The Sunday News
Tinomuda Chakanyuka
On 1 December 2014 Zimbabwe held the African Union World Aids Day commemorations in the resort town of Victoria Falls in Matabeleland North province, amid calls for African countries to hastily move towards self funding of HIV/Aids response programmes.Holding such an event was historic for the country. It was the third continental event of such nature and magnitude to be held, the first in the country, with representatives from 47 African countries as well as various partners in the fight against the virus, converging on the Elephant Hills golf course to mark the day.
Critical issues were raised during the commemorations and as mentioned above, one of the most topical issues raised was the need for African countries to start mobilising more domestic funds towards the fight against HIV/Aids.
During the commemorations people living with HIV made a bold statement with a thought provoking banner, inscribed in bold print: “WHAT HAPPENED TO THE
ABUJA DECLARATION?”
The banner evoked a lot of thought and debate among delegates on the commitment by African governments to move towards self sustenance in the fight against HIV Aids.
Summary of the message that was being conveyed by the people living with the virus was that there was a funding gap in the continent’s fight against HIV/ Aids, a gap which continues to threaten to retard efforts to meet various set targets.
Last year’s World Aids Day Commemorations ran under the theme “Getting to Zero in Africa – Africa’s Responsibility, Everyone’s Responsibility, resonating with the global theme (2012-15) Getting to Zero – Zero new HIV infections, Zero Discrimination and Zero Aids-Related deaths.
What has however become apparent and disturbing, is that most African countries, Zimbabwe included, have failed to meet the getting to zero targets by 2015, under the prevailing funding conditions, yet there are more new targets that have been set.
According to UNAIDS, all countries should ensure that by the year 2020, 90 percent of their population must know their HIV status, 90 percent of those who are HIV positive must have access to treatment and 90 percent of those on treatment must have their viral load undetectable.
Meeting such targets calls for scaled up efforts and would inevitably increase the amount of funds needed for HIV programmes.
With more targets being set, the consequent increase in funding requirements and the possibility of donor partners reducing their funding, Africa is faced with a Herculean hurdle in its fight against the virus. Something has to be done.
Through the evocative banner by people living with HIV, a subtle question was posed on the capacity of African countries and commitment of governments to attain such targets, especially in light of possible donor pull out and apparent reluctance by governments to channel more funds towards the health sector.
In 2001 African Heads of State committed themselves at a meeting in Abuja to devoting a minimum of 15 percent of government funds to the health sector in order to address the massive burden of ill-health facing countries in Africa, particularly within the context of a growing burden of HIV, Aids, TB and malaria.
The agreement was thus termed the “Abuja Declaration” and is so referred to.
Zimbabwe is a signatory to the declaration.
Regrettably 10 years down the road most countries, Zimbabwe included, have failed to achieve this target with the regional average remaining at seven percent and even then this is largely influenced by international donor funding not domestic resources.
The domestic funding discourse has risen and gained prominence in recent years amid fears of possible withdrawal of support by major financiers of the continent’s fight against HIV and Aids.
Most African countries heavily depend on external funds for their HIV response programmes, a situation that obviously leaves them vulnerable in the unfortunate event of donors deciding pull out, something that is becoming more and more apparent with each day.
For example, the National Aids Spending Assessment (NASA) study conducted for 2011 and 2012 in Zimbabwe showed that of the $314 million spent on HIV and Aids in 2012 only 30 percent was from internal sources, with the remainder coming from donors.
It is no secret that, owing to the global financial crisis, many government donor agencies and international donors are reviewing their financial commitment to funding health and HIV on the African continent.
In view of such looming adjustments, there has never been any time better than now that African countries need to hastily move towards more self reliant funding models in their fight against HIV if they are to meet set targets in eradicating the virus.
Various strategies have proposed, which African countries could explore in efforts to mobilise enough domestic resources to respond to HIV.
AU Commissioner for Social Affairs Dr Mustapha Sidiki Kaloko acknowledged that it was now time for Africa to be self reliant in funding the health sector as donor funding was no longer reliable and overtly unsustainable.
Dr Kaloko warned of a possible recurrence of the epidemic, in the event that donors pull out of Africa at a time when African governments are not prepared to carry the burden on their own, a situation most African countries may not want to imagine, especially those in the Sub-Saharan region where the disease burden is heaviest.
“The continent has a disastrous disease burden yet there seems to be low health perception. If as a continent we don’t strengthen health infrastructure and funding there is a possibility of the epidemic recurring.
“What is required is sustained commitment from leaders to explore possible ways of harnessing local resources towards HIV response programmes.”
Chairperson of the Parliamentary portfolio committee on Health and Child Care Dr Ruth Labode, proposed, that government considers extending the Aids levy to churches, vendors and airtime recharge cards.
“We should start engaging mega churches and propose a presumptive tax. We really should introduce a tax on airtime dealers. That way we know we will be capturing the informal sector because they do their business on the phone.
“We can dangle carrots say remove tax when they import cars or musical instruments. We have many mega churches and something can be realised from them,” she added.
Nigeria and Zambia have already implemented such tax regimes.
Zimbabwe is one of the few countries in the continent that have taken a leading role in mobilising domestic resources towards the fight against HIV and Aids through the Aids levy, which however falls far too short of what the country really needs to fight the disease.
More still needs to be done.
Dr Kaloko commended Zimbabwe for its pathfinder role in domestic funding of HIV and Aids programmes.
What is however saddening and an unfortunate irony is that Africa, saddled with the heaviest burden of the disease, its governments seem to have a low health perception and are a little reluctant to priorities the health sector in their annual budgets.
Almost 70 percent of people living with HIV worldwide live in sub-Saharan Africa while the highest number of deaths due to Aids have also been recorded in the region.
Such statistics are reason enough for African governments to increase their pace especially in light of new targets that have been set in efforts to stamp out HIV and Aids and the inevitable need for more funding.
Indications by the donor community of changing funding models all the more make it more imperative that African governments explore other avenues of sourcing funding for HIV response programmes.
The task that lies ahead in the fight against HIV is not insurmountable nor are the targets unachievable, but require unprecedented commitment by our governments and a complete paradigm shift in the funding models of the battle.
Implementing the Abuja declaration would be the first step, and one in the right direction.
