'HIV is not in recession'
2009-06-12 11:50
Verashni Pillay
Cape Town - A staggering 70% of African people on antiretroviral treatment (ART) are at risk of losing this life saving treatment in the next 12 months due to the economic crisis, according to a recent World Bank report.
Considering that only one in three HIV-positive people in Africa actually receive ART, the economic crisis holds a serious health threat to the continent.
"This was based on a survey that sought this information from governments so this is what governments themselves are saying. But of course the actual situation may be far worse," Paula Akugizibwe from the Aids and Rights Alliance for Southern Africa (Arasa).
"What is most disturbing is that our governments don't seem too terribly frightened about this. We'd hope to see some pretty drastic measures being taken but we're not seeing any evidence of that."
Funding for healthcare
Albert van Zyl from the International Budget Partnership, an organisation lobbying for greater transparency and consultation on countries' budgeting processes, said that there were three sources of funding for healthcare in Southern Africa: tax revenue, donor funding and remittances - people working elsewhere and sending money back home.
"All three of those are under pressure," said Van Zyl. "Donors had their money invested in stocks which have crashed, governments are collecting less tax and VAT because of the recession and if you lose your job you can't send money back home."
Speaking at a press conference at the TAC's offices on Wednesday, Van Zyl said the lack of transparency on government budgets was concerning. "Governments tell us a whole lot about what they plan to spend but they tell us almost nothing about what they're actually spending."
This leads to drastic cuts when budgets fall short, like the moratorium on ART rollout in the Free State for four months in 2008 which lead to an additional 30 people dying every day, according to some estimates.
The TAC's Rebecca Hodes said the organisation has found South Africa is over R1bn short to meet the treatment target for people on ARVs for this year alone.
Priorities
"The primary course for this is improper and wasteful budgeting processes and a lack of monitoring and accountability at government level," she said.
A lack of priorities was also a problem. While activists were told the Free State provincial government couldn't afford the R700 000 it cost to supply treatment during the moratorium, R30m was spent on election campaigning in the province, Hodes said.
Akugizibwe pointed out it made no fiscal sense to deny or interrupt people's treatment. "Our health systems are generating additional costs for themselves don't the line," she said. "When it comes to infectious diseases there isn't really such a thing as costs avoided. It's costs deferred and when its costs deferred its usually costs magnified."
As an example, the World Bank found in a cost benefit study in 2007 that the benefit of treating tuberculosis was 1/25 of the cost if it wasn't treated. Like drug resistant TB which is far more expensive to treat, interrupting people's HIV treatment could lead to drug-resistant HIV down the line.
TAC struggle ‘far from over’
"Even if you boil it down to simple economic terms the decisions we're making are completely irrational," said Akugizibwe.
Hodes noted that many thought the TAC's work was done now that the South African government has committed to battling the HIV and TB pandemic after years of denialism.
"But this isn't the case, our struggle is very far from over," she said. "South Africa is facing a financial crisis but HIV and tuberculosis are not in recession."
Activists from various organisations including Cosatu marched outside the Cape Town's international Convention Centre on Thursday where world leaders met for the 2009 World Economic Forum on Africa. Click here to see photographs.