Unless the South African government develops a treatment plan for people with HIV/AIDS, this country is not going to get access to the multi-billion rand Global Fund to Fight HIV/AIDS, Tuberculosis and Malaria.  

This is according to the Treatment Action Campaign’s (TAC) Nathan Geffen. TAC is part of an international lobby to ensure that a substantial portion of the fund goes towards buying the cheapest possible drugs for countries most affected by HIV/AIDS.

The first ever meeting of the fund’s board takes place in Geneva on 28-29 January to decide on how the $1,7-billion should be allocated.

The fund was set up after a call last year by United Nations Secretary General Kofi Annan for developed nations to contribute to a “war chest” of $10-billion a year to fight HIV/AIDS.  

The fund’s board will consist of seven representatives each from donor and developing countries. It will also have two non-governmental representatives and two from the private sector.

Uganda is to represent the interests of southern and eastern Africa, while the donors claiming seats are the USA, Britain, France, Italy, Japan, Sweden and the European Union.

Goran Lindahl, deputy chair of Anglo American PLC, was chosen over a shortlist of mainly pharmaceutical executives to represent business.  

Lindahl was seen as the less controversial choice, as there is already controversy over the fund’s drug policy. The US wants it to buy brand-name drugs, whereas international humanitarian organisations such as Oxfam and Medicins sans Frontieres say the fund should not just be another rich client for the pharmaceutical industry, and are lobbying for generic drugs.

South African AIDS expert Professor Jerry Coovadia, who recently chaired a roundtable meeting of African medical specialists to identify priorities for the fund, said the most important role for the fund was “to create hope”.  

The roundtable meeting identified “progressive, universal access to medicines for HIV/AIDS and related infections” as the most important way in which hope could be created.  

“Anti-retroviral drugs were a key feature of the roundtable meeting. I would encourage government to consider the opinion of African doctors,” said Coovadia.

Funding applications will be fed to the fund through “country co-ordinating mechanisms”, which will be set up by governments.  

However, given the South African government’s opposition to antiretroviral drugs, and its antagonistic relationship with members of the HIV/AIDS medical fraternity and various non-governmental organisations, consensus on funding priorities is unlikely to be reached in South Africa’s country co-ordinating mechanism.

Health Department spokesperson Jo-Anne Collinge said the fund did make provision for lobby groups that felt they were being sidelined by their governments to make direct representation to the fund.

However, such a situation would pose a diplomatic dilemma for the fund’s management, which is far likely to simply allocate the money to countries where stakeholders do agree.

Coovadia said the allocation of money was “such a difficult issue” and those controlling the fund would inevitably face criticism.

However, he said that he hoped the fund “would insist on a partnership between government, NGOs, community organisations and the private sector” to ensure that funds were dispersed effectively.

“The Global Fund must not be another huge magnet that draws funds away from organisations and programmes that are working,” he added.