The South African government on Monday demanded a greater say over the way millions in United States HIV/Aids funding is spent in the country, arguing that giving the money directly to local programmes created a coordination problem.
”Our view is that external funding must be coordinated through government structures to achieve better outcomes,” Health Minister Manto Tshabalala-Msimang said at the opening of a conference on the US President’s Emergency Plan for HIV/Aids Relief (Pepfar).
About 1 200 delegates from around the world, including the US government’s implementing partners and other HIV/Aids programme representatives, are meeting for four days in Durban to discuss successes and challenges in confronting a pandemic that has killed an estimated 25-million people.
The Bush administration has pledged $15-billion to combat HIV/Aids over five years in 15 of the world’s worst-hit countries, including about $221-million for programmes in South Africa in 2006.
Tshabalala-Msimang said South Africa was surprised to be identified as a key beneficiary when the plan was announced in 2003.
”We were not consulted,” she complained in her opening address.
Despite starting ”on a wrong foot”, however, Tshabalala-Msimang said her government and Pepfar officials were starting to ”find one another and accommodate other African countries in dire need”.
Mark Dybul, the State Department’s deputy global Aids coordinator, said the Bush administration agrees ”completely” with the need for better coordination to support South Africa’s national programmes.
”We live in a time of great hope engendered by action,” he told the conference. ”For too long, the world has expressed sympathy without action. We need to rededicate ourselves to saving lives. There can be no higher calling.”
Private HIV/Aids groups, however, expressed concern about handing over too much control to the South African government, which has drawn criticism for its sluggish response to a disease that has infected up to six million people here, more than in any other country.
Nathan Geffen, spokesperson for the local Treatment Action Campaign, said groups should be free to approach Pepfar directly as government coordination would introduce ”an unnecessary level of bureaucracy and political control”.
He said the South African National Aids Council, which coordinates grants from the United Nations Global Fund to Fight Aids, Tuberculosis and Malaria is ”very inefficient”.
Geffen’s group, a frequent critic of South African authorities, has not applied for Pepfar funding.
South Africa, which has won international praise for its HIV prevention efforts, refused for years to provide life-prolonging treatment through its national health system, questioning the safety and cost of the medicines. It has now promised to provide free treatment to all who need it, but continues to draw criticism for delays in rolling out the program.
Helen Evans, deputy director of the Global Fund, said about 875 000 people were now on treatment around the world thanks to the UN and US initiatives. She warned, however: ”We will never turn the tide if we don’t put maximum effort into prevention.” ‒ Sapa-AP