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Africa: AIDS Needs More Than Money And Drugs, Say NGOS

by Samanta Sen

London, Apr 6 (IPS) — Several non-governmental organisations (NGOS) are backing a proposal by Harvard academics to set up a central fund to battle AIDS - but say a money pool will not by itself solve the problem.

Oxfam, a leading British charity, welcomed the move strongly. It has been calling for a 5-billion-dollar global fund to tackle disease in the developing world.

A fund to tackle AIDS in Africa “would be a great step forward, and something we very much welcome,” a spokesperson for Oxfam told IPS. “It would have to be worked out who should provide the services, but it could be the UN or somebody along those lines.”

The move was welcomed by other British NGOS but more cautiously. “We would welcome anything that raises more money, and makes the world realise that more money is needed”, Christian Aid spokesperson Judith Melby told IPS. “But AIDS is not an isolated disease.”

She said drugs alone would not be able to tackle the issues around “education, health services and poverty that go with AIDS.”

A central pool is “an interesting concept but we need to think about it,” she said. “What we need is really for the OECD (organisation for Economic Cooperation and Development) countries to live up to that UN yardstick of providing 0.7 per cent of their GDP (gross domestic product) as aid. If that were to happen it would release $100 billion for AIDS and much more.”

“We need a holistic and comprehensive approach,” Melby added.

Dr. Kusum Gopal, who is researching social issues around AIDS at the London School of Economics told IPS that the role of pharmaceutical companies will have to be looked at very closely if a central fund is set up. “There is a real danger that funding will be tied up with commercial interests,” she said.

“These companies have a very powerful lobby in the US.”

This may not just be central funding as it appears, Dr. Gopal said. “Ways would have to be found to make sure that the money addresses local needs rather than the needs of the pharmaceutical companies,” she said..

“It is customary to see money interests tied to funding, and this aspect will have to be watched carefully.”

Dr. Gopal said a central fund must make sure also that treatment reflects local needs rather than a central plan. “In Mozambique we found that a good deal of headway was made by using traditional healers to promote awareness about AIDS,” she said.

The outbreak of AIDS in Mozambique and in Malawi and Zimbabwe was closely related to the refugee crisis, she said. “A central fund must be managed by representatives from the countries and the regions to address their local needs.”

Several NGOS want a fund to tackle also such wider issues. “This is not about setting up funds,” Aditi Sharma from Action for South Africa (ACTSA) told IPS.

“There is a real question beyond that about the whole affordability of drugs.”

The group is taking a strong interest in a test case to come up soon in South Africa on supply of generic and even patented drugs to tackle serious conditions like HIV, tuberculosis and malaria.

“But certainly we support a co-ordination of grants and relief,” Sharma said.  “You have too many private companies making offers to particular groups.” And there are too many countries making bilateral offers to other countries. “So that the relief then goes to countries that can negotiate the best deal,” she said. “At the very least tackling AIDS needs a regional approach.”

A pool of a billion dollars is a great start, but the programme needs very much more to make some headway, Sharma said. “You will need about 1.5 billion dollars just to do some basic promotion,” she said, because while “providing treatment is one thing, providing access to treatment is equally necessary.” Another $1.5 billion will be needed to provide basic drugs to some of those suffering, she said. “So far this has not been forthcoming.”

The problem at hand is gigantic. An estimated 25 million people in Africa are HIV positive. Of these an estimated three to five million suffer from AIDS in an advanced stage.

The Harvard faculty members figure that an initial pool of 1.1 billion dollars can treat a million people suffering from AIDS. They plan to build that pool to 5 billion dollars in five years time to treat about five million people.

But this budget takes no account of the attendant needs that NGOS speak of. The Harvard academics want the US to pay for about a third of the global fund. The US TNCs Merck, Bristol-Myers Squibb and Abbott have offered to supply drugs at cost. But it is not clear yet who will pay that cost.

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