ARVs - Time to Roll Out Plan B. 11/12/10

Does the country have a strategic back-up plan in the event of donors pulling out?

AllAfrica

Molly Gumbo, a rural woman from Seke, is a mother of two teenage boys and has been living with HIV for the past six years.

She has been on antiretroviral therapy (ART) for the past four years and has been collecting ARVs from Seke Hospice Home Based Care.

Her health has improved tremendously in the years she has been taking the life-prolonging drugs and she is pregnant with her third child and is on the prevention of mother to child transmission (PMTCT).

Seke Hospice Home Based Care is among one of the many NGOs that include DFID, Hivos, Irish Aid, Sida UNAIDS among many others and programmes like PEPFAR that have been providing the less privileged HIV-positive people with antiretroviral drugs and support helping Government fund the pandemic.

Last year NGOs provided 41 percent funding for HIV and Aids programmes, while the Global Fund gave 55 percent with the Aids Levy contributing 4 percent.

The National Aids Trust Fund (NATF), commonly known as the National Aids Levy, was introduced by the Government in 2000 through the National Aids Council Act Chapter 15/14 of 2000.

The Act mandated individuals and companies in Zimbabwe to pay 3 percent of their income and corporate tax towards the National Aids Trust Fund, which would be used to finance various programmes to respond to the HIV and Aids pandemic.

But, Government's contribution remains a drop in the ocean and these are the worries that people like Molly and thousands others who are HIV positive go through on a day-to-day basis.

Their main worry is what would happen if donors stop funding HIV programmes in the country. Does the country have a strategic back-up plan in the event of donors pulling out is one the questions that begs for an immediate answer.

National Aids Council finance director Mr Albert Manenji said domestic funding of the national response is made up of efforts being done by corporates and individuals in the country.

"Measurement of contribution by this sector is a big challenge as information is not readily available.

"Information currently on hand is for the Aids Levy. The year 2009 stood at US$5,7 million and projections for 2010 is US$16,6 million (4 percent).

"Other domestic contribution accounts for 16 percent.

"Other resources came from partners that include the Global Fund US$103 million (55 percent), donor community (USG, ESP,) US$77 million (41percent)," he said.

The 2011 National Budget allocated US$2,2 million towards the improved supply of drugs for HIV (US$0,8 million), TB treatment (US$0,2 million) while US$1,2 million was earmarked for malaria prevention and treatment.

Finance Minister Tendai Biti in the Budget presentation confirmed that financial constraints continue to be the biggest obstacle in achieving universal access, while on the other hand patient uptake of ART is also affected by the unavailability of drugs and stigma.

Mrs Ratidzo Bere, who has been living with HIV for seven years, said there was need for Government through the National Aids Council to draw up a back-up strategic plan that will address all their fears in the event that the country wakes up with no donor funding.

"If donors withdraw funding, therefore, this will ultimately lead to more deaths, and we cannot guarantee that people who will volunteer to go for testing in future if they are not certain whether they will have access to life-saving ARV care if positive.

"We know that donors have the freedom of where to take their money," she said.

Mr Brian Munodawafa of Chitungwiza said Government should find other means of financing HIV and Aids programmes.

"You find out that the Aids Levy is only being collected from individuals who are formally employed and from companies.

"Government should put in place a policy that will ensure that even those in the informal sector pay their portion of the Aids Levy just like they pay VAT when the buy from supermarkets," he said.

He added: "This is a very big problem for people living with HIV and Aids because if the international donors decide to withdraw their funding, the HIV programmes will not be sustainable according to the present funding levels by the Government if the money allocated in the 2011 Budget is anything to go by.

"We already have so many problems to take on including stigma, beliefs, misconceptions, cultural practices that contribute to the spread of HIV in the community, without having to worry about the source of funding to catch up on our treatment.

"When donors eventually decide to withdraw funding and commitment for treatment, no matter how slowly, in the end, life for a lot of people in this country will be unbearable."

Executive director of The Centre Mr Freddie Kachote said as an organisation, they have been exploring ways to have safety nets that will act as a back-up in the event that donor funding becomes dry.

"We have been arguing that whereas we have to get funds from donors, we should have safety nets encompassing projects that will bring money back to the people who need it. For example, Oxfam has shops in the United Kingdom and they get products that include crotches, clothes, seat covers, etc, from Zimbabwe.

"They sell the merchandise and bring back the money to Zimbabwe through funding.

"What is needed is to put an action plan for the roadside vendors in Binga, Masvingo and Chinhoyi roads to improve the quality of their carvings so that they can be sold and benefit communities through the purchase of ARVs," he said.

Mr Kachote said the country would face serious drawbacks for as long as donors are bankrolling the bigger chunk of HIV and Aids programmes.

"We should have a strategy and improve public funds and there are various ways to do so.

"About three years ago, we proposed the creation of Southern Africa Herbal Aid Research Initiative (SAHARI) under which the Ministry of Health and Child Welfare would enable us to identify a farm and carry out herbal research with the help of traditional healers.

"This would reduce the number of HIV drugs we are buying from pharmaceutical companies outside the country as proper research would be carried out on the identified herbs, which may end up at Natpham," he said.

He added that the biggest hindrance in the collection of the Aids Levy from all productive sectors of the economy is planning.

"There is need to set up proper mechanisms for the collection of the Aids Levy in the informal sector if the Government wants to add on to their coffers.

"We also need transparency for the money currently being collected under the Aids Levy so that one easily get statistics if they walk into NAC," he said.

Journalist and activist Catherine Murombedzi said while the Aids Levy was a noble idea more can still be done to increase the funds.

"The informal sector is not contributing anything, this is a collective effort so they must channel some proceeds to the fund.

"In fact, it benefits everyone without prejudice to belief, race or creed. As the Finance Minister tasked the local councils to collect some form of tax, the same should be done for the Aids Levy.

"New companies registering can pay a once off instalment too so as to boost the coffers.

"We should say get to 40 percent of the funding coming from locals. Imagine the scenario where the Global Fund to stops funding. Remember 2004 and the period thereby, funding was constrained and people died then. We need to get donor assistance, yes, but the corporate world must play their part too.

"When they make profits, declare part of that to be channelled to the fund," she said.

She added that she understands that some companies do not have ART on their sleeves and this should change.