‘international’ coverage would be echoed around the ‘social’ media sector of the mainstream media. There would be titillating stories about lurid practices alleged to give rise to this virus, which must have come from ‘somewhere else’.

If the case fatality rate was higher than 40%, compared to the 0.04% death rate recently estimated from monkeypox virus, and the virus in question this time was Ebola, you’d expect to hear more about it than we have heard about monkeypox virus, right?

But not when it occurs in Uganda, it would seem. Whether you read the fairly cautious Infectious Diseases Society of America’s report, or the Wikipedia coverage (now that they and their peers have fallen in with the mainstream when it comes to well branded epidemics and pandemics), the current outbreak in Uganda is extremely serious.

There are a few other media stories, but this has not been deemed worthy of front page coverage or breathless interviews with people in spacesuits ‘on the frontline’. Weren’t we promised vaccines during the ebola epidemics in several West African countries a few years ago?

Media coverage of disease outbreaks and other disasters has no correlation with the severity or extent of the occurrence. What determines worthiness to be graced with genuine concern and attention?

The Felicific Calculus used by international institutions and global media has decreed that all the bad things in the world, whomever or whatever may have been blamed for them in the past, are now almost entirely accounted for by Covid-19. The world of ordinary people knows that the calculus is a hoax, and that poverty, sickness, disability, economic and environmental collapse, anything that is getting worse since the pandemic started, are a result of the response to it, not the pandemic. 

The English Guardian churns out another clickbait article, deeply concerned about the effects of Covid-19, seemingly oblivious to the fact that every item ticked off in their spreadsheet predates the virus by decades, even centuries. Other media have jumped in with organ trafficking, persecution of people with HIV, family planning provision, availability of sanitary pads, teen pregnancy, child abuse, domestic abuse, female genital mutilation (sic), child marriage, orphans and much else, striving to update their advocacy with the latest hashtags. 

And the universal solution to all these problems is technology! There are vaccines, masks, hand sanitizers, handheld computers and anything else that can be sold to people who have lived their whole lives without access to running water, an adequate and varied diet, in environments that have been depleted, to a large extent, by the same countries that produce all the technology and the purported solutions and their array of placebo suppositories. 

For the Guardian, decades of progress on extreme poverty is now in reverse due to Covid, so the title goes. But much of the ‘evidence’ for this is from a World Bank wonk, who pours out the usual sanctimonious spiel about all the great things that have been achieved, but that are now threatened by a pandemic. They are not threatened by a pandemic, they are threatened by the response to it. 

Bear in mind, this is the institution to which almost every poor country is in debt. Much of those countries’ annual earnings is sent to repay loans they have been persuaded to take over a period of several decades. A handful of international institutions have pushed poor countries to reduce public sector employment, spending on health, education, infrastructure and social services. Indeed, they have ensured the destruction of the very things that they now claim are vital to address Covid-19: hospitals, schools, infrastructure and social services. 

Poor countries are arm-twisted by such international institutions into handing over all resources that are of value to multinationals. Multinationals are not content to rip out everything they can get their hands on, but will happily destroy environments, communities, water supplies, economies and anything else, and leave behind an enormous tab for the host to pay. The very means to survive for most people, fertile land, water, food, employment, agriculture, etc., are denied to those countries in the name of modernization and development. 

The World Bank knows more than most about the conditions in poor countries, because they have spent so long reducing struggling economies to rubble. Countries that had anything worth exploiting were, effectively, colonized by poverty profiteers, people who were paid to take what they wanted, and often took a lot more. Media, like the Guardian, dutifully cover ‘disasters’ as if the damage they wreak on increasingly vulnerable populations is entirely unforeseen, unpredictable, an ‘act of God’. 

Since when has the World Bank been the go-to source of ideas for reducing poverty, or for improving the conditions that most people in the world live in? The countries that have followed their ideologies, as they gradually moved from the vile and despotic policies of 40 years ago to the most comprehensive and widespread enslavement and subjugation of people living in poor countries that we see today, are the ones suffering the most now. 

