The dip in funding levels for HIV and AIDS programmes will undoubtedly put paid years of progress in the response to the epidemic in sub Saharan Africa. Reduced funding will not only cause more deaths, but also in more offloading of responsibility to poor and marginalized communities. Persons in need of care will increasingly have to resort to already over-burdened community and home based care providers, mainly women and girls.
Given that the financial drawback for AIDS programmes is occurring at a time when two million people are still dying each year in sub-Saharan Africa due to the disease, the consequences for will be drastic particularly at community and familial levels.
“The donor turn-around will not make the patients in need of life-saving treatment go away. On the contrary, it is likely to increase the numbers of people in urgent need of care and will negatively impact their family, community and the health care system. In the end, the cost of inaction will be far higher than that of action,” states a recent report by Medecins Sans Frontieres titled, “No Time to Quit: HIV/AIDS Treatment Gap Widening in Africa.”
According to the report – which analysed funding patterns in eight Africa countries – there are worrying signs that donor commitment needed to sustain and increase the current momentum in the fight against HIV and AIDS is waning.
External funding of HIV and AIDS programmes has been the cornerstone of the response to the epidemic in most parts of sub-Saharan Africa, increasing the availability of life-saving medication to many people. The availability of ARVs, in particular, has seen a reduction of people dying from preventable life-threatening diseases. But this has also meant that in poor communities care providers have seen an increase in workload as they are the frontline in the provision of care and counseling to persons living with HIV and AIDS.
Volunteer care providers, the vanguard of HIV and AIDS care at community level, will have to face additional challenges in the context of diminished HIV and AIDS financing. Already, care providers are having to make-do with little to no resource. In fact, care providers are invisible in the global AIDS infrastructure. Yet, they are key to enabling people living with HIV and AIDS to lead lives of good quality, helping them with psychosocial support and towards lives of economic well-being and develop of their families and communities.
While there is no doubt that substantial and sustained investment is urgently required to continue scaling up treatment, it must also be pointed out that the needs of care providers – disproportionately women and girls – need to be recognized in funding mechanisms.
Governments in sub-Saharan Africa need to develop and implement policies that ensure appropriate recognition of the work carried out by care providers, the majority of whom are women, allocation of resources and psychological support for caregivers as well as promote the involvement of men in the care and support of people living with HIV and AIDS.
In conclusion, there is a need to influence financing for the work being done by poor and marginalized care providers as well as empower them to know and claim their rights.