Sub-Saharan Africa carries the highest burden of HIV and AIDS in the world. An estimated 22.4 million sub-Saharan Africans have HIV. That is about two-thirds of the world’€™s HIV-positive population. Two years ago around 1.4 million people died from AIDS in sub-Saharan Africa and almost two million acquired HIV. It is no wonder then that the region needs the most financial resources to address the scale and impact.   The international community realized the need to assist and commited itself to offer support.

‘€œThere are several countries that have difficulties to find funding for it. Without international funding it will be very difficult’€, says Dr Mit Phillips is health policy analyst at Medecins Sans Frontieres (MSF), a medical humanitarian aid agency.

But recently, donor nations and agencies have been reducing their financial support, not increasing it or totally withdrawing it. Dwindling resources suggest that one-time friends in need have lost interest in the cause.

‘€œWhy do they do it? Why?’€ , asks Dr Eric Goemaere, MSF’€™s medical co-ordinator in southern Africa.

Many donors have blamed their actions on the recent economic down-turn. But Goemaere has another theory.

‘€œWe believe strongly that the economic crisis is the scapegoat’€, he says. ‘€œWhat we understand and what is happening there is that everyone tries to escape what was a commitment and becomes an entitlement. Why so? Because (AIDS is a) life-long disease. There is a shift today from international donors to say, ‘€˜no, it’€™s not their responsibility in the long run’€™. They ‘€˜accepted responsibility in the short-term, but not in the long run’€™, Goemaere continues.

In other words, donors and rich nations have realized that if they don’€™t pull their support now, they will be forced to foot the bill for sub-Saharan Africa’€™s AIDS programmes infinitely. Inevitably, reduced or no foreign funding will derail AIDS programmes that are beginning to show success. Money has to be found somewhere. That means that local governments have to look to their own resources to fund AIDS treatment and prevention. African leaders promised in 2001 to increase their national health care spending. They are just as guilty of letting their countries down.

 ‘€œOur own African governments made a promise at the Abuja Declaration that they will increase their health spending by 15%. Most of the countries, including South Africa, are only sitting at between 8 and 9% of their GDP financing in health.

 That cannot necessarily only be blamed on the fact that there is no commitment from these governments. There is also a political, moral and legal obligation to keep their promise’€, says Nonkosi Khumalo, chairperson of the Treatment Action Campaign.  

‘€œGovernments have a responsibility to look after the health of their people. This is because the people pay taxes to them. It is true that international donors fund up to about 95% of the HIV programme and ARVs in Kenya, currently. It is my belief that the government should be able to cater for better treatment levels to ease the people. That’€™s the bottom line. But the government continues to rely so much on external funding in order to sustain its programmes. In 2001, the national budget allocation spent on HIV treatment was about 1%. Currently it has increased to about 5%’€, adds Jimmy Gideyi, an AIDS activist from Kenya.

It is widely accepted that most governments in Africa cannot finance their own national AIDS programmes without outside help. Even if they raise their health spending to 15%, countries like South Africa and Kenya will still be far short to satisfy the need. The TAC’€™s Nonkosi Khumalo called on both international donors and African leaders to step up their efforts in the response against AIDS in sub-Saharan Africa.        

‘€œThe international donors together with our African governments’€¦ we’€™re saying to them: ‘€œRe-commit to your commitments’€. We are saying to our own African leaders, ‘€œplease do increase your health spending to 15%. You have a responsibility to save these lives. Save life. Preserve dignity and uphold human rights’€, Khumalo said.