The only thing more disgusting than promulgating this kind of poverty porn is the pretence that the English Guardian, the World Bank or any of the other big players in the media, international financial institutions and the development industry have the slightest sympathy for those who suffer most from the conditions that underlie this veneer of humanitarianism and philanthropy.  

If these prognostications from the media are correct, and many things really have improved over the past 30-40 years, then we must return to where we were before the pandemic, and identify what we were doing right, and do more of that. Many things will need to be done differently, and the big players of the past will be reluctant to do anything not in their interest. But these lockdowns are a disaster and must be ended before the damage they are doing becomes irreversible. 

To those who herald in the ‘new normal’, there’s nothing new about poverty, disease, food shortages, droughts and disasters. Lockdowns exacerbate and further institutionalize phenomena that have been around for as long as people in poor countries can remember. There’s nothing new about authoritarianism, but we have been happy to overlook it when it was imposed on distant countries. It now threatens everyone and it’s not something to be encouraged. 

Dr Joseph Sonnabend’s first concern was always the welfare of his patients, their families and the people they loved. Before HIV was identified as the virus that caused Aids, Dr Sonnabend was treating people suffering from the shocking illnesses that he and others were discovering among their patients in New York, mostly gay men. Many people infected in the 1980s died. But some survived because of the work of professionals such as Joseph. He pioneered safe sex as a response to HIV and Aids among gay men, and gave his patients the undivided attention that few others were prepared to give.

Joseph set up and ran several institutions to address the epidemic, care for sick people and research the disease. But when some of his colleagues joined with other parties to create a myth about an imminent ‘heterosexual Aids’ pandemic in order to raise funding, he left. Joseph was branded a ‘denialist’ by those who didn’t wish to deal with any of the numerous concerns that he raised. However, Joseph continued to insist that you cannot understand the spread of a disease if you fail to identify the most important circumstances surrounding its transmission. He still held his ‘multi-factorial’ view of HIV a few months ago, in a discussion about the history of the pandemic with Sean Strub and Dr. Stuart Schlossman. When Schlossman claimed that no one held such a view any longer, Joseph disagreed, but did not have the opportunity to defend his position at that time.

Joseph told me later that his ‘multi-factorial’ view of disease transmission is a characterization of epidemiology as the study of pathogen, host and environment, and not an idiosyncratic theory of his own. He said that most people he worked with in immunology and epidemiology held a similar view, and did not reduce the explanation of HIV infection and the development of Aids to an account of the pathogen, alone, independent of host and environment factors. That’s why the multi-factorial view of HIV explains a lot more than its sexual transmission among men who have sex with men. The theory can also be used to understand the extraordinary outbreaks of HIV transmission among people who are neither male, gay, intravenous drug users, nor even sex workers. The worst of these outbreaks are all to be found in a few countries in southern and eastern Africa, including Zimbabwe and South Africa, where Joseph spent several decades of his life.

Joseph confirmed my belief that HIV is not ‘all about sex’ in high prevalence countries, and that the worst epidemics cannot be accounted for by alleged ‘unsafe’ sexual behavior among African people. He often asked how women can transmit HIV to men via sexual intercourse, saying he knew of no causal mechanism to explain it. Something about the host and the environment, African people and the conditions they live in, the experiences they have, the diseases they suffer, their crumbling healthcare facilities, their poverty and their position as former possessions of European powers could turn out to be a part of a credible explanation of the highest rates of HIV transmission in the world.

Joseph was concerned about the way people lived, their welfare, their “complete physical, mental and social well-being and not merely the absence of disease or infirmity” (WHO’s definition of health, not necessarily exemplified by their activities). He was not content with vaccines and cures, treatment regimens and medications, alone. In fact, Joseph was opposed to what he saw as the rapidly increasing ‘medicalization’ of healthcare, and disgusted by the systematic humiliation of African people, who were blamed for their own sickness and told to quietly accept what they were given.

