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KwaZulu-Natal HIV compromise may ruin UN deal
Lynne Altenroxel. The Star, July 18 2002. Reprinted courtesy of Independent Newspapers (Pty) Ltd.
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KwaZulu-Natal's dream of providing antiretrovirals to HIV patients will be dashed if it doesn't get the Global Fund money it wants.
Its proposal, sent to the UN Global Fund for HIV, TB and Malaria, says the province is poised to take its first steps in providing triple therapy to a limited number of people.
But it emerged on Thursday that the compromise to pool the funds into a national kitty may not suit the fund's specifications. It is insisting any money it makes available to the province is used only in KwaZulu-Natal.
The objectives listed in the province's proposal are to:
* "Offer a package of care to TB patients... which includes antiretrovirals"; and
* "Offer a comprehensive package of HIV/AIDS care for HIV/AIDS-infected health-care workers employed by the public health service throughout KwaZulu-Natal, which includes antiretrovirals."
Both proposals would be pioneering work.
Triple therapy is only available to South Africans who can afford to pay for it, to a limited number of patients on drug trials and to a few dozen individuals benefiting from a pilot project run by Medecins Sans Frontiers in Cape Town.
But KwaZulu-Natal could lose the US$72-million (R720-million) it was awarded by the Global Fund due to the ongoing feud between the province and Health Minister Dr Manto Tshabalala-Msimang.
It could also be stopped from providing antiretrovirals if the national department gets a say in how the money is spent.
Tshabalala-Msimang blocked KwaZulu-Natal's access to the money on the grounds that the province applied for the funds without sanction from the government.
Her department's proposal is very different to KwaZulu-Natal's and does not make provision for antiretrovirals.
Negotiations to resolve the spat led to an announcement that the money would be dished out between all nine provinces.
But on Thursday Global Fund external relations manager Mariangela Bavicchi said the funds were meant only for KwaZulu Natal.
"The funds have to go to a certain proposal. We are very specific," she said.
Tshabalala-Msimang is facing calls for her resignation over the debacle, in which the presidency and the ANC have come out in her support.
"No one has the right to call for her resignation except the president who appointed her," the party said in a statement.
"Fortunately, the President's Office has indicated that the president remains convinced of her capacity to lead the Ministry and no amount of pressure will force the President to review his opinions of his Cabinet," it said.
What the national Health Department proposed:
* Additional funding for loveLife.
* Additional funding for the National Association of People Living with HIV/AIDS (Napwa).
* Improving prevention programmes - particularly those targeting TB, HIV and sexually transmitted diseases.
* Improving the national communication campaign for HIV and TB prevention.
Amount awarded: $93,3-million over five years.
What KwaZulu-Natal proposed:
* Providing antiretrovirals to TB patients.
* Expanding hospice activity.
* Providing Nevirapine to pregnant women.
* Providing a place of safety for orphans.
* Giving health workers antiretrovirals.
* Training health workers to provide triple therapy.
* Expanding counselling and testing.
Amount awarded: $71,9-million over five years. |
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