Inter Press Service - October 6, 1999
Gumisai Mutume

In a review of progress made in battling the acquired immune deficiency syndrome (AIDS) while preparing its new five-year plan for 2001-2005, UNAIDS points to the situation in Africa as a grim reminder of the havoc AIDS can cause due to a lack of resources.

The organisation has just committed a further 8 million dollars out of its 33 million dollar Operating Reserve Fund for use in Africa where 95 percent of all HIV cases are estimated to live in countries south of the Sahara.

One in eight South Africans, one in seven Kenyans, and one in four Zimbabweans are estimated to have HIV/AIDS and U.S. Surgeon General David Satcher has likened the epidemic in Africa to the plague that decimated Europe in the 14th century.

Part of the challenge facing the world over AIDS in the new millennium is to increase the availability of affordable drugs to needy developing countries, UNAIDS says.

For instance if the 34 million people infected with HIV were put on the 12,000 dollars-a-year "cocktail" of drugs which can turn AIDS from being a death sentence into a chronic illness the annual bill would roughly equal the size Mexico's gross domestic product.

So far, pledges of support have been tiny in relation to the size of the global problem.

The United States gave 100 million dollar toward the effort to fight AIDS in Africa and the World Bank recently announced a new Strategic Plan for Africa to "ensure a coordinated, strengthened, and expanded global response".

The United States is the largest funder of international AIDS programming, contributing 135.2 million dollars in 1997. When broken down as a proportion of gross national product, however, Norway and the Netherlands come out on top. Overall, the amount allocated for HIV/AIDS remains small - less than one percent of the annual overseas development assistance (ODA) budgets of donor countries, UNAIDS notes.

A study by the Francois-Xavier Bagnoud Center for Health and Human Rights at the Harvard School of Public Health on 15 donor countries, seven UN organisations and 64 developing countries between 1996 and 1997 shows that the future is bleak due to the inadequate response to the epidemic.

"The study shows clearly that the gap between HIV/AIDS needs and resources has never been deeper, and unless much more is invested today, the situation will only grow much worse," says Daniel Tarantola, formerly the Director of the International AIDS Program at the Centre and now Senior Policy Adviser to the Director-General of the World Health Organization.

After a quick influx of donor support, AIDS funding began to level off in 1990. Between 1990 and 1997, when the number of people living with HIV more than tripled - from approximately 10 million to 30 million - HIV/AIDS funding rose only from 165 million dollars to 273 million dollars, the study notes.

"Weighed against the global catastrophe of the AIDS epidemic, the level of spending for HIV prevention around the world is minimal", says Peter Piot, Executive Director of UNAIDS.

The 64 countries included in the study spent a total of 550 million dollars of national funds on HIV/AIDS programmes in 1996. Brazil and Thailand were the two biggest country-level spenders in the developing world, UINAIDS said.

In Africa 25 countries spent 141 million dollars, 14 countries in Asia and the Pacific reported 163 million dollars and four countries in Latin America and the Caribbean spent 215 million dollars.

In sub-Saharan Africa, the region most affected by the epidemic, only Botswana, Kenya, Malawi and Uganda reported spending more than one million dollars of national funds for HIV/AIDS activities.

The recently released report "AIDS and Developing Countries: Democratizing Access to Essential Medicines" by Robert Weissman says that addressing the HIV/AIDS crisis around the world requires a massively accelerated prevention effort.

Weissman, a co-director of Essential Action, a corporate accountability group argues that it also will require revitalizing the decimated public health systems in most developing countries, making quality health care much more widely available.

"This, in turn, will require major new investments in public health, the abandonment of structural adjustment requirements to collect 'user fees' from people seeking health care...and ways to promote access to essential medicines involve compulsory licensing and parallel imports."

The strongest opponents to such a solution have been the big pharmaceutical companies, eager to reap the profit of years of investments while seemingly oblivious to the needs of developing countries.

An example of this was a lawsuit, recently dropped, bought by the Pharmaceuticals Research and Manufacturers Association (PhRMA) against the South African government eager to use parallel importing and compulsory licencing to meet the needs of its people is an example.

PhRMA, representing big American Companies like Glaxo Wellcome, Bristol-Meyers, Pfizer and Johnson and Johnson says such a step would render further research and investment into drugs futile.

While US officials have not said what part of international trade agreements would be violated by South Africa if it went ahead, Washington has applied similar pressures on other developing countries such as Brazil and Argentina. "However, it is interesting to note that the United States has not interfered with parallel importing of drugs by Britain, Canada and the Netherlands," says Anna Lynne of the US lobby-group AIDS Drugs for Africa

While the international fight against Aids remains disjointed, profit-driven and cheap drugs remain beyond the reach of the poorest communities, it is also still clearly not a priority of many governments.

In 1996, Nigeria, with 120 million people reported spending just four million dollars in its fight against Aids in 1996 compared to the 37 million dollars spent by Uganda which has about one-sixth of Nigeria's population.

The recent 'Eleventh International Conference on Aids and Sexually Transmitted Diseases in Africa' held in Lusaka, Zambia presented frightening trends in the development of the epidemic in the sub-region but hardly produced anything else of note.

There have been 10 other conferences of its kind all calling for more urgent attention to the scourge, more money and greater political commitment. As if to kick it in the teeth, not a single African head of state including the host president Frederick Chiluba attended the Lusaka conference. (END/IPS/gm/ 99)
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