Africa, Development & Aid, Headlines, Health, Poverty & SDGs

HIV/AIDS: Fund Rejection Worries Health Campaigners

Lameck Masina

BLANTYRE, Malawi, Jan 3 2011 (IPS) - Health rights activists in Malawi are expressing concern over the recent rejection of the country’s proposal for close to six hundred million dollars to the Global Fund to fight HIV, tuberculosis and malaria between 2011 and 2016.

But the government maintains there is no need for concern. Executive Secretary for Malawi Global Fund Coordinating Committee Edith Mkawa told journalists last Tuesday in the capital Lilongwe that the country’s proposal has been refused again.

The proposal focused heavily on tackling transmission of HIV from mother to child by providing lifelong HIV/AIDS treatment to all HIV-positive pregnant women. Malawi had hoped to scale up its ARVs roll-out from 287,000 to 537,000 by the end of the funding year.

Malawi had also planned to scale up voluntary male circumcision to help slow down the HIV infection rate that has stagnated at 12 percent since 2007. Nearly one million men could have been circumcised within the implementation period.

Mkawa said no reasons were given for the rejection of the proposal. “We are yet to receive the reasons as to why the proposal has been turned down by the world body,” she told local journalists. However, to some the rejection hasn’t come as a surprise.

Médecins Sans Frontières (MSF), an international humanitarian aid organisation better known as Doctors Without Borders, had warned in an article on its website on December 8 that due to budget shortfalls, several African countries “may be disqualified from HIV/AIDS funding in the near future”.

“MSF is seriously concerned that several low-income countries with high HIV-prevalence such as Malawi, Zimbabwe, Mozambique, Swaziland and Lesotho risk being denied funding for HIV and TB in this round,” reads the article in part.

Executive Director of Malawi Health Equity Network, Martha Kwataine, says the news is disappointing. “The impact is quite enormous. About 90 percent of HIV activities in Malawi are donor funded. So this means that there will actually be a halt in the fight against HIV.

As a result we might find our (HIV) statistics plummeting again”, she says. Kwataine says the development should serve as a warning on the part of government to stop over-relying on donor funding.

“We can’t keep on relying on donor funding. And these are our people who need to be on ARVs forever. I have always said that Malawians are not Global Fund people. They belong to the government. The state is responsible for providing health care to its citizens”, she says.

HIV/AIDS has been blamed for 59 percent of deaths among those aged between 15 to 59 years in Malawi, which has a population of 13 million. According to Kwataine the rejection has put the rights of many more Malawians at risk.

“That’s very risky because if people stop taking ARVsfor about two or three months they develop resistance and in the end they die. On the other hand, we have adopted the WHO guideline. Now how are we going to implement the new guidelines? It’s a really a challenge because we will not make any step forward,” she says.

Executive Director for the National Association for People Living with HIV/AIDS in Malawi, Amanda Manjolo, says the denial of funding will have a pernicious effect on the lives of those who are taking ARVs.

“Since the main focus of the proposal was on the procurement of the ARVs, this definitely means that there will be ARV shortages in the near future”, she says.

Concurring with Kwataine, Manjolo says this will affect the government’s plan to take into account the new WHO guidelines that people should start taking ARVs at a CD4 cell count of 350.

Principal Secretary in the Office of the President and cabinet responsible for Nutrition and HIVAIDS programmes, Mary Shawa, plays down the fears.

“Although it is a sad development, the rejection will not have immediate effects because currently we have enough resources to carry us up to 2012. But we take it as a wake up call because we need to continue providing ARVs to those with HIV”, she says.

Shawa says the government is now strategising on how to find non- traditional donors to bankroll its HIV programmes. Like other countries in the SADC region, Malawi has begun treating HIV- positive pregnant women at the WHO-recommended CD4 count of 350, but the standard CD4 count threshold for initiating ARV treatment remains 250.

“We will continue the WHO guidelines. We have enough funding with the money we received from other donors, including the World Bank and DFID”, says Shawa.

According to the Global Fund, only 79 submissions out of about 150 proposals have been awarded this year. Other countries who have been denied funding are Swaziland, Mozambique, Democratic Republic of Congo and Zimbabwe.

Zimbabwe, like Malawi, has been receiving assistance from the Global Fund since 2002.

Manjolo says with the funding gap, which the Global Fund has created, HIV- positive people in Malawi are likely to suffer severe opportunistic infections and even early death. She is calling for the urgent introduction of a new round of funding to allow rejected applications to be resubmitted.