Global Financial Woes Roil AIDS Fight

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[Global News]

The raging global financial crisis is now forcing most African countries to cut their budgets including expenditure on critical programs like combating HIV/Aids.

This has further weakened health care systems and eroded the modest gains that have been registered in the fight against the pandemic in the past few years.

Tanzania was the first sub-Saharan country to announce a 25% slash of its annual HIV/Aids budget. Health experts say this will have a significant impact on human resources in the sector and on health service delivery in this East African country.

They further say that long-term health planning will become completely unpredictable as funding dwindles for most HIV/Aids programs on the continent.

The global financial crisis has forced commodity prices to nose-dive dealing major blow to agriculture and mining-based African economies which had registered some positive growth in export revenue over the last few years. Mining companies in mineral dependent economies in Africa are scaling down operations resulting in massive retrenchments and lay–offs.

Botswana, South Africa, Zambia, the Democratic Republic of Congo and Zimbabwe were some of the hardest hit countries in the southern Africa region. These countries have registered significant cuts in their export receipts severely affecting revenue flows for the governments and expenditure on HIV/Aids programs.

Even the large mining companies are scaling down expenditure on HIV prevention programs, affecting thousands of employees and their families. The Botswana government announced recently that it will not be able to include new patients in its free antiretroviral (ARV) treatment program from 2016 onwards, because it doesn't have sufficient funds to expand the program.

In Zambia, the situation is dire with the large copper mining companies making massive cuts on HIV spending as the companies lay off thousands of workers due to the global financial turmoil engulfing Western countries which are the main drivers of commodity prices since they are the substantial consumers.

Zimbabwe’s economic problems in the past few years have led to the deterioration of the country’s health care systems. Most HIV patients are still having problems in accessing HIV drugs; if when drugs become available, purchasing choices are stark: medication or food?

Poverty, unemployment, and poor crop harvests in some parts of Zimbabwe and the dwindling financial resources for most non-governmental organizations (NGOs) is likely to compound the problems facing people living with HIV.

Of the estimated 320,000 people in need of ARV treatment, only about 100,000 are accessing the medication at public health facilities. Besides the treatment gap, government hospitals are struggling to deliver services in the face of shortages of drugs, medical staff and foreign currency.

Big international donor organisations are also reeling from the financial crunch.

The Global Fund to Fight AIDS, Tuberculosis and Malaria recently announced it is at least $4 billion short of the money it will need to continue funding essential HIV, TB and malaria services in 2010. The Fund says there is a $10.7 billion funding gap for regional implementation of the Global Plan to Stop TB alone.

Most HIV health service organization and HIV and TB activists in the sub Saharan Africa region are rallying together to press for more funding for HIV/Aids programs to mitigate the impact of the financial crisis on HIV health service provision.

Activists argue that the right to health and treatment are non-negotiable and press African governments and international aid organizations to stick to their commitments made to increase and improve HIV treatment and care.

"Broken promises and skewed priorities of governments and donors have reduced the right to health and access to treatment to unattainable rhetoric," said Nonkosi Khumalo, South Africa Treatment Action Campaign women's health program coordinator. Khumalo spoke at a meeting of HIV/Aids coalitions in Cape Town recently.
“In the last few months, we have seen trillions of dollars spent on financial bailouts to stimulate economic recovery. A tiny portion of this sum could have bought quality, sustainable healthcare for millions of people," Khumalo added.

According to the 2009 World Bank report, "Averting a Human Crisis During the Global Downturn", countries in Eastern and Southern Africa are the most vulnerable. Researchers estimate the negative impact of this crisis will affect 70% of people on ARV treatment in Africa within the next 12 months.

Apart from countries such as Botswana and South Africa, most countries have limited fiscal space they can use to cushion the impact of a decline in international aid, the World Bank says.

Most households in Sub-Saharan Africa are poor, and the large number of people on treatment means ever-increasing treatment program costs. The trend is worrying as Sub-Saharan Africa only accounts for one percent of global health expenditure and two percent of the global health workforce.

Health experts further say that only one third of HIV-positive Africans in need of ARV treatment can access it.

Failure to shore up funding for HIV programs in Africa will threaten the modest gains recorded in the fight against the pandemic.
Commitment made to set aside 15% of their national expenditure towards health made by African heads of state during a meeting in Abuja, Nigeria, in 2001 will remain a dream.

Tsiko is The Black Star News’ Southern Africa correspondent based in Harare.

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