South Africa’s battle against HIV/AIDS has been given a massive $165-million (about R1,8-billion) boost from the Global Fund to Fight HIV/AIDS, TB and Malaria – almost double the national HIV/AIDS budget of R1-billion for this year.

The bulk of the money, some $93-million (over R1-billion), will go towards the treatment, care, and support of people with TB and HIV over five years.  

The remaining $72-million (about R792-million) will be go KwaZulu-Natal for a range of care-oriented services for those infected and affected by HIV/AIDS. These include voluntary counselling and testing, treatment of opportunistic infections, home-based care, anti-retroviral treatment and orphan care.  

However, government’s head of HIV/AIDS, Dr Nono Simelela said she was unsure why the Fund had approved a grant for KwaZulu-Natal.  

“Kwa-Zulu-Natal wrote to the Fund and withdrew its application after in-principle agreement to channel all applications to the Fund through the SA National AIDS Council (SANAC),” said Simelela, adding that the Minister of Health would have to take up the matter with the Fund.

The national TB-HIV application to the Fund was spearheaded by the Department of Health through the SANAC, while the KwaZulu-Natal one was driven by the Nelson R Mandela School of Medicine’s Enhancing Care Initiative and HIV/AIDS Public Health Programme, a collaboration between the medical school and the provincial Department of Health.

The Enhancing Care Initiative facilitated the formation of the provincial co-ordinating mechanism, which brought together the university, the Durban Chamber of Commerce and Industry, various other organisations and the provincial department of health.

KwaZulu-Natal’s biggest allocations are for a partnership between the university and the Durban Chamber of Commerce and Industry and home-based care. Significant funds have also been approved to provide comprehensive care – including anti-retroviral drugs — to HIV-infected patients in the public and private sector.

The services will be rolled out over five years under the guidance of an advisory board made up of key stakeholders in the University of Natal, department of health, the private sector and community, non-governmental and religious organisations.

Professor Umesh Lalloo and Dr Robert Pawinski, drivers of this initiative, were ecstatic with the approval of funding, although they did not want to comment until a meeting with all the stakeholders had taken place.

However, the Treatment Action Campaign’s Nathan Geffen said the grants were “marvellous” , and would make a significant difference to fighting HIV/AIDS in the country.

“The challenge is to ensure that the funds are spent properly,” said Geffen.  

It was highly unusual for the Fund to grant the money directly to a province, as Fund rules state that priority will be given to proposals from country co-ordination mechanisms, or “collaborative partnerships” between government, non-governmental organisations, people living with the three diseases and the private sector.

However, Fund representative Dr Christoph Benn said that in exceptional cases, organisations could apply directly to the Fund. These exceptions include cases where countries “suppress or have not established partnerships with NGOs”.

The grant could be seen as an indication of the international community’s impatience at the politicking over HIV/AIDS in South Africa.

South Africa has the biggest HIV positive population in the world. Over six million people are expected to be infected by the end of the year, according to the Actuarial Society of SA. In KwaZulu-Natal, one in three adults are estimated to be living with HIV.