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Aid Not Enough to Fight AIDS

Miriam Gathigah

BUSAN, Dec 1 2011 (IPS) - Billions of people are marking yet another World AIDS Day – this one themed “Getting to Zero”, for zero AIDS-related deaths, zero new infections, and zero stigma and discrimination.

But in Africa, what may be needed is zero tolerance for corruption so that funds required to fight HIV/AIDS and create awareness around the virus do not get siphoned away.

“In East Africa alone, Uganda has had its main source of HIV funding suspended. Kenya has, on several occasions, come close to a similar fate due to evidence of massive misappropriation of HIV funding,” says John Peter Kaguruzi, a public policy analyst in Rwanda.

“In Djibouti, of the 5.3 million dollars given as an anti-HIV grant, 750,000 dollars were spent on expenditure that cannot be explained. Similar stories are rife in Zambia and Mali. More audits would most likely reveal misuse of such funds which has denied many people access to preventive as well as curative initiatives,” Kaguruzi says.

Creating awareness has been important in places like Kenya where those afflicted were stigmatised and seen as promiscuous. When they died, they were buried in a polythene bag.

Over the years, Kenyans have become more aware of HIV/AIDS but that has not reduced the stigma attached to the disease. Neither has it significantly curbed risky sexual behaviour. Some 1.4 million Kenyans are currently living with HIV.

Statistics by UNAIDS, the joint United Nations Programme on HIV/AIDS prevention and cure, show that an estimated 22.5 million people were living with HIV in Sub-Saharan Africa. Slightly over half of them are women. Children have not been spared; they account for 2.3 million of this figure.

Years of research do not appear to have brought scientists any closer to discovering a cure for HIV/AIDS, and the condition claims at least one million lives every year in Sub-Saharan Africa alone.

But if millions of people in Africa infected with HIV are still alive, it is because of donor funding that makes it possible for them to access life-sustaining drugs.

“There’s need for more funding to provide treatment,” Mary Naliaka, a nurse in Kenya, told IPS.

But more funding is perhaps not what African countries need.

“Of the 145 countries that receive aid to fight HIV, an audit into 25 of these countries shows that they received a total of 4.8 billion dollars, but these grantees cannot account for 39 million dollars. In Mauritania alone, 67 percent of aid to fight HIV was misused,” Kaguruzi explains.

But he is quick to caution that the lost money is not a comprehensive figure.

“This is only an indication that massive corruption exists. In some countries the audit did not assess the entire grant, only a part of it. In Djibouti for instance, only 80 percent of the fund was audited, revealing a 30 percent misappropriation.”

Programmes that popularise prevention of HIV/AIDS by creating more awareness of the condition, HIV programmes in health facilities and the provision of free condoms are all affected by missing funds.

Ann Kariuki, a counsellor at an HIV/AIDS voluntary testing centre in Kenya, told IPS: “Often, condoms dispensers are empty. Not so long ago we would plead with people to use the free condoms provided by the government through the Ministry of Health. Now there are rarely enough free condoms.”

When the Global Fund to Fight AIDS, Tuberculosis, and Malaria was established in January 2002 as a public-private partnership, the aim was to provide financial support for global responses to HIV/AIDS, tuberculosis (TB), and malaria. However, with the fund in financial crisis, this may not be possible.

“The Global Fund saves 4,400 lives daily in poor countries, like in Africa. The ongoing crisis facing the fund is bound to have a negative impact on HIV prevalence. Already, Sweden has suspended 83 million dollars to the fund until the crisis is resolved,” says Peter Mwendwa, an HIV/AIDS activist in Uganda.

Sweden is the 11th-biggest contributor to the Global Fund but it is facing a shortfall of five billion dollars.

In South Africa, the Treatment Action Campaign (TAC), an AIDS activist movement, which successfully sued the South African government to provide free treatment to HIV- positive people, has said that it faces closure if the Global Fund does not fulfill its funding commitments. The TAC is the recipient of a five-year grant from the fund for a large portion of its work.

For many African countries the fund provided an opportunity to deliver treatment for ailing people, who at that time lived for an average of about six years

In poor countries, treatment for 70 percent of HIV patients is financed by the Global Fund. And based on the financial crisis facing the fund, the millions of people in need of ARVs face an uncertain future.

But an evaluation of how the Global Fund money is spent in Africa has revealed gross misappropriation of grants, denying many HIV positive people in need of anti-retroviral drugs an opportunity to live healthy and normal lives.

As of February 2011 out of 145 poor countries that were recipients of this grant, the Global Fund had uncovered a misuse of funds in 11 countries, totalling 44.2 million dollars.

Even more unfortunate is the fact that an estimated 63 percent of misused funds were identified in four countries – Djibouti, Mali, Mauritania, and Zambia – all countries with very high HIV prevalence rates.

According to Tiaji Salaam-Blyther, a specialist in global health, in line with its policy of zero corruption, “the Global Fund is reported to be seeking compensation of the funds and has already recovered 4.5 million dollars and submitted evidence in support of criminal investigations in Mali, Mauritania, and Zambia.”

At least 20 arrests have been made in these countries as the Global Fund gets to the bottom of who bears the responsibility of misusing funds for personal gains.

Mali, Mauritania, and Zambia have also had their grants suspended. Others whose funds have been suspended or frozen include Chad, Uganda and Djibouti.

In order to create transparency and accountability, the Global Fund released a statement earlier this year stating that it had established strict measures “to reinforce its financial safeguards and increase its capacity to prevent and detect fraud and misuse in its grants, many of which are already underway.”

According to the statement, these measures include “expanding the mandate of firms that monitor expenditure in countries in order to enhance fraud prevention and detection.”

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