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MALAWI

Malawi is slightly smaller than the State of Pennsylvania, with a population just over 10 million. It is landlocked,a narrow elongated plateau with rolling plains, rounded hills, and some mountains. Twenty-three percent of the land is arable; there are deposits of limestone, and unexploited deposits of uranium, coal and bauxite.

Lake Nyasa, 580 km.long,is its most prominent physical feature.

I recently (Oct. 22, 2004) received a letter from Michael Burt, who heads the World Medical Fund (WMF) working with AIDS orphans in Malawi. He reports that newly-elected Presiden Bingu is establishing an excellent reputation for ridding the country of corrupt ministers. He (Michael Burt)regards Malawi as the least corrupt of all sub-Saharan countries, and reports he has never, in his years of working there, been asked to give a bribe. He reports Malawi is giving free education to all orphans. WMF used to pay their secondary school fees, but the recent food shortage in Malawi has prevented that, except in the case of very exceptional students. Malawi has a very ambitious program to provide ARV's to everyone who needs them, but there is not enough money for this program, and probably only 10% to 20% of those who need ARV's will be supplied. WMF will probably play a part in the ARV program, as it has already set up a children's mobile clinic program. They work in remote villages where there is no access to health care.

African Heads of State, including President Bingu of Malawi and Mr. Museveni of Uganda, are seriously questioning the way the World Bank and the IMF have handled aid for sub-Saharan Africa. The two agencies have dictated rules for African countries that have not had the desired effect; in fact, the leaders argue, their policies and demands have had the opposite effect. For Malawi, they argue that programs which began a decade ago have resulted in Malawi becoming poorer each year. The leaders argue that this is the case because solutions have been imposed on them, rather than being designed in conjunction with Africa. And when the programs do not work as expected, the IMF blames the country, not its own policies.

The IMF has begun to listen to these African voices, and has pledged to work with Africa to find policies which will lead to the real development of the area.

A recent update by the Malawi National AIDS Commission, (NAC), says in Lilongwe, the capital, there is a decline in HIV infection levels among young women from 26% in 1006 to 16% today. However, HIV prevalence is very high in Blantyre, Mzuzu City, and several semi-urban areas, 20% to 36%.

The Global Fund has just issued a report on Malawi. They say, in part, "Malawi, one of the world's poorest countries, has one of the highest HIV/AIDS prevalence in the world. There are an estimated 15% of those aged 15-49 infected, while the national prevalence is estimated at 8.4%. By 2000, lfe expectancy declined to 39 years frin a orijected 54 years without the HIV/AIDS epidemic. The epidemic has taken a great toll on the young and middle-aged population, thereby undermining the country's efforts to reduce poverty. The very high rates of HIV prevalence (24% on average) in women of reproductive age, together with high fertility rates, imply high rates of mother to child transmission of HIV.

Global Fund summarizes as follows: "The burden of disease on the Malawi's economy, the social distress of thousands of child-led households, the loss of large numbers of the country's workforce, and the spiral of poverty [the average percapita income is $170]that accompanies continued ill-health threaten to disrupt the political stability of the country."