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The Global Fund to Fight HIV and Aids, Tuberculosis and Malaria is a UN agency mandated to help countries combat the three diseases. In Zimbabwe, the Fund has been shamelessly playing politics with the lives of patients of these diseases, despite the fact that Zimbabwe has one of the best intervention programmes in the world. In 2004, the Fund's then executive director, a Briton, was reported to have admitted that, "yes, the politics of a nation plays when we determine the country's application". Mabasa Sasa examines the sad tale of the Global Fund in Zimbabwe.

A popular hymn sung by people who believe that Zimbabwe is not under any form of economic sanction is that the West has placed "targeted sanctions" on individuals in government.

This is, however, despite the explicit wording of America's innocuously named Zimbabwe Democracy and Economic Recovery Act (particularly Section 4C, the Act was passed into law in 2001) and the fact that Zimbabwe has not received any balance of payments support from donor agencies and countries for nearly 10 years.

The Zimbabwe government has through the years maintained that the sanctions regime has impacted negatively on the economy and that ordinary people are being hurt by these so-called targeted sanctions.

At one point the former US ambassador to Zimbabwe, Christopher Dell, was told point blank by an official of the Africa University based in Mutare in the east of Zimbabwe - which is largely funded by American Methodists - that the university had failed to access software from Microsoft because the American Treasury had advised the company not to deal with Zimbabweans.

More recently, there has been evidence that online payments facilities, such as PayPal, have also been advised by the US Treasury not to open Zimbabwean accounts.

This means Zimbabwean businesses are deprived of access to 190 global markets, 17 currencies and over 100 million potential business partners in the thriving new world of e-commerce.

However, one area that has received very little attention has been that of HIV and Aids. The simple truth is that the Global Fund to Fight HIV and Aids, Tuberculosis and Malaria has refused to support Zimbabwe's highly successful intervention measures and there are now whispers doing the rounds that someone holding the purse strings does not want the country to access any money.

Zimbabwe has been one of the most successful countries in the world in combating HIV and Aids. Statistically, Zimbabwe leads the entire Southern Africa region in reducing the prevalence and incidence of HIV despite the withdrawal of Western aid.

When the UN recently reviewed its estimates of global prevalence, it gave special mention to Zimbabwe's intervention efforts. In 2003, Zimbabwe's HIV prevalence rate stood at 24.6%. This declined to 18.1% in 2005 and a few weeks ago, Zimbabwe's Health and Child Welfare Ministry announced that this figure has since further fallen to 15.6% for the most vulnerable 15-49 year-old bracket.

Mauritius, South Africa, Swaziland, Namibia and Botswana are believed to have the highest figures of prevalence and incidence despite their strong economic performance, while Zimbabwe - facing illegal economic sanctions and donor withdrawal - has managed to record a significant decrease in both.

Despite all these statistical advances, the international donor community, in particular the Global Fund, still feels that Zimbabwe's efforts should not be supported.

According to UNICEF, health financing through donor support per person in Zimbabwe is now down to US$4 per annum. This is in sharp contrast to US$39 in Lesotho, US$104 in Botswana, US$139 in Swaziland, US$190 in Zambia, US$192 in Mozambique and US$362 in Uganda.

Another independent estimate says that on average, donors spend around US$240 per HIV or Aids patient in Sub-Saharan Africa - that represents a figure 60 times higher than spending on Zimbabweans living with HIV and Aids.

And nobody believes that donor fatigue is to blame for this huge gap in resource allocation for a problem that is essentially the same in Zimbabwe and in Uganda.

Another statistic: At present only about 86,000 Zimbabweans have access to the life-prolonging ARV drugs at a time when a reported 800,000-plus people in the country are in urgent need of them.

So where, ask many Zimbabweans, is the logic in sidelining Zimbabwe and its successes when the country is at the geographical center of Southern Africa?

In truth, sanctions on Zimbabwe translate into sanctions on the whole Southern Africa region since there is great mobility in the region, and HIV/Aids, TB and malaria are not controlled by borders.

There is no logic in heavily financing the fight against these diseases everywhere else in the region except Zimbabwe, for the simple fact that as long as it is prevalent in one country then the entire region is affected.

Writing as far back as 2004, Dr Paul Chimedza, the president of the Zimbabwe Medical Association, noted that the Global Fund was largely a political institution.

He said: "Zimbabwe is unfortunate to be inflicted by all the three conditions (HIV/Aids, TB, and Malaria). One would expect that distribution of the Global Fund monies will be according to the burden of disease, meaning that those countries which are affected get more money to enable them fight these diseases.

"Unfortunately, the people running the Fund at the moment have a 'fairer' way of distributing these funds and that is according to which side of the political coin a country falls."

He continued: "To put things into perspective for those not familiar with the issue, in 2002 Zimbabwe applied to the Global Fund for US$8.8m for malaria and US$14.1m for HIV and Aids. The proposals were so well put that it would have been inhuman to reject them. The applications were approved for both malaria and HIV/Aids at the end of 2002. Since then our government has been battling to get these approved funds.

"Out of the US$8.8m approved for malaria, Zimbabwe only received a paltry US$1.4m and for HIV and Aids we are still chasing our tails, and there is no hope for us ever getting this money."

Dr Chimedza, one of the most respected medical administrators in the country, said they soon realized that it was not a matter of there being strings attached, but indeed there were "ropes attached".

"The money was initially supposed to have been received by the National Aids Council (NAC), but the Global Fund said the NAC had no capacity to handle US$14.1m despite the fact that they receive millions from our Finance Ministry and elsewhere every year."

When round two of applications came, Zimbabwe was still battling to get its approved monies, so it didn't put in another application. When round three came, Zimbabwe put in another application, this time for US$218m for HIV and Aids. Just to make sure things were done correctly, some of the best consultants from WHO and UNAids were employed to assist Zimbabwe's technical team to prepare the proposals.

Dr Chimedza lamented: "Successful proposals from Uganda, Zambia, Malawi, Botswana, Mozambique and Tanzania were thoroughly studied so mistakes could be minimized, but this time our application was rejected outright and we were asked to appeal."

At a recent SADC health conference at the Zimbabwean tourist resort town of Victoria Falls, Malawi's health minister, Dr Majoria Ngunje, said there was need for health issues to be apolitical but the Global Fund did not seem to appreciate this.

She said: "The Global Fund is a pool of resources set up to help countries which do not have enough resources on health and should not be political. We urge the Global Fund to be apolitical and start helping people without regard to creed, color or race. It's unfortunate that Zimbabwe has failed to get its share just like Malawi at times had its request rejected by the Global Fund."

In mid-2004, Dr Richard Feachem, Global Fund's executive director, was reported to have admitted that "a measure of sanctions were in place against Zimbabwe" which explained the country's failure to access money from the organization. "Yes, the politics of a nation plays a role when we determine the country's application," he was reported to have said.

Richard Feachem's franc-parler forced Zimbabwe's health minister, Dr David Parirenyatwa, to say: "These are the sanctions that anti-government organizations and the opposition MDC are calling for, and this has resulted in a humanitarian proposal being turned down.

They purport that the sanctions are targeted at individuals within the ruling party when in fact the whole society is being targeted. This is very distressful. No matter how good your proposal is, they do not consider that. They only consider their own respective political gains. It boggles the mind how the so called superpowers would target such a small country even on humanitarian grounds."

Dr Feachem, a British national, was the first executive director of the Global Fund and the UK has always been a key institutional donor of the body founded in 2001. When viewed from the perspective of the UK being the cheerleader of the Western sanctions regime against Zimbabwe, it becomes easier to understand why Zimbabwe is treated so shamelessly by people who would like to be viewed as philanthropists.

Just recently, in November 2007, the Global Fund rejected yet another Zimbabwean request for funding under Round Seven. Zimbabwe applied for US$75m, of which US$48.5m would have been spent on malaria and the rest on TB.

The Fund turned down the proposals, citing "technical reasons", but Dr Owen Mugurungi, the national HIV/Aids, TB and malaria coordinator, says the government is still not aware of the reasons behind the rejection.

"We are very disappointed by this decision to deny us funding to fight these health problems," Dr Mugurungi said. "This money would have been used to strengthen our surveillance systems through the procurement of equipment, drugs and improving our infrastructure."

What does the future hold? In an address to SADC health ministers in November, President Robert Mugabe said: "The failure [to get funds] is often explained in lame terms. But for Zimbabwe, who have been subjected to declared and undeclared sanctions for the past seven years, the reason for the Global Fund response is much easier to fathom.

"Unwillingly, the Fund has fallen victim to the Western policies that have sought Zimbabwe's destruction, certainly our punishment for the bold step we took to empower the majority of the people through the land reform programme."

Zimbabwe has relied on its own innovations such as an Aids levy on all formally employed people, collected by the government and administered through the National Aids Council. In 2000, when the international donor community started pushing Zimbabwe into the cold, the country came up with a sustainable Aids Trust Fund to pay for its Aids support programmes.

And if the statistics indicating a steady decline in prevalence are anything to go by, the intentions are bearing fruit.

Zimbabwe is still not sure whether it will apply for funds under Round Eight. After all, to date, after seven rounds of proposals, the country has only received funds under two rounds, and even then, not all the promised money was delivered.

A total of US$35m has been given to Zimbabwe in nearly six years, with US$50m still outstanding.

In August 2007, Zimbabwe received a paltry US$7m from the Global Fund to finance various health programmes. Health minister David Parirenyatwa was not happy: "We were denied the second, third, fourth, fifth and sixth round. We only benefited in the seventh round and this is minimal support we are getting from outside the country."

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