Geog 340 (Spring 2014) Global Actor Project Paper
For this paper, I have chosen the Clinton Health Access Initiative (CHAI) and their work in sub-Saharan Africa. Research for this paper was a mixed bag of results. The web had plenty of articles that were reports on how donations were gathered, and “feel-good” public relations stories. It a substantial amount of digging to finally get the main link – CHAI must work with an African countries’ local Ministry of Health. Without that partnership, all the knowledge and experience the CHAI has had building successful health care models are squandered.
For my resources, I contacted the Ebling Library, the Memorial Library via phone ...view middle of the document...
However, I got some very useful data for this paper with what I did find.
Formed in Boston, Massachusetts by President Bill Clinton in 2002, the CHAI has had great success in reaching both the governments and the people of the African Sub-Saharan regions due to a combination of donations, access to and improvement of diagnostic data and collaboration with the local governments.
In order for one global actor/region (Boston) to effectively have an impact on the other region (Sub-Saharan Africa) a relationship between the two entities had to be created. The CHAI needed to get the African governments and their associated branches (e.g. Federal Ministry of Health - FMOH or simply the Ministry of Health (MOH) engaged in the implementation process. Donations could be procured, but using the monies effectively to reach affected people is the main goal.
According to Sean Riley of CHAI, the way CHAI linked with the sub-Saharan region was via the governments, namely the Ministry of Health (MOH). “CHAI was invited in at the government’s request”, he said. This applied in each country in order to begin the method of attacking the HIV/AIDS crisis. The pattern of success began with involvement in Rwanda and Malawi. “In both cases, the government asked us to come in, pledged full cooperation and assured us that our work was consistent with their own development strategies” (Giving p.120).
The challenges CHAI has met in the regions are substantial. Sub-Saharan Africa is home to two thirds of all diagnosed HIV/AIDS cases, with “more people afflicted than any other part of the world, 15 million, since 1981” (Course textbook p. 212). Rural people are the hardest hit, and Ethiopia’s population alone is 85% concentrated in rural areas. This limits access not only to proper health care and health care workers, but significantly delays diagnostic data due to distance.
Stigma is a large hurdle in getting infected patients treated. The fear of being discovered as an HIV/AIDS patient makes many families feel that they’ll be treated with no dignity, much less vital medical treatment. Most negatively seen in Uganda, where the Anti Homosexuality Act of 2014 not only makes homosexuality illegal, it makes those who don’t report it at risk for life in prison. This has a huge negative impact on health care workers who are trying to contain the HIV/AIDS crisis. This Ugandan act also includes NGO’s like CHAI as possible offenders, therefore exposing them to the same harsh penalties.
A recent BBC story - http://www.bbc.com/news/world-africa-26864819 - illustrated the stigma’s overwhelming strength. People who are infected are using fake test results to get work. The disgrace and excommunication from society is so strong infected people resort to fraud for survival. This prevents accurate data retrieval, as antiretroviral drug usage and infection rates are essential to combat the disease effectively.
“In Uganda we actually had to provide $150,000 to set up a company...