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Zimbabwe’s 'Exclusion' from Global Fund Questioned
Eunice Mafundikwa, Inter Press Service (IPS)
July 23, 2004

http://www.ipsnews.net/interna.asp?idnews=24759

HARARE - The decision to ‘’exclude’’ Zimbabwe from benefiting from the Global Fund to fight AIDS, TB and Malaria has raised a number of ethical questions. Campaigners are asking whether need and desire to prolong people’s lives should prevail over politics and controversies surrounding the legitimacy of President Robert Mugabe’s government.

Zimbabwe is at the epicentre of the epidemic, coming third on the ladder of countries with the highest infection levels. One in four Zimbabweans is infected with HIV. Life expectancy has been reduced to 35 and the orphan population now stands at around one million.

In an interview with IPS at the just ended 15th International AIDS Conference in the Thai capital Bangkok, Global Fund to fight AIDS, TB and Malaria executive director, Richard Feacham, said Zimbabwe would not benefit from the fund.

"Yes, the politics of a nation plays a role when we determine that country’s application," he said. "There are a broad set of challenges in Zimbabwe that we considered - in coming up with an agreement to reject their proposal. How and to whom do we disburse the funds? What exchange rate regime will we use?"

"It does not help the people of Zimbabwe to pass money through channels which are not well worked out," Feacham said.

However, the fund’s director of operational partnerships and country support, Elhadl Sy contradicted Feacham. "I am surprised that politics comes into play. To my knowledge the assessment is purely on the technical merits of the application," he told IPS.

Zimbabwe, whose proposal had inputs from an expert from the Fund, had applied for 516 million dollars, the bulk of which was to support an anti-retroviral drugs (ARVs) roll out. Out of the 1,820,000 Zimbabweans infected with HIV, 5,000, or less than one percent of the infected population, are on treatment therapy.

Judith Kaulem, coordinator of the Poverty Reduction Forum in Zimbabwe, said: "Anti-retroviral support in Zimbabwe is not a luxury to keep infected people alive but rather a medium through which we curtail poverty by keeping the breadwinners earning income for the upkeep of their extended families. A breadwinner is the social security for an entire village.’’

"When you withhold the much needed treatment you are not just depriving the people living with AIDS, but are essentially depriving an entire clan of their source of sustenance," she said.

David Parirenyatwa, Zimbabwe’s Minister of Health and Child Welfare said he had always suspected that politics was a factor whenever the fund discussed Zimbabwe. "The Fund approved our first round application in 2002 and to this day we have not received that money. They keep shifting the goal posts," he told IPS.

By not including Zimbabwe in the initiative, Parirenyatwa feels the Global Fund is depriving the world from benefiting from Zimbabwean experiences.

Parirenyatwa claimed Zimbabwe was among the countries with the best coordinating mechanism (CCM), a key requirement by the Fund that encourages co-operation between civil society, private sector and the government. Zimbabwe through a private company, Varichem, is manufacturing ARVs but this is not enough.

Kate Mhambi, director of the Zimbabwe AIDS Network (ZAN), the umbrella body of AIDS organisations, said her agency was collaborating with government, particularly during the write-up of the forth-round bid.

"ZAN has been collaborating with government and to us the CCM is just a continuation of that," she told IPS.

While the Global Fund has a provision for civil society to make applications independent of their governments, the organisations need to prove beyond reasonable doubt that they were excluded from the countries with the best coordinating mechanism (CCM).

"For this reason we cannot go behind the government and make independent applications. Besides, to operate in Zimbabwe as an NGO or charity organisation, we need to register and we cannot afford to antagonise the government because they will simply deregister us," said coordinator of a home-based care project who requested anonymity. "It’s a catch 22 situation that we find ourselves in."

Humanitarian aid is not often withheld because of governance issues. It could be channeled through non-governmental organisations or other non-state actors.

"It’s an extraordinary step to withhold humanitarian support because while suspension of aid to rogue regimes justifies itself politically, withholding humanitarian support raises a lot of moral questions," said chairperson of the Crisis in Zimbabwe Coalition, Brian Kagoro.

Leonard Okello, HIV and AIDS director for Action Aid International, said the Bangkok meeting confirmed that the war against AIDS is one which can be won if the commitments and passion of millions of people working in this sector were translated into action.

"The main challenge now is to go beyond the politics in order to fight HIV and AIDS and swing into real action of making resources available to all including our political enemies. At the end of the day we are punishing the citizens of these countries who continue to die unnecessarily of HIV and AIDS," he said.

Mandi Mawodzwa-Taruvinga of the Southern African AIDS Trust - that supports community-based organisations and NGOs to build community competence in responding to HIV/AIDS said it was a tragedy of major proportions when humanitarian groups turn their backs on millions of people because of politics.

"I can understand it when (U.S. President George W.) Bush decides not to support Zimbabwe because I associate him with politics. It boggles the mind when initiatives like the Global Fund drag politics into the arena at the expense of millions of people far divorced from politics," she said.

She urged Global Fund to rise above politics and show leadership by providing resources to those who need them.

"The behaviour being displayed by the Global Fund raises questions of leadership and accountability. We cannot but ask to whom the fund is accountable. Is it accountable to the major donors or to the millions of men, women and children who are infected and affected but who have no influence over the political direction in their country?" asked Mawodzwa-Taruvinga.

She warns that the challenges of the epidemic cannot be localised because of the cross-border impact. "The tragedy is not a Zimbabwean tragedy but a global tragedy," Mawodzwa-Taruvinga said.

Zimbabwe, which has contributed one million dollars to the Global Fund, is not among the 14 African countries meant to benefit from Bush’s 15 billion-dollar project to fight AIDS.

In its latest editorial, Zimbabwe’s weekly ‘Standard’ newspaper, which is critical of the government, said the world cannot hope to make a difference in the fight against HIV and AIDS if some of the countries were denied access to the global resources because of ‘’misdemeanors" of their political leaders.

"It is in this context that we call on the international community to make a clear distinction between the political leadership of a country and the population of a country. People cannot be made to suffer for the sins of their leadership. By all means, punish the leaders but spare the citizens," it said.

Lynette Mudekunye, of Save the Children UK-chapter in South Africa, said isolating Zimbabwe was a sure recipe of undoing all the work on AIDS being done in the sub-region and beyond. "You cannot deal with a public health issue by isolating the epicentre of the epidemic. We might as well close shop," she said.

Kagoro said the notion that people deprived of ARVs would revolt against their regimes was simplistic. "This discounts issues of food insecurity, job scarcity and other ills. Somebody who is famished cannot be expected to focus on redressing the governance crisis," he argued.

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