HEALTH-SOUTH AFRICA: More Funds Needed for HIV Prevention and Treatment

• by Kristin Palitza (cape town)
• Monday, March 08, 2010
• Inter Press Service

The Treatment Action Campaign (TAC), the AIDS and Rights Alliance for Southern Africa (ARASA) and Médecins Sans Frontières (MSF) expressed alarm over dwindling commitment to fund HIV programmes in poor countries.

They expressed their concerns on the eve of a high-level meeting on Mar. 9 in the United Kingdom that could determine whether the G20 — the Group of Twenty of finance ministers and central bank governors established in 1999 to stabilise the global financial market — will uphold a 2005 commitment to bolster HIV treatment.

Five years ago, the G8, the group of the world’s eight most powerful political leaders, committed to achieving universal access by 2010, a move that was then described as a 'historic opportunity'. 'But now, this has become a historic disappointment, because we are less than half way to achieving those goals,' said ARASA advocacy coordinator Paula Akugizibwe.

'Funders appear to have thrown in the towel and begun to shift their attention elsewhere, while 10 million people still need access to treatment [worldwide],' she added. 'This has let to disappointment and anxiety.'

Most African countries depend on external funding to sustain their national HIV treatment programmes, but leading funders, such as the United States President’s Emergency Plan for AIDS Relief, have not increased funding over the past few years, representatives from the three NGOs stated.

They were also concerned about shifting donor priorities that have made uncertain support for the Global Fund to Fight HIV/AIDS, Tuberculosis and Malaria, which has thus far paid for two thirds of people on HIV treatment worldwide.

'Five years ago, the G8 countries set these targets. Why do they suddenly shift their attention elsewhere?' asked Akugizibwe. 'The bottom line is money. HIV treatment is expensive. That’s why governments are backtracking.'

Some politicians have argued that HIV has received a disproportionate amount of money over the years compared with other diseases, while others say too much money is going towards HIV treatment and not enough towards prevention.

But AIDS activists highlight the fact that HIV cannot be separated from other health needs. 'The past decade of increased HIV funding has shown that treatment works. We have seen a decline in HIV infection and a reduction in infant and overall mortality. We have reduced TB cases and improved mother and child health,' said MSF Khayelitsha HIV/TB medical coordinator Gilles Van Cutsem.

He also stressed the positive impact HIV treatment had on the Millennium Development Goals. 'Research has shown that a one percent decrease in HIV prevalence equals an 80 percent increase in Gross Domestic Product or eight years of economic growth,' Van Cutsem explained.

Apart from this, decreased funding is likely to lead to a major health crisis. 'Lack of funding will cause drug stock-outs, which will interrupt treatment and lead to increased drug resistance. This will make HIV much more difficult to treat,' warned Van Cutsem. 'It will also mean slower access to treatment.'

The activists warned that pulling funding away from HIV treatment will ultimately destabilise health systems in developing countries. 'Governments and donors must continue what they started,' demanded Van Cutsem. 'Anything less will lead to poor quality programmes and a waste of the initial investment. Flat or decreased funding is not good enough.'

TAC HIV educator Andile Madondile further noted that a decrease in funding will have detrimental effects on the four million people currently receiving treatment. 'We must not undo this progress,' he said.

Madondile further explained that unavailability of treatment is likely to have a negative impact on prevention, for example the number of people accessing voluntary counselling and testing: 'Seven out of ten people need treatment urgently in South Africa, but if treatment cannot be guaranteed, it is hard to motivate others to get tested.'

Apart from holding the G8 accountable to its commitment to achieve universal access, the activists also noted the responsibility of African countries to fight HIV, for example by upholding the Abuja Declaration on HIV/AIDS, Tuberculosis and Other Related Infectious Diseases, which was signed by the heads of state of the African Union in Nigeria in April 2001. As part of the declaration, heads of state pledged to allocate at least 15 percent of their annual national budgets to the health sector.

'[Out of 53 African nations], only 16 spend more than ten percent of their budgets on health as promised,' complained Akugizibwe. 'It’s more rhetoric than resource commitments. We need to see more accountability and efficiency in the region.'

TAC Ekurhuleni district coordinator Nokhwezi Hoboyi appealed for stronger political leadership in the response to HIV: 'We need higher levels of investment in health as well as more transparency. But this cannot happen without stronger leadership.'

According to the Global Fund, 20 billion dollars is needed in the next three years to sustain existing HIV, TB and malaria programmes and allow for a slight scale-up of these programmes. The Fund is currently facing a budget gap of at least 4 billion dollars.

'We call for the Global Fund to be replenished. Anything else would cause a tragic regression,' said Akugizibwe.

© Inter Press Service (2010) — All Rights ReservedOriginal source: Inter Press Service

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