African HIV/AIDS Program Drastically Affected by Global Financial Crisis

The global financial crisis has forced most African countries to slash their HIV/AIDS program budgets, according to a recent report by Black Star News.

Botswana, South Africa, Zambia, the Democratic Republic of Congo and Zimbabwe are some of the countries hardest hit by the economic downturn. These countries' export revenues have dropped, severely affecting revenue flow for government expenditure on critical HIV/AIDS programs.

Program cuts have already been announced throughout the region. Tanzania introduced a 25% cut to its annual HIV/AIDS budget, and the Botswana government declared that it will not include new patients in its free antiretroviral treatment program from 2016 onwards.

Major international donor organizations are also being hit by the financial crisis. The Global Fund to Fight AIDS, Tuberculosis and Malaria announced a $4 billion dollar budget shortfall for essential services in 2010. In addition, the group faces a $10.7 billion funding gap for the regional implementation of their Global Plan to Stop TB.

Health advocates are pressing African governments and international aid organizations to stick by their commitments to improve HIV/AIDS care, arguing that the right to heath treatment is non-negotiable.

“In the last few months, we have seen trillions of dollars spent on financial bailouts to stimulate economic recovery,” said Nonkosi Khumalo, a women's health program coordinator at the South African Treatment Action Campaign, speaking at a recent meeting of HIV/AIDS coalitions in Cape Town. “A tiny portion of this sum could have bought quality, sustainable healthcare for millions of people.”

According to the 2009 World Bank report, "Averting a Human Crisis During the Global Downturn", countries in Eastern and Southern Africa are the most vulnerable. Researchers estimate the negative impact of this crisis will affect 70% of people on ARV treatment in Africa within the next 12 months. Apart from countries such as Botswana and South Africa, most countries have limited fiscal space they can use to cushion the impact of a decline in international aid, the World Bank says.

The complete article "Global Financial Woes Roil AIDS Fight" by Sifelani Tsiko can be found here: http://blackstarnews.com/news/126/ARTICLE/5724/2009-05-28.html

The World Bank has more information on the impacts of the Global Financial Crisis at: http://www.worldbank.org/html/extdr/financialcrisis/

Update, 23 June 2009:
World Bank Report Predicts Contracting Global Economy Will Hurt Poorest Countries

The World Bank released a report Monday, projecting "a 2.9 percent contraction in global GDP this year, as rich countries contract by 4.5 percent," the Wall Street Journal reports. "The crisis of the past two years is having dramatic effects on capital flows to developing countries, and the world appears to be entering an era of lower growth," World Bank Chief Economist Justin Lin said (Burns, Wall Street Journal, 6/22).

The report -- which was issued at a conference in Seoul, South Korea -- forecasts more dire predictions than those the World Bank made just months ago and contrasts with the views of "its sister organization, the International Monetary Fund (IMF) ... which is forecasting a global contraction of only 1.3 percent this year and growth of 2.4 percent in 2010," Bloomberg/Los Angeles Times reports. "[W]hile a global recovery may begin this year, impoverished economies will lag behind rich nations in benefiting," the newspaper writes. "The lender called for 'bold' actions to hasten a rebound and said the prospects for securing aid for the poorest countries were 'bleak'" (Bloomberg/Los Angeles Times, 6/22).

CNN reports, "Developing countries will be hit hard by falls in private investment ... seeing nearly $1 trillion less in foreign investment this year than they did two years ago" (CNN, 6/22). "The real challenge is going to be to manage going through this period of very slow growth, to keep government programs that are critical for longer term growth (infrastructure, health and education policies)," Andrew Burns, acting manager of the World Bank's Global Trends Team, told VOA News. Burns said that in response to the growing need, the World Bank "is stepping up lending to the region" -- with plans to lend about "$33 billion this year and next year" (DeCapua, VOA News, 6/22).

UNAIDS and World Bank Release Report Detailing an Interconnectedness Between Prevention Efforts and Transmission

A recently released report from UNAIDS and the World Bank finds that national HIV prevention strategies are not reaching at risk groups in at least 5 African Countries. The study was conducted from 2007 to 2008 and focused on determining where most HIV cases were occurring in each country, and whether these statistics were a result of inadequate prevention programs or under-funding issues.

If national HIV prevention strategies are to succeed, countries must first understand the character and drivers of their epidemic and focus on effective interventions. Kenya, Lesotho, Mozambique, Swaziland and Uganda were all determined to have inadequate HIV prevention strategies, and the report determined that this was in large part due to the failure of prevention initiatives to address the most common forms of transmission. For example, in Lesotho most new infections occur because of concurrent sexual relationships, both before and after marriage, but the prevention efforts in this country tend to focus on unsafe sex with multiple partners instead of prevention methods for those in long term monogamous relationships. Mozambique presents another example of the interconnectedness between prevention and transmission of the disease. An estimated 19% of new HIV infections are transmitted as a result of commercial sex work, but Mozambique has very few programs that target the specific category of sex workers.

In the wake of the current financial crisis, many African countries' budgets have been drastically reduced, and essential programs have been cut. In many of the surveyed countries, spending on HIV prevention has dropped, leading countries to concentrate their efforts on general prevention, instead of targeting specific at risk groups. In Lesotho, only 13% of the national HIV/AIDS budget is spent on prevention, and these efforts may not even be completely effective. Even though budget spending is being cut, an emphasis must be placed on prevention programs in order to address the problem from the beginning. If prevention efforts are stepped up, the country will have to deal with fewer cases, which means less funding for medical treatments and other problems associated with high infection rates in society. There is often a mismatch between HIV prevention efforts and the actual factors driving new infections, which can lead to significant resources being invested in programmes of limited effect. In order to reach those most at risk, spending must be focused on effective spending efforts.

The report also provided recommendations for those countries surveyed on how to better implement evidence-based prevention efforts. Based on collective evidence, the report determined that Lesotho should revise its prevention messages to address multiple concurrent partnerships and integrate the subject into future initiatives, and Mozambique should focus condom promotion on groups such as sex workers.

To read other country specific recommendations, you can access the report in its entirety at: http://www.unaids.org/en/KnowledgeCentre/Resources/FeatureStories/archive/2009/20090512_UNAIDS_WB_epi.asp