More than 350,000 people living with HIV and Aids might fail to access anti-retroviral drugs because of lack of donors.
Many western donors were severely crippled by the 2008-9 ‘great recession’ and most of the donor funds have dried up.
The government of Zimbabwe’s HIV/AIDS programme has relied heavily on donors in the past, with government contributing only 24 percent of the total amount.
The rest is provided by donors.
Currently 35 percent of people receiving ARVs are funded by the Global Fund, 18 percent by USAid, 24 percent by the National Aids Trust Fund (collected from the Aids levy) and 22 percent from the Expanded Support Programme (ESP).
The ESP is supported by various western donors.
The Global Fund has been supporting HIV and Aids, tuberculosis and malaria programmes in the past 10 years, but will suspend support in 2014, due to holes in its budget. The Fund is also said to be riddled with internal management problems which have crippled its capacity to deliver global programmes with the same efficiency as it did since it was founded.
Today, despite the Global Fund’s track record of managing its funds well, demonstrating impact and acting swiftly to deal with corruption, donors have cited “bad governance” as an reason for withholding further commitments, although the financial crisis is the oft cited reason. Critics argue that governance issues are used as an excuse by the west because in the last two years, the Global Fund’s biggest donors ― the US and the UK ― have been able to bail out badly managed banks and other lending institutions, despite overwhelming evidence of unethical behaviour, abuse of power and “bad governance” by senior management.
Development economist Jeffrey Sachs has pointed out, the US defence budget, for example, amounts to $1.9 billion a day ― just three days of that would plug the gap facing the Global Fund.
Zambian economist, Dr Dambisa Moyo, has argued against aid, which she calls “dead aid”, saying that it creates dependency on the part of the developing world.
The sum pledged at the height of the global financial crisis of $11.7 billion does not reach the desired minimum amount of $13 billion, estimated to cover current programmes
This has severe implications for many low income countries that have depended on the Global Fund’s donations and have not come up with viable alternative national policies.
In 2011, the The Global Fund announced at a board meeting in Accra, Ghana that it was canceling its next round of fundraising and is changing its management. No new grants or funding will be made until 2014, and will be at a reduced level from previous years.
The new stark reality however is that in this next three-year phase, an era of austerity, angst and uncertainty, robust growth by the Fund will not likely happen.
Zimbabwe, for example, is likely to face a US$227 million deficit by 2018, according to reports from the just-ended Zimbabwe Parliamentarians against HIV workshop in Kadoma at the weekend.
National Aids Council director for finance Mr Albert Manenji said Zimbabwe should come up with alternative funding to deal with the anticipated deficit caused by the withdrawal of donors.
“The financial gap for HIV is actually quite huge. This gap is progressing and is expected to get wider,” said Mr Manenji.
“As of 2012, the gap will be US$10 million and by 2018 it will be US$227 million and about 358 000 people who will need treatment will not be able to afford it.
“The gap would be compounded by the withdrawal of Global Fund that has been funding 35 percent of our people on ARVs; they have not committed themselves beyond 2014,” he added.
At least 300,000 people are on ARV treatment on the Government programme in Zimbabwe out of over 600,000 that are in need of the drugs.
Mr Manenji said it was important to come up with internal solutions to deal with the impending shortfall in funding.
“We have to come up with a number of strategies to deal with the issue and one of them is to efficiently and effectively use the funds that we have,” he said.
Zimbabwe has managed to slow down the spread of the virus using local resources.
“Although we have received less from outside, we have done much better than those receiving and it has been proved that you can do better with internal resources,” he said.
Mr Manenji said people on medical aid could assist by increasing their monthly contributions by at least US$4 to access ARV treatment. This would allow vulnerable groups to be accommodated on Government-supported initiatives.
*Dr Itayi Garande can be reached via firstname.lastname@example.org
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