Important note: Information in this article was accurate in 2008. The state of the art may have changed since the publication date.

Reuters NewMedia - December 3, 2008
Pascal Fletcher

Elizabeth Lule, manager of the bank's AIDS team for Africa, told Reuters that with the United States and Europe sliding into recession because of the global economic downturn, both donor and recipient countries would be juggling competing priorities.

Three quarters of the estimated 33 million people worldwide living with HIV/AIDS were in sub-Saharan Africa and the disease was the largest single cause of premature death in the world's poorest continent.

Lule said that with recession expected to bite deeply -- perhaps as much as by 30 percent -- into the GDP of major donors like the United States, it was difficult to see how targets to ramp up AIDS prevention and care could be maintained.

These included the United Nations-backed Millennium Development Goal of halting and beginning to reverse the spread of HIV/AIDS by 2015 and making access to treatment for HIV/AIDS universal for all who need it by 2010. Only 30 percent of people who required treatment were currently receiving it.

"I would say that it is very difficult to see how we would scale up treatment if there are no more resources coming from the donors, because the African countries themselves cannot come up with that," Lule said in an interview.

"I sincerely hope that this will not happen with HIV/AIDS, because this will mean very high adult mortality which would then have a ripple effect on economic growth," she said, speaking on the sidelines of an AIDS conference in Senegal.

Lule said that although commodity price swings, whether for oil or minerals exports or for food and fuel imports, had the biggest macroeconomic effect on African economies, HIV/AIDS had an impact "at the microeconomic and household level".

"If you lose your skilled workers, of course, you are not going to recover from recession very easily," she added.

TOLL ON WORKFORCE

In southern Africa, epicentre of the world AIDS epidemic where factors like multiple sex partners, labour mobility and rape drive the disease, some private firms recruited two people for every job in anticipation of losing staff to the virus.

After a decade of impressive African growth that drew investors, the International Monetary Fund (IMF) sees the tough global conditions holding down sub-Saharan Africa's growth to 6 percent in 2008 and 2009, down from 6.5 percent in 2007.

Lule said that in a climate of scarce financial resources, anti-AIDS programmes should focus on prevention to rein in new infections because not enough money would be available to cover the costs of future drugs treatment for all.

The U.N. anti-AIDS agency estimates that five new people are infected each year for every two put on treatment.

African governments needed to ensure funding for HIV/AIDS programmes was clearly allocated within their national budgets, and should be able to demonstrate to donors that financing was being used effectively rather than squandered, Lule said.

"Is that money leaking somewhere, do we have good governance frameworks and anti-corruption measures and do we have social accountability in place to make sure governments are investing in the right things?" she asked.

International donors and African governments also needed to coordinate HIV/AIDS initiatives even more closely.

"It looks very gloomy at the moment, but I'm very optimistic that we can find solutions as a global community," Lule said.

On the eve of the conference in Dakar, anti-AIDS campaigners paraded giant puppets of U.S. President-elect Barack Obama and French President Nicolas Sarkozy to demand that they deliver promised funds for plans to fight the disease.

(For full Reuters Africa coverage and to have your say on the top issues, visit: africa.reuters.com/)

(Editing by Daniel Magnowski)

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