Yesterday (TUESDAY) a media conference and a special session spoke about the lack of funding for health programmes and HIV/AIDS interventions, in the light of successful efforts to in a short space of time gather billions of dollars to bail out banks or money to boost military spending in so-called low and middle-income countries.
Dr Eric Goemaere of Medecins Sans Frontieres in South Africa recalled a meeting in Uganda in September 2001 where they pushed for Africa to be given ARVs. ‘People were asking whether we are crazy and asked whether we were really serious about putting people in Africa on ARVs,’ he said. Today, four million people have been initiated onto ARVs, however threats of funding shortages are now endangering the sustainability of these programmes, condemning poor people to die.
‘People are coming in masses because they have believed what we have promised,’ said Goemaere.
He revealed among others that:
– Tanzania’s HIV budget had been reduced by 25%;
– Swaziland has reduced its 2011 treatment coverage target from 60% to 50%;
– Uganda has sent an instruction to stop enrolment in some Pepfar (US government) funded NGOs;
– Malawi is expecting a national drug shortage and is devising an emergency contingency plan;
– South Africa has already reported stock-outs and revealed that there is a financial ceiling in terms of what can be done to reach to the National Strategic Plan targets.
Professor Robin Wood of the University of Cape Town warned against ‘backsliding’.
He shared data from a suburb in Cape Town where they were achieving 90% ARV coverage which has in turn seen a 20% decline in tuberculosis rates and a mortality rate that is similar to HIV negative people with TB.
‘What message are we sending to patients who have been told about adherence and the lifetime commitment to treatment when we inform them we no longer have drugs,’ he asked, cautioning that interrupting people’s treatment would lead to viral suppression and the need to move patients to second line treatment at six times the cost.
Paula Akugizibwe of the AIDS and Rights Alliance said that the money was available, but that it was not being spent on people’s health. ‘The African Union has estimated that U$148-billion has been lost to corruption, that’s pretty much the funding gap we face.’
‘If you limit the money you spend on health, you are prescribing how many people get to live. If you are pitting one Millennium Development Goal against another, you are prescribing how they die. It may be different MDGs, but it’s the same people,’ she said.
Akugizibwe handed out fake dollar notes calling to ‘Show us the money for Health’ with pictures of African leaders on the flip side and the money they have wasted. Uganda President Yoweri Museveni is accused of spending U$48-million on a private jet which is more than his country spends on HIV/AIDS.
Zimbabwe President Robert Mugabe is accused of spending U$250 000 on his birthday bash ‘ enough for 10 501 treatment courses for TB.
‘We need to understand why the social determinants (access to clean water and good sanitation) are getting worse while the world is getting rich,’ said University of Western Cape professor and People’s Health Movement representative David Sanders.
He cited diarrhea, a common killer of people living with HIV. ‘We will not kill that problem unless we address water and sanitation,’ he said.
Statistics show that between 1990 and 2004 the number of people without access to water increased by 23% and those without access to sanitation by 30%. Over 40% of people in sub-Saharan Africa have no access to water and sanitation.
Sanders said he wanted to warn the AIDS fraternity that the world has a track record of departing from comprehensive primary health care to selective primary health care. ‘There was a big increase in oral rehydration therapy and immunization in the 80s, but it changed when the donor fashion changed and now only 50% of children in Africa are being immunized. So you need to ask where we are heading if they so easily deserted basic and simple programmes while we know ARVs are much more complex,’ said Sanders.
Stephen Lewis of AIDS-free World called for people to fight the good fight over enlarging the pie ‘or everyone will lose’.