AN aid agency has warned that donor fatigue is threatening to reverse HIV/Aids programmes in developing countries including Zimbabwe. Medicines San Frontiers (MSF) in a recently released report titled Punishing Success? says the success in the fight against the pandemic had largely depended on donors.

"Over the past decade, enormous resources have been mobilised globally to address the HIV/Aids crisis on a large scale," reads part of the report.

"MSF has seen first-hand the achievements. . . the good news is that four million HIV-positive people are alive on antiretroviral therapy (ART)," reads part of the report.

"The scale-up of ART in developing countries has allowed individuals to live longer and enjoy a better quality of life, leading to a restoration of dignity and autonomy and an ability to contribute to family and societal life."

However, mounting evidence on the ground shows that there is reduced commitment to fund HIV and Aids programmes, MSF says.

Zimbabwe is one of at least 30 countries where the agency says the effects of donor fatigue have become evident.

The report adds: "Today, MSF teams working to treat HIV/Aids are witnessing worrying signs of waning international support to combat HIV/Aids.

"In some high-burden countries, patients are being turned away from clinics, and clinicians are once again being forced into the unacceptable position of rationