Health: More Money and Better Spending Needed
Activists call on African and global leaders to sustain HIV funding,
increase investments in health across the board and improve
transparency and accountability. See their statement here.
African activists have called on national and donor governments to
sustain their funding commitments to HIV, increase their investment in
the entire health system, and to improve transparency and accountability
in the way that health funding is used.
The activists were speaking at a press conference in Cape Town, where
they are attending a regional advocacy meeting on health funding
organized by the AIDS and Rights Alliance for Southern Africa (ARASA).
Adejoke Sonoiki of Nigeria-based Journalists Against AIDS warned that
the fight against HIV is far from over, and that it cannot be separated
from the fight for better health across the board.
“We should not let people far away from reality draw artificial lines
between the diseases that are intertwined in many of our lives”, said
Sonoiki , adding that without substantial increases in the amount of
money dedicated to health by national governments and donors, their
ostensible commitment to strengthening health systems was “empty talk”.
At the press conference, Paula Akugizibwe of ARASA presenteda statement
entitled “HIV is not over-funded: Health is under-funded”, which has
been endorsed by 87 civil society, research and health professional
groups from 30 countries around the world. The statement warned that
“shifting funding from HIV will not fill the yawning gaps in resources
for health”, describing this move as “a cheap diversionary tactic that
offers no genuine or long-lasting solutions for health systems”.
Akugizibwe pointed out that the long-standing neglect of health, even
prior to the HIV response, has resulted in a wide array of public health
crises that are now forced to compete against each other for a meager
pool of funding. “This competition is completely irrational,” she said.
“We cannot keep shuffling our scanty resources from one disease to
another and expect to see lasting change. Health, a vital requirement
for stable societies and socio-economic development, needs to be
prioritised and funded appropriately. But this cannot be at the expense
of HIV, which underpins so many other health challenges.”
Akugizibwe highlighted that more than half of people who need treatment
still do not have access to it – and that lack of treatment increases
the burden of other diseases. In at least 4 Southern African countries,
more than 50% of under-5 deaths are HIV-related; and globally, HIV is
the leading cause of death in women of child-bearing age. However, as
warned by Carol Nyirenda of the Zambian group Community Initiative to
Fight AIDS, TB and Malaria, who also sits on the board of the Global
Fund to Fight HIV, TB and Malaria, backtracking in funding commitments
is threatening the sustainability and scale-up of HIV programmes.
Nyirenda described the next round of the Global Fund as “extremely
uncertain”, explaining that the failure of the US government and others
to meet their funding commitments has resulted in a situation where the
more than 2 million people who are on ARV and TB treatment due to the
Global Fund’s support may see their continued access in jeopardy, and
millions more may not be able to access treatment at all. “I am living
proof the Global Fund has saved lives,” she said, calling on donors to
“fund the Fund”. She points out that in 2007, for the first time, global
AIDS deaths began to decline. “Why undo this progress? This is not a
time to slow down investment in the Fund, but to accelerate them.”
Harriet Mabonga from The AIDS Support Organisation (TASO) in Uganda,
emphasised that while more money for HIV and for health in general is
needed, more transparency and accountability from national governments
is also crucial. Last year, Uganda lost US$12 million from the Global
Fund due to poor accountability – a situation that has been repeated in
several countries across the region. “It is criminal to take from the
sick to line the pockets of the wealthy and powerful. We will continue
to fall behind unless our governments commit to using funds
appropriately,” she says. She decries the lack of transparency in health
budgets and expenditure, citing the immense difficulties that are faced
in accessing data on health budgets, expenditure or outcomes – from both
national governments and donors. “Withholding information is the best
way to prevent accountability,” she said.
African governments were also put in the spotlight for their failure to
meet regional health funding commitments, and for poor laws and policies
that prevent access to health services for certain groups, even where
resources are available. Allan Maleche, a human rights lawyer from the
Kenya Ethical and Legal Issues Network on HIV/AIDS, pointed out that
most African countries are yet to meet the pledge made in the 2001 Abuja
Declaration, to devote 15% of national budgets to health. He also
cautioned against discriminatory, laws such as Uganda’s
anti-homosexuality bill that would institute the death penalty for
same-sex relationships in people living with HIV, which he describes as
“counter-progressive, both for human rights and public health”. He
emphasised that the struggle for better health is not only about money
and clinical services, but requires a range of social and legal reforms
in order to be successful.
Lawrence Mbalati of the South African Treatment Action Campaign (TAC)
described some of the challenges that have been faced in South Africa
with drug stock-outs, and people being turned away from receiving
treatment in clinics. TAC has launched a campaign on resources for
health to address these challenges. “It is time to revitalise the
struggle for better health for all, which includes sustained scale-up of
access to HIV treatment,” he said.
The activists spoke against a backdrop of eyeballs inscribed with the
words “We are Watching – Fund the Fight against HIV and TB.”
“We are watching donors, we are watching governments, and we will hold
them accountable for the promises that they have made. The right to
health is non-negotiable,” concluded Sonoiki. Following the press
conference, the activists will be launching a “Show Us The Money for
Health” roadshow across the Cape Town city centre and townships to
mobilise public attention to this issue.
See the statement here: