How Should the War on Aids be Waged?

Welcome to AllAfrica's public forum on the status and direction of the campaign against Aids in Africa.

The Global Fund to Fight AIDS, Tuberculosis and Malaria opened its fourth board meeting in Geneva on Wednesday. This week's meeting will consider nearly 100 proposals from 60 countries totaling almost $800 million.

The night before the meeting began, U.S. President George W. Bush announced that he was asking Congress for $15 billion over five years to treat two million people with anti-retroviral drugs, prevent seven million new infections and provide care for those sick and orphaned. Money would be targeted to a dozen African nations -- Botswana, Ivory Coast, Ethiopia, Kenya, Mozambique, Namibia, Nigeria, Rwanda, South Africa, Tanzania, Uganda, and Zambia - as well as Haiti and Guyana in the Caribbean.

The proposal has been widely hailed as a major new commitment. "President Bush tonight saved millions from the certainty of death by pledging treatment and the money to purchase life-sustaining drugs," said Michael Weinstein, President of AIDS Healthcare Foundation, which calls itself the largest organization of Aids care providers.

"It opens the floodgates of hope," said Stephen Lewis, the United Nations special envoy for HIV/AIDS in Africa. At a news conference in Johannesburg, Lewis said that Bush's remarks were "the first dramatic signal from the U.S. administration that it is now ready to confront the pandemic and to save or prolong millions of lives." He said the announcement is a challenge to other industrialized nations to follow suit.

At the same time, anti-HIV campaigners do have concerns. Lewis raised questions about where the additional money would come from and how much of it would be channeled through the Global Fund. Prega Ramsamy, executive secretary of the Southern Africa Development Community, said the money should be dispersed to small-scale community projects if it is to have any real effect on people's lives. "We need to make sure that it filters down to the level of people that most need it," he said.

Spending Priorities

In sub-Saharan Africa, an estimated 2.4 million people died of Aids last year. Three million children under the age of 15 are infected. In a world of many problems, what level of international response to Africa's crisis is justified?

The Global Fund for AIDS works to amass and disperse funds to combat the disease. Should more resources be directed through that international effort, or are bilateral programmes just as - or perhaps more - effective?

There are signs of hope in several countries and communities, where the rate of prevalence has remained low - or even declined. What are the most effective ways to replicate the "best practices" that have achieved those results? Should aid be targeted directly to local projects?

Should the most affected countries get the most assistance? Or are there other considerations that should determine where aid is targeted?

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