Many people have learned a great deal from Joseph, and benefited from his work. He distanced himself from those who saw HIV and Aids as a launchpad for their own careers and ambitions, and he refused to get involved in the more lucrative side of the pandemic. He will be much missed.

The World Peace Foundation should be more circumspect when criticizing a country for its approach to Covid-19. The word ‘denialism’ has a distinctly pejorative use in the selectively diplomatic world of international health. Those using the word see themselves as right, empirically and morally, upholders of the orthodoxy, unassailable. 

The title ‘Tanzania’s Layered Covid Denialism’ is more inciteful than insightful, and calculatedly so. Clearly, the author does not believe there is more than one valid view. If you are not with the orthodoxy, you are against it, an authoritarian, intent on imposing your will on those you lead. 

On the basis of a handful of headline-grabbing titbits, several from Twitter, the author claims that “access to information about Covid-19 has become an elite privilege”.

Let me give you a real example of elite privilege: 

“Use of improperly sterilized syringes and other medical equipment in health-care settings can also result in HIV transmission. We in the UN system are unlikely to become infected this way since the UN-system medical services…use only new or sterilized equipment. Extra precautions should be taken, however, when on travel away from UN approved medical facilities, as the UN cannot ensure the safety of blood supplies or injection equipment obtained elsewhere;…avoid direct exposure to another person’s blood — to avoid not only HIV but also hepatitis and other bloodborne infections.” 

Note, the UN believes that their personnel risk bloodborne infections from healthcare facilities available to the public in Tanzania or South Africa. But they insist that those same facilities are safe for people living in those countries, because they claim that almost all HIV transmission is a result of unsafe sex and only a tiny fraction results from unsafe healthcare. 

For all his faults, Thabo Mbeki questioned the view that ‘unsafe’ sexual behavior could explain massive HIV epidemics in a few African countries, but nowhere else. He questioned that old western prejudice about ‘African’ sexual behavior, employed throughout history to justify numerous and lengthy lapses in ethical research and healthcare. 

Sadly, Mbeki was pushed into rejecting the far better supported view that Aids is caused by a virus, HIV. What he should have rejected was the view that HIV is almost always transmitted via heterosexual sex, because outside Africa, it isn’t. 

Mbeki was punished, branded a ‘denialist’, because he didn’t agree with the orthodox view, and said so. The international health community knows that HIV is not commonly transmitted via heterosexual behavior outside of a few African countries. They should have admitted that this serious anomaly tarnishes the entire orthodoxy. 

President Magufuli of Tanzania is certainly not in the same position as Mbeki, because Covid-19 is expected to kill relatively few people, especially compared to numerous pathogens that cause extremely high morbidity and mortality rates in African countries. 

With the economies of Tanzania’s partners under threat, and the strength of the global economy at stake, Magufuli imposed a less stringent lockdown than most other countries. Thankfully, outbreaks of violence, civil unrest, food insecurity and economic collapse seen in countries with similar economies to Tanzania’s were averted. 

Labelling someone a ‘denialist’, whether it’s about HIV or Covid-19, is an unmistakable piece of cultural imperialism. Magufuli’s initial response was entirely reasonable and sensible, more so than those of Kenya, South Africa and many other countries. Since you can’t shame the country into copying an almost global failure to address the virus, maybe you can learn from them?

Silence may have been the most profound contribution to what we know about the Covid-19 epidemic in Tanzania. In fact, silence is the only truly sustainable measure to reduce the onslaught of questionable information emissions during the current infodemic. I hope to hear more of it. 

I am not referring to silence about cases, deaths, lockdown measures, masks and the like. I’m referring to the silence of the media about the terrifying consequences of extreme and irrational lockdowns. Tanzania didn’t follow other poor countries, so they don’t have to face such consequences. 

