COTONOU, Nov 30 (AFP) - Every week Africa's AIDS pandemic notches up new victims in the small west African republic of Benin while local doctors and health staff complain, generating a large income for a new breed of charlatan medical charities.
The grim spectacle of an already poor continent slipping into the grip of such a scourge has loosened the purse-strings of many international governments and funding bodies, keen to fund worthwhile local projects set up to teach prevention and to care for the sick.
But in Benin, as in some other parts of Africa, doctors suspect that much of the aid flow has been redirected to self-serving charities and non-governmental organisations (NGOs) which are either entirely fraudulent or basically incapable of providing the services they promised to victims and donors alike.
"Today it's easy to get money from the AIDS business," said Joel Adekambi, a doctor who works in a state-run hospital in Cotonou.
"You just set up an association of health officials or students of medicine or sociology. Then you draw up a plan for a public health education campaign or for a scheme to care for AIDS patients and present it to foreign donors. You're on to a winner, without any proven results on the ground," Dr Adekambi said.
The Beninois health ministry officially records more than 200 AIDS-related charities and associations, in a country of just seven million people and in which, at less than an estimated three percent, HIV infection is proportionately lower than in much of the rest of the continent.
The victims of such an unregulated free-for-all are people like 26-year-old Joseph A., who has sat by the front gate of Cotonou's Hubert Koutoukou Maga Hospital every day for six weeks coughing up blood and waiting for an NGO official who took down his name, promised him help and then disappeared.
He was diagnosed as being HIV positive last year and cannot afford the anti-retroviral drugs which are the only way that has yet been discovered for doctors to halt or delay the onset of immune-system failure and eventual death from AIDS-related illnesses.
Six weeks ago, however, he was given a reason to hope.
"When I started to feel tired I came to the hospital where I met fellow HIV-positive people who were signing up to a list after showing their test results certificate. I did the same," he said.
"The official said he was going to go and find funding from his project to help us get anti-retrovirals," he explained.
Since that day the health worker has never reappeared and the 20 or so people on the list are either, like Joseph, maintaining vigil outside the hospital or bedridden at home and awaiting their fate.
One of those at the gate, a 21-year-old man, died on Tuesday this week after being admitted to a bed in the immunology ward to see out his final hours under the helpless gaze of the underfunded medical staff.
"These cases of people living off the backs of HIV victims are more and more common," complained nurse Alexandre Houdete. "They just do it to get funds from international organisations, then use the cash for other things," he alleged.
Without help from international donors, Benin's HIV positive patients are forced to rely on a government run scheme for subsidised treatment.
Health minister Celine Kandissounon said that when a sufferer's CD4 count, a measure of the strength of his or her immune system, falls from a healthy 1,000 to a critical 200, the state will provides anti-retrovirals at between 1,000 to 5,000 CFA francs (two to 10 dollars / 1.5 to 7.5 euros) per month.
But one doctor from the National Programme for the Fight Against AIDS, who asked not to be identified, told AFP: "Only 30 percent of the money set aside for HIV positive patients actually gets to them, and even that's when the whole budget isn't embezzled!"
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