[afro-nets] Africa must find new ways to fund AIDS fight

[Brian Pazvakavambwa <PazvakavambwaB@whoafr.org>]

Africa must find new ways to fund AIDS fight
--------------------------------------------

By Gichinga Ndirangu
The East African (Opinion piece)
http://www.nationmedia.com/eastafrican/

African heads of state meet this week in Abuja, Nigeria, to review
progress made in reversing the spread of HIV/Aids, malaria, tuberculosis
and other infectious diseases.

The review is taking place five years after the leaders set a target of
increasing health spending to a minimum 15 per cent of national budgets
to accelerate a continental response to the Aids pandemic and other
diseases.

But the scorecard is dismal. Only Botswana, for instance, has managed to
devote 15 per cent of national budgets to health with an emphasis on
HIV/Aids programmes.  

At 14.5 per cent, Zimbabwe comes a surprising second, mainly due to an
innovative employee/employer Aids levy introduced in 2003, which has
leveraged additional resources. At 13 per cent and 12 per cent
respectively, Tanzania and Uganda are in Africa's top league, with Kenya
trailing at 7 per cent. 

The heads of state are not expected to set any new targets but to
recommit to the unmet Abuja targets and an accelerated response to the
Aids pandemic, which could be compounded by the lack of additional
resources to scale up prevention, treatment and care for those infected
and affected. 

It is widely expected that this week's summit will endorse a proposal
due for discussion at next month's UN General Assembly for a massive
effort to put 10 million people on antiretrovirals by 2010. The majority
would be drawn from Africa, which bears a disproportionate burden of the
disease. 

This week's special summit takes place against the backdrop of rising
incidence of Aids in Africa, where 22 million have already died, out of
a global total of 25 million. The number of Aids orphans, estimated at
12 million, is expected to reach 18 million by 2008. 

Africa's leaders will be shamed by their failure to launch a response
that is equal to the challenge and for having missed the targets set in
2001, significantly being unable to devote more resources to combat the
scourge. 

A progress report prepared by the African Union to track progress
against the 2001, targets is critical of the half-hearted response by
African governments. 

"NATIONAL RESOURCE mobilisation efforts have been inadequate as shown by
the low percentage allocation of national budgets to the health sector
in almost all countries," says the report. The AU wants countries to
redouble their efforts to raise internal resources. 

But experts agree that resources are not the only constraint. Indeed,
since the 2001 targets were set, Africa has had new resource coming from
the Global Fund, the World Bank multi-country Aids programme and the US
government under the President's Emergency Plan for Aids Relief
(PEPFAR). 

International financing for HIV/Aids to Africa has increased from $1.7
billion to over $4.7 billion. 

Accessing the funds has, however, been complicated by stringent
conditions and competing donor priorities not always aligned to the
strategies of specific countries. 

The scale of the pandemic has also not kept pace with required
resources. Last year, available resources could only meet half the need
and, if unchanged, will underwrite only 25 per cent of the projected
cost in 2007. 

GROWING COMPETITION for international funds from Asia and Eastern
Europe, where HIV/Aids is becoming more pronounced, is expected to
create additional pressure and the need for African governments to
mobilise more resources internally. 

Currently, Africa is the region with the lowest spending per capita on
people living with HIV/Aids. This has increased the burden of treatment
borne by individual households, estimated at 40 per cent of household
income in most countries. 

There is growing unanimity that the exodus of health personnel to the
West in search of greener pastures has further undermined Africa's
capacity to respond to the Aids.  

Budgetary caps on health sector spending and inadequate incentives means
that few countries can replace those migrating nor motivate those who
remain. 

This week's summit is expected to maintain a focus on increasing the
number of people on antiretroviral treatment with a corresponding
emphasis on prevention, predominantly targeting the youth. It is now
widely acknowledged that the lack of comprehensive knowledge on HIV/Aids
is undermining behaviour change and fuelling the spread of the disease
among the youth. 

But increasing the number of people under treatment will require
investment in quality control laboratories to ensure availability of
quality medicines. This has become pertinent as more African countries
plan to launch local production of Aids drugs to lower costs and
increase the number of those on treatment. It is thought that a
mechanism should be developed to secure the quality of locally produced
medicines in Africa. 

The AU summit is expected to pitch strongly on extending debt relief
beyond the existing number of Heavily Indebted Poor Countries to free
more resources for social sector spending, including on health.

Africa is presently estimated to have a debt stock of $330 billion and
spends $15 billion annually to service its debts to rich countries and
international financial institutions.

--
Brian Pazvakavambwa
AFRO-NETS Moderator
WHO AFRO
Intercountry Support Team for HIV/AIDS
Harare, Zimbabwe
mailto:PazvakavambwaB@whoafr.org
mailto:bpazva@yahoo.com