But there is silence in the mainstream media about the fact that Tanzania is peaceful, the economy is better than most, people are going to work, buying food in the market, agricultural production is little affected and children are going to school, and all because of their moderate response to Covid-19.

The media was all abuzz about what Tanzania’s President Magufuli said about praying and religious devotion, but not his advice about continuing to work, looking after families, sending kids to school and going to hospital in the event of any illness, including, but not limited to suspected Covid-19.

Negative impacts are reported in local Kenyan and Ugandan media, where rash curfews have been brutally enforced by police. But the mainstream media are not interested in that. We hear less about people persecuted, held in unhygienic and insanitary conditions, exposed to numerous health and other risks than we do about Magufuli questioning the efficacy of tests. 

There have been substantial increases in food prices, shortages of staple foods, with many in Kenya and Uganda facing starvation. Kenyan schools will reopen next year, by which time state school pupils will have missed almost a year of schooling. Both countries struggle to maintain law and order and keep their economies afloat.   

Uganda’s President Museveni is less widely quoted, but his only advice to his people was stay at home and pray, nothing else. There are no mainstream media articles about how astute Magufuli has been, nor mention of the moderate lockdown imposed in March, a more moderate one than their neighbors imposed, and for a few months, not indefinitely.   

Does this selective silence in the mainstream media suggest a tacit admission that they were wrong about how poor countries should best address Covid-19, wrong to sneer at Magufuli for his exemplary response, while ignoring the chaos that resulted from neighboring countries’ slavish obedience to wealthy donors?

The media have been quick to trumpet anything President Magufuli of Tanzania says about faith, or the power of prayer, in defeating Covid19. He has refused to address the epidemic in the manner prescribed by the WHO and numerous ‘experts’. Magufuli is anxious to keep things ticking over, as a developing country must.

Specifically, the president had no wish to risk the kind of economic meltdown or civil unrest that some developing countries are now experiencing. The WHO (Guardian, BBC, NY Times, etc.) had all the answers about Covid19, or so they would have us believe. But they are not responsible for the security and welfare of people who live in poor countries. 

Mainstream stories about Tanzania have come from social media, opposition politicians, NGOs and other parties whose views may not be entirely impartial. No one would claim President Magufuli has only ever made sound decisions during his five-year tenure. But standing up to international institutions, foreign donors and the media is a courageous move, one that most leaders will never make. 

Magufuli can be described as having done the opposite of what most countries have done. Or he can be described as having made the right decisions for a country where the majority depend on the informal economy for their livelihoods. Today’s journey, work, purchases and sales pay for today’s meals. Few pathogens can make staying at home, perhaps indefinitely, the better decision. 

Magufuli is frank in his belief that God will keep Tanzania safe. People want to go about their daily tasks in relative safety and security. Some may have little. But no one needs a lockdown to remind them how close they are to having less. Mafuguli refuses to accept the orthodoxy of institutions urging everyone to cower in their homes, indefinitely. This is far from blind faith.

If I were working for a UK government health agency, I would be obliged to sign a non-disclosure agreement and would be prohibited from sharing information about the agency. That’s standard, in public and private employment in the UK. 

The BBC and Guardian have been inviting people from government agencies to give them information that would breach such an agreement. Both outlets claim that people working in the public sector have given them confidential information about Covid-19 activities. 

Many, whether working for health agencies or not, will know that certain things published by these media outlets are biased; some of them don’t even sound credible. But who are we to judge the pronouncements of a free press in a democratic country? 

UK media report with glee how horrific things are in Sweden. But a UK doctor posts an article by a Swedish doctor, who writes that Covid-19 has been blown out of proportion. The UK doctor has tried to interest UK media, but only Russia Today ran the article.

Tanzania is reported as taking a ‘faith-based’ approach in an article in the BBC. Like Sweden, Tanzania implemented more moderate measures, sent children home from school, and reassured people that the lockdown was a short-term measure, that no one should panic. 

New Zealand seems to have been lucky, with few confirmed infections. However, a slight rise in cases and the coming election is postponed for a month. It will be in October, like Tanzania’s. 

Australia, in contrast, has announced that Covid-19 vaccination will be mandatory. That’s even before a vaccine, safe and effective for everyone, has been developed. Even people in favor of vaccinations may wish to object to mandatory vaccination against a virus that is not a threat to most people. 

Big social media is being cautious about saying the ‘right’ thing about Covid-19, as if there are true and indisputable things about the virus, and untrue, contemptible things, and moderators who can tell them apart. 

After the 2007 Kenyan election, when the country descended into violence and looting, people said they were told to stay inside, so they did, because there was a curfew. If they went outside for food they risked being shot, and accused of looting. 

This went on for months, there was starvation and displacement, schools, hospitals and other facilities were closed. Banks were closed as food prices rocketed, people tried to move to safer areas, but transport and infrastructure were disrupted. 

President Magufuli warned against scaremongering and advised people to keep working and running their households. He knew that if people panicked, peace would quickly deteriorate. What happened in Kenya in 2008 could happen in Tanzania. Indeed, things in Kenya now look similar to 2008. 

Before ridiculing Tanzania’s leader, accusing him of being irresponsible and undemocratic, implying that he has a naïve belief in religion, check which countries have food security and are at peace, and which are threatened with economic collapse and civil unrest.

The Open Society Initiative has announced a Covid19 Emergency Response Fund. Great to hear, but first key area on their list is health system strengthening. Health systems have been in need of funding for decades.  

Second on the list is mitigating the economic impact of Covid19, but that is far more a matter of the devastating effects of lockdowns, people unable to work, purchase food, tend to food production, sell produce, etc. 

A few headlines highlight some of the emergencies faced by African countries and they seem to be either: 1) caused by the response to Covid19, not the virus itself, or 2) emergencies that go back many decades, and increase the harm that kneejerk lockdowns, curfews and the like can cause. 

Unemployment, nothing new, but exacerbated by global lockdowns: Nigeria Records 21.8 Million Jobless People After Covid-19 Effects 

Female Genital Mutilation, nothing to do with the pandemic, but NGOs need to follow the money: No Christmas for West Pokot Girls 

Economic inclusiveness, again, every cause needs to mention the current focus of the media: Covid-19 – Where to From Here for Efforts to Support Youth Economic Inclusion? 

The number of confirmed deaths from Covid19 in Africa is about a third of the number of people who die of rabies every year: Lessons From a Community-Driven Rabies Vaccination Campaign in Kenya 

Diabetes, a recognized risk factor for many conditions long before Covid19: Covid-19 – Understanding the Increased Risk in People With Diabetes 

Foot and Mouth, like all other health conditions, put on the back burner. If there’s an outbreak of this disease now, countries that have closed their economic and administrative functions down will be able to do little to protect themselves: Mozambique: Foot-and-Mouth Outbreak in Maputo Province 

Tourism, conservation, environmental and other projects, all threatened by lockdowns: In Kenya, Maasai Entrepreneur Moves Conservancy Beyond Tourism Hit By Pandemic 

Hardly surprising that food prices have rocketed. They are unlikely to drop anytime soon. Unlike most articles on the pandemic/response, this one identifies other pressures driving up food prices, all of which were there before Covid19, but are made a lot worse by the response: Food Prices in Nigeria Have Shot Through the Roof 

If countries can’t get food locally, or import it from other countries because they can’t get around restrictions on movement and trade, they may end up depending on illicit trading, black markets and other threats to economic and political stability. The above list is from today’s AllAfrica.com newsletter, not at all exhaustive, unfortunately. 

Many are now questioning the wisdom of rigid Covid19 responses urged on them by international institutions, NGOs, donors and foreign leaders. Tanzania is one of the only one to impose a modest lockdown with a viable exit plan. Other countries could soon follow their example. None can afford the millions shelled out by rich countries.