Government commitment to HIV/AIDS funding only really materialised in 2000 with the introduction of special conditional grants, according to Alison Hickey, manager of Idasa’s AIDS Budget Unit.
‘Before 2000, the AIDS budget was minimal, even inconsequential,’ says Hickey. ‘But the 2004/5 national budget shows a serious commitment to making financial resources available for the new ARV treatment programmes. National Treasury has specifically allocated R1.439 billion for HIV/AIDS programmes and services in this year.
‘This is seven times what was set aside to fight HIV/AIDS in 2000/1. However, HIV/AIDS funds still constitute less than 1% of the total budget.’
Money for ARV treatment is sent to provinces via conditional grants. However, Hickey is concerned that provinces such as the Eastern Cape and Mpumalanga may struggle to spend their grants.
‘For those provinces with weaker financial and project management skills, absorption capacity could well be the primary obstacle to roll-out,’ she says.
One of the weaknesses in the national Department of Health identified by the Auditor General is its inability to monitor conditional grants properly.
A new clause in the Division of Revenue Bill allows unspent HIV/AIDS grants to be relocated to better-performing provinces.
Researcher Hein Marais found that the Western Cape, Eastern Cape and Mpumalanga did not allocate any funds specifically for HIV/AIDS in 1998. Gauteng was the only province to allocate a substantial sum, with R49 million allocated across all its departments and R4 million set aside for NGOs.
