Pressure is mounting against the South African government for continuing to delay a $72-million grant to KwaZulu-Natal from the Global Fund to Fight HIV, TB and Malaria.

Speaking at the World AIDS conference in Barcelona yesterday (wed), Global Fund director Dr Richard Feachem said the fund was “concerned” by the delay.

“It is incredibly important that states, provinces and local governments can seek funds from the Global Fund. In South Africa, this has proved difficult,” said Feachem.

“We hope and expect that this will be resolved quickly internally in favour of KwaZulu-Natal. If not, we will enter into negotiations with Pretoria to see what we can do to unblock the blockages.”

The Treatment Action Campaign’€™s Mark Heywood said his organisation also wanted an explanation from Health Minister Dr Manto Tshabalala-Msimang about why she was delaying the grant, which was announced in April.

“KwaZulu-Natal has the highest HIV prevalence rate in the country. If necessary, we will take legal action against the Minister to ensure that the money comes through,” said Heywood.

The grant has been stalled as the South African government was unhappy that the money did not go through the national Country Co-ordinating Mechanism (CCM). According to fund rules, all applications should be agreed on by an inclusive group of stakeholders constituted in a CCM.

However, at the time that KwaZulu-Natal’€™s application was finalised, there was no CCM. Later, government declared that the SA National AIDS Council (SANAC) would act as the CCM. By that time, the KwaZulu-Natal application ‘€“ which is supported by the provincial government, the Durban Chamber of Commerce and Industry, non-governmental organisations and AIDS researchers ‘€“ had already gone to the fund.

Government’s head of HIV/AIDS, Dr Nono Simelela said at the time 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 SANAC,” said Simelela.

However, a press release from the Fund said it had decided that “sub-national proposals are eligible for funding, provided they receive endorsement of the CCM’€¦ The provincial co-ordinating mechanism from KwaZulu-Natal, therefore, has been asked to co-ordinate its proposal with that of the CCM”.

“Formal correspondence from the applicants indicates that their discssions are proceeding in a positive direction and the Fund expects that an optimal arrangment will soon be reached by these partners,” said the Fund statement.

Constitutionally, health care is a concurrent function of national and provincal government which means that legally the province should be able to raise money to fund its own priorities.

The KZN grant has been awarded 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.

The KwaZulu-Natal application 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.