Dwindling funding, antiretroviral stock shortages, fund mismanagement and the global economic crisis are some factors threatening the already straining battle against HIV/Aids.
"The need for action has been clear for years, but now it is an absolute emergency," said Paula Akugizibwe from the Aids and Rights Alliance for Southern Africa (ARASA) at a recent press conference for the Treatment Action Campaign (TAC).
In recent years, when funds for HIV/Aids were plentiful, health systems in Africa have only managed to supply antiretroviral treatment (ART) to 30% of people who need it. But in the current financial climate, 70% of the lucky few people currently receiving ART are at risk of losing this lifesaving treatment within the next 12 months. This is according to a recent World Bank report that looked at the impact of the global economic crisis on various human development issues.
The global economic crisis has put all sources of healthcare funding under pressure, according to Albert van Zyl from the International Budget Partnership, an organisation lobbying for greater transparency and consultation on countries’ budgeting processes. The three sources of healthcare funding in southern Africa are tax revenue, donor funding and remittances – people working elsewhere who send money back home.
"Donors had their money invested in stocks – which crashed," said Van Zyl. "Governments are collecting less tax and VAT because of the recession, and if you lose your job you can’t send money back home."
This leads to budget shortfalls, which in turn lead to cuts in the provision of health care – a recent example is the suspension of ART in the Free State late last year. "As a direct result of that, the HIV-commissioned society estimate that an additional 30 people died everyday in the Free State because they could not get access to antiretrovirals," said the TAC's Rebecca Hodes.
"These shortages are occurring with increasing frequency, and the primary cause for this is improper and wasteful budgeting processes, and lack of monitoring and accountability at government level," said Hodes.
Backlash against HIV funding
Many believe that HIV/Aids have received too much money, and recent donor trends show a global backlash against HIV/Aids funding. "Money is now starting to shift and attention is starting to shift away from HIV, and away from TB," said Akugizibwe.
United Nations secretary-general Ban Ki-moon have also called on governments not to use the economic crisis as an excuse to cut funding for fighting Aids. Ban warned that "the economic crisis should not be an excuse to abandon commitments – it should be an impetus to make the right investments that will yield benefits for generations to come."
"Even as we see signs of cutbacks in AIDS funding in many countries, we must remind governments and the international community that the world has the resources to mount the kind of AIDS response to which we have committed. If we all for cuts now, we will face increased costs and great human suffering in the future," said UN general assembly president Miguel d'Escoto Brockman.
At a UN general assembly meeting d'Escoto cited that: 29 million people who need HIV treatment still lack medication, roughly two out of three HIV-positive pregnant women don't receive services to prevent mother-to-child transmission, and an estimated 370,000 children under the age of 15 became infected with HIV in 2007 and are less likely than adults to receive treatment. – (Wilma Stassen, Health24/Sapa, June 2009)