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The year 2011 concluded with the convening of the International Conference on HIV/AIDS and Sexually Transmitted Infections in Africa (ICASA) in Addis Ababa, Ethiopia.
This was where medical experts and health officials from all parts of the continent and some international players like former President George Bush (whose administration launched the PEPFAR initiative) took stock of the state of the “War Against AIDS”.

The annual event is described as “opportunity for dialogue and exchange among scientists, communities, people living with HIV, leaders and development partners about recent developments and research findings in prevention, treatment, care and support and to distil their implications for dealing with the AIDS epidemic in Africa”.
The year’s theme was “Own, Scale Up, Sustain” referring to individual African nation’s AIDS efforts.

One prominent speaker is known for his interest in Swaziland’s AIDS situation. Dr. Stephen Lewis is now co-director of the Canadian-based organisation, AIDS-Free World.

At the ICASA conference, he roundly condemned the suspension of new Global Fund Grants, which will certainly hinder progress against AIDS in Swaziland, as “unconscionable, indefensible, and outrageous. It’s murder. And the donor countries expect to get away with it because there is a culture of fiscal impunity”.

He called upon African leaders to address the Global Fund directly and demand that AIDS funding not be interrupted. Lewis, who is Canadian, was quite militant in his comments and insisted that the developed world “owes” Africa financial assistance to combat AIDS, given the developed world’s historic exploitation of the continent, in his view.

Dr. Michel Sidibe, the Executive Director of UNAIDS was also critical of the Global Fund’s decision to halt future grants until at least 2014.Medicins san Frontiers (MSF) released the results of its survey of nine sub-Saharan African countries which found that a majority of these countries had to suspend or reduce health programmes, including an upscale of their ARVs rollout campaigns. The reasons were all the same: lack of funding.

Back in 2001, all African countries committed themselves to government spending on public health that is the equivalent of 15% of their government budgets. At the ICASA meeting it was revealed that a decade later only six countries – Rwanda, Botswana, Niger, Burkina Faso, Zambia and Malawi – are in fact spending this amount on health care for their peoples.

Even these six countries have to rely on international donor funding to provide services, and if left to their own resources would not be able to achieve the target.
Officials at the ICASA conference argued that the money to fight AIDS exists in government budgets, but it is being channelled to other uses. They called for “new priorities” in government spending.

Swaziland is certainly not alone in its funding needs. In fact, throughout Africa 85% of HIV and AIDS funding comes from international donors.  Only a much smaller fraction (15%) of AIDS funding comes from African countries themselves.

The Kaiser Family Foundation released its 2011 survey of international funding on health care, and the report documented a significant drop of 10% international funding for AIDS programmes in developing countries.

The Kaiser survey concluded; “Now many African countries are facing the real threat of not meeting their budget requirements for implementing the much needed scale up of ART programmes, relying heavily on the Global Fund and PEPFAR to sustain these programmes”.

No wonder the Global Fund crisis is being described as a “wake up call” aimed at rousing officials into action. What is needed is for Swaziland and all other African countries to develop and sustain an HIV/AIDS funding strategy that is not hostage to external “shocks” like the Global Fund grants suspension.

The ICASA conference looked ahead to a future which is much like the present: no AIDS vaccine yet developed and thus a sustained need for mitigation and treatment programmes like those ongoing today.

Between now and 2032, the worldwide cost of AIDS will be about twice what is currently spent on the disease. In Africa, where AIDS is most prevalent amongst the general population, the cost of AIDS will more than double.

Officials like UNAIDS’ Sidibe referred to the funding crisis and AIDS efforts as being at a break or make point. “Of all the parts of the world where the global funding crisis hasan impact, Africa’s (AIDS) crisis would be most affected,” he said.

The conference conclusion had implication for the way the AIDS battle will play out in 2012 and beyond: International funding may not soon return and so it is imperative that African countries devise new funding strategies aimed inward, to local resources and re-examine all other manner of government spending that is not directed toward an epidemic that is sabotaging the health of their people’s health and the performance of their countries’ economies.

Fuente: Swazi Observer