“It is time African governments started walking the talk and fulfilling their obligations,” James Kamau, director of the Kenya Treatment Access Movement, told a press conference in the capital, Nairobi, on 19 May. “The Kenyan government spends just 5.6 percent of the national budget on health, yet half a million people need ARVs [antiretrovirals] immediately.”  

In 2001, African Union leaders signed a declaration in Abuja, Nigeria, that health budgets should constitute a minimum of 15 percent of national budgets, but according to Kamau, apart from notable exceptions like Botswana, Namibia and Zambia, the vast majority have failed to achieve this.  

“Programmes like PEPFAR [the US President’s Emergency Plan for AIDS Relief] are intended to be emergency short-term programmes – African governments need to plan for the long term,” he said. “Many, many more people need ARVs.”  

The Regional Network on Equity in Health in Southern Africa (EQUINET), a network of research, civil society and health sector organisations, said African governments accounted for less than one percent of global health spending despite carrying 25 percent of the global disease burden, having over 60 percent of those living with HIV, and the highest burden of tuberculosis and malaria.  

The activists said it was imperative that African governments step up their funding, but it was also important that the US reconsider its spending on global HIV programmes, especially in the short term.  

Paul Zeitz, executive director of the US-based Global AIDS Alliance, pointed out that US President Barack Obama’s proposed allocation of US$6 billion for PEPFAR’s HIV/AIDS programmes in 2010, and $900 million for the Global Fund to Fight AIDS, Tuberculosis and Malaria, fell short of his campaign commitment to allocate $7.5 billion a year to PEPFAR’s AIDS programmes, and $2.7 billion to the Global Fund.  

“The funding shortfall in US spending on global HIV programmes is a tiny fraction of the total US budget of 3.6 trillion dollars,” Zeitz told the press conference. “That money can be found easily, with just a little political will.”  

Researchers have estimated that 1.2 million deaths in Africa were averted between 2004 and 2007 as a direct result of interventions funded by PEPFAR.  

“We have a saying in Kenya that if the lead sheep is limping, all the rest fall behind. The US’s decision could be a sign of things to come,” Kamau commented.  

“The US has made a commitment to provide one-third of the total Global Fund budget; a decrease in US funding is therefore likely to translate to a decrease in funding provided by the other donors,” Zeitz noted.  

“Governments are having to recalibrate their plans for HIV – in Malawi, for instance, the government has announced … that it will, from now on, only purchase and distribute first-line ARVs.”  

Zeitz said AIDS activists appreciated that the US was in the midst of an economic recession, but “The US just spent one trillion dollars to bail out the banks on Wall Street, and the military budget has been increasing year on year; it is really a question of priorities.”  
This feature is used with permission from IRIN/PlusNews – www.plusnews.org