Global Fund on AIDS, TB and Malaria/Cost/KwaZulu-Natal
The Daily News, 11 October 2002, World Aids war needs R156bn, say experts

By Liz Clarke

By 2007 a staggering $15-billion a year (more than R156-billion at the current exchange rate) will be needed to combat Aids on a global scale, according to the latest estimate by United Nations resource and economics experts.

Even in the short term $6,5-billion (R68-billion) will be needed to fight the epidemic in 2003, which means that funding from all sources will have to double from the present levels.

The question is, can the Global Fund set up to fight Aids, TB and malaria cope with such a mammoth cost?

This is one of the sobering questions that Global Fund executive board members will be asking at their annual meeting in Geneva this week.

Apart from sub-Saharan Africa, Russia, China and India are recording figures that as one United Nations epidemiologist put it "are climbing like the peaks of Everest".

Meanwhile in South Africa, government appears to be softening its stance on the use of antiretroviral therapy to treat HIV and Aids. It announced in the cabinet this week that it is planning to widen access to antiretroviral medicines in the public sector.

However if the process of introducing treatment programmes takes too long, mounting pressures on the Global Fund could see South Africa "miss the boat".

With the first round payments of R800-million from the Fund to fight HIV and Aids in KwaZulu-Natal still sitting in the World Bank, only a portion of what has been promised by the Fund has actually reached South Africa.

The KwaZulu-Natal pledge could not be accessed because of the Department of Health's objection to the bid process.

On the government's side, one of the major stumbling blocks to providing antiretroviral medicines to HIV-positive patients in the public sector has been the high cost of the drugs.

The drugs are currently available only in the private sector, although in the past few months an increasing number of companies have announced plans to make antiretrovirals available to their HIV-positive workers.

The cabinet said after the meeting that it was "actively engaged" in creating the conditions that would make it "feasible and effective" to provide antiretroviral medicines in public hospitals and clinics.

But the government's about turn comes at a time when the Global Fund is facing immediate cash flow problems.