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Dwindling donor support hits HIV/AIDS programmes
Chronicle (Zimbabwe)
November 20, 2008

When the Matabeleland AIDS Council (MAC) received funding from the Global Fund, the world's biggest funder of HIV and AIDS activities a few years ago, it used the fund to roll out counselling programmes in two districts.

The Bulawayo-based AIDS service organisation managed to reach out to many people living with HIV and AIDS in Bulilima and Mangwe districts of Matabeleland South, thus alleviating the emotional and physical suffering of the infected from the two districts.

"The money helped us tremendously," said acting MAC director Miss Viola George. "It boosted our presence in the two districts, particularly in terms of our counselling of people living with HIV and AIDS. Without that support from the Global Fund, we would not have been able to do what we did to our clients at that time."

MAC is not expecting any funding this time because it has already benefited. The Global Fund meant to fight HIV and AIDS, TB and malaria, recently approved a US$500 million application from the Government.

But Miss George said sub-recipients (individual organisations that will receive part of the Global Fund money through the Government) under Round 8; disbursements will have their work boosted.

Every year, governments across the developing world apply for funding from the Global Fund to implement national activities to combat HIV and AIDS, TB and malaria, the three biggest killer diseases in the Third World.

The approval, only the third given to the country since the fund was set up 10 years ago, has delighted the Government, service organisations involved in HIV and AIDS work and people living with the virus.

"It is good for the country," said Miss George.

"You must remember that Zimbabwe has not been receiving as much international funding as it requires to fully respond, especially to the HIV and AIDS pandemic."

The health delivery system is suffering as a result of declining donor support because of illegal Western sanctions. There are widespread shortages of drugs, consumables, equipment and skilled manpower.

But the impending disbursement, which health experts say is very significant, is expected to go a long way in addressing some of the challenges being faced.

On five occasions Zimbabwe's applications for funding were approved by the Global Fund's secretariat but later shot down at the technical review panel stage for "technical reasons".

If an application fails at the panel stage, it is automatically dropped.

Zimbabwe only got limited assistance under rounds one and five.

Proposals for funding are based on a comprehensive needs-assessment, including efforts to scale up access to key prevention services for the three diseases through both public and non-public implementers.

The Minister of Health and Child Welfare, Dr David Parirenyatwa, who also chairs the Country Co-ordinating Mechanism, welcomed the approval.

"We are very pleased," he said, "that the TRP has approved our application because funding for Zimbabwe was long overdue considering that we did not get anything from the previous two consecutive rounds, yet our neighbouring countries got funding many times compared to us. The country has also posted many achievements, especially in the area of HIV and AIDS where we have recorded a downward trend in the HIV prevalence rate."

Zimbabwe sought US$296 752 070 for HIV and AIDS under an application titled, "Towards Universal Access: Addressing Critical Gaps in HIV Prevention, Care, Treatment and Support".

It also requested an additional US$58 million to fight TB under an application titled, "Towards Universal Access: Ensuring Access to High DOTS".

The country is seeking US$59 million for malaria treatment and control programmes. A separate request for US$81 728 254 to strengthen health systems and revive the health sector was also made.
But at some point, the positive news of the approval of the proposal was spoilt by reports that the Global Fund wanted the Government to repay US$7,2 million, which had not been used for HIV and AIDS programmes.

There were fears that the fund would, after rejecting the country's applications on "technical" grounds, use that disagreement as a credible reason to deny the country more funds.

But after some consultations, the Government made a commitment to pay back the money, and indeed made good its promise, paving the way for the impending disbursement.

People living with HIV and AIDS have commended the Global Fund for its decision.

Mr Benjamin Mazhindu, chairman of the Zimbabwe Network for People Living with HIV and AIDS said the money was coming at a time challenges facing the health system had worsened.

He said he was more than happy because his organisation was among the beneficiaries of the pending disbursement.

"We will use the money that we will receive to strengthen our structures, from provincial, district down to ward levels," said Mr Mazhindu.

"The money would also help us to pay the salaries of our secretariat. Depending on the amount of money we will receive, there is a plan to expand the secretariat."

"Some of the money," added Mr Mazhindu, "is earmarked for promoting treatment literacy for people living with HIV and AIDS."

"t is crucial for infected persons to take drugs at prescribed times, in the right doses and so on," he said. "This kind of literacy is very important because in HIV and AIDS and TB treatment, a patient must religiously adhere to advice from their health experts. Failure to follow the advice often causes drug resistance, which in most cases results in premature deaths."

Another sub-recipient under Round 8, Women's AIDS Support Network (WASN) is also happy with the Global Fund's approval.

WASN executive director, Ms Mary Sandasi, said: "It was a long wait for us as a country. Most funders are holding on to their money but this amount is so significant that it will help us as a country to scale up our response to the three diseases (TB, malaria and HIV and AIDS), especially HIV and AIDS."

She said her organisation would use the disbursement to promote treatment literacy as well as advocacy activities.

She expressed hope that the decision by the Global Fund, would be a catalyst to easing the fatigue that foreign donors have shown on supporting Zimbabwe's health programmes.

It is estimated that while foreign donors are spending as much as US$100 on every HIV infected person in countries like Zambia, they are spending as little as US$4 per person in Zimbabwe.

However, the lack of funds has not disrupted Zimbabwe's fight against HIV and AIDS, as the prevalence rate has consistently dropped from around 26 percent some seven years ago, to 15, 6 percent last year.

This, health experts say, is a big achievement for the poorly-funded health system, because in other countries which have more money, the HIV and AIDS prevalence rates have stagnated.

"They (Global Fund) must have noted the commendable achievements that we have scored as a country with limited external funding and decided to chip in this time," said Ms Sandasi.

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