Department of Health officials yesterday denied that government had decided not to accept money from the multi-billion rand Global Fund to Fight HIV/AIDS, Tuberculosis and Malaria, initiated by United Nations Secretary-General Kofi Annan.

This is despite comments made by Finance Minister Trevor Manual in New York this week that South Africa did not need money, but rather required the capacity to address HIV/AIDS and other health problems.

Manual was responding to comments made by Harvard University’s Jeffrey Sachs that government needed money to buy anti-retroviral treatment for people with HIV/AIDS.

Sibani Mngadi, Health Minister Dr Manto Tshabalala Msimang’s spokesperson, pointed out that the minister had been part of “the Transitional Working Group that facilitated the establishment of the Global Fund”.

The Minister had worked hard to ensure that the Fund “remained focused on the three diseases” and “has emphasized that the Fund should also be used for improving health systems and capacity in the most affected countries”, he added.

However, while Mngadi stressed the minister’s involvement in the Fund he would not be drawn on whether South Africa would apply for funds, and implied no decision had been taken on this yet.

“South Africa will consider what is in its best interest and how the country and the SADC region can benefit from international initiatives such as the Global Fund,” said Mngadi.

“Jeffrey Sachs has tended to reiterate a view that reduces the complex subject of HIV/AIDS related treatment to the single issue of anti-retroviral drugs and the procurement of these drugs.”

Other health department sources expressed shock and said they were convinced Manual had been misquoted. However, there is considerable tension between the health and finance ministries and it is possible Manual expressed his own personal view which he had not canvassed with the health minister.

Meanwhile, the Treatment Action Campaign’s Nathan Geffen said that if government claimed the public service lacked the capacity to address HIV/AIDS then this “reflected very poorly on the highest echelons of government”.

“It is their job to ensure that the public service develops that capacity,” said Geffen.

“I think Minister Manual is simply shooting from the hip,” added Geffen. “He has conducted no study to show exactly how much money is needed to address the HIV/AIDS pandemic in this country.

“Besides, it is crazy to turn you back on the fund, when fund money can be used to build capacity.”

The Global Fund was set up after an appeal by Annan, in response to lobbying from AIDS activist groups, to developed nations to put together a “war chest against HIV/AIDS”.

Its board was formally constituted last week in Geneva, with Ugandan Dr Chrispus Kiyonga elected as chairperson. It has almost $2-billion to disburse.

The fund describes itself as “an independent, public-private partnership whose cornerstone objective is to help save lives by making an ongoing and significant contribution to reducing infections, illness and death”.

AIDS, TB and malaria are responsible for more than a third of all deaths in Africa.

The board consists of representatives from seven developing countries (Brazil, China, Pakistan, Nigeria, Uganda, Thailand and Ukraine), seven developed countries (US, Japan, France, Italy, The European Commission, Sweden, and the UK), the private sector (Anglo-American Plc), the Gates Foundation, and two representatives from non-governmental organisations. The World Bank, World Health organisation, UNAIDS, and a representative from communities living with or affected by the three diseases have non-voting status.

Ministries of health in potential recipient countries have already been sent an announcement from the fund calling for funding proposals.  

The first deadline will be March 10. Proposals received by then will be discussed at the board’s next meeting on March 23-24. All proposals will be evaluated by an independent, expert Technical Review Panel which will advise the board.

Countries intending to apply for money are supposed to set up country co-ordination mechanisms (CCM) representing all stakeholders to formulate proposals.

This is bound to be a sticky process in South Africa, given the antagonistic relationship between government and certain HIV/AIDS NGOs. However, NGOs who feel they have been excluded from the CCMs can apply directly to the fund.