Are countries spending enough on HIV/AIDS?
The impact of HIV/AIDS in Southern Africa is now well recognised, but the
critical question is whether enough funding has been allocated to deal with the
epidemic, a report by the Human Sciences Research Council (HSRC) said.
In April 2001 in the Nigerian capital, Abuja, African leaders committed
themselves to allocating at least 15 percent of government expenditure to
the health sector. But except for Zimbabwe and South Africa, none of the
other Southern African countries surveyed in the report - Botswana,
Lesotho, Mozambique and Swaziland - had fulfilled this promise. Analysts
have questioned the accuracy of the Zimbabwe figures.
"Botswana comes closest among the remaining countries, spending 10
percent of government expenditure on health. The other countries spend about
half of the 15 percent target," the study noted.
Although it was likely that Botswana and Swaziland would meet their
obligation, the "constrained macroeconomic environment" in Mozambique
and Lesotho made reaching the 15 percent threshold less likely.
Failure to meet these targets could also be attributed to "very poor
tracking mechanisms", Teresa Guthrie, project coordinator for the HIV/AIDS
budget programme at the Institute for Democracy in South Africa (IDASA),
told IRIN.
"In some of these countries you will find that the money is hidden in
other government components, and not necessarily in the health budget. We cannot
really say they have not been meeting targets - it has just been
difficult to track the money they have spent," she commented.
Nevertheless, the aggregate government expenditure on the disease in the
six southern African countries surveyed was nearly US $70 million
annually - ranging from a high of US $33 million in South Africa to a low
of US $0.8 million in Lesotho. When measured as a percentage of GDP,
expenditure on HIV/AIDS was highest in Botswana.
Government spending per HIV-positive person in these six countries was
more than three times higher than the average in the sub-Saharan African
region as a whole.
According to the report, apart from South Africa, the countries relied
heavily on donor funding. In Mozambique, Lesotho and Swaziland, more than
80 percent of total spending on HIV/AIDS was funded externally.
This raised questions about "who controls the AIDS money", IDASA's
HIV/AIDS budget programme manager, Alison Hickey said. She warned that
donor-funded projects - particularly antiretroviral campaigns - would not
last unless national governments started to shoulder the burden of their
AIDS spending.
"The whole point of Abuja was to get political leaders to make health a
priority in their national spending - with their own resources," she
added.
The Global Fund was another strategy for mobilising resources, which
governments could use as a crutch. "It is important that the gains made by
the commitment in Abuja are not reversed by the Global Fund's US $500
million allocations made to Botswana, Lesotho, Mozambique, Swaziland,
South Africa and Zimbabwe," the report said.
Admitting that more resources were needed in the region, Hickey called for
better accounting and monitoring of HIV/AIDS financing.
"We need to ... look at whether governments are spending correctly on
the
right programmes, and also whether the money is actually being spent," she
said. - IRIN
More information:
To access the report:
http://www.synergyaids.com/documents/Finance_CompAnalys.pdf
[This Item may not necessarily reflect the views of the United Nations.
Copyright (c) UN Office for the Coordination of Humanitarian Affairs 2003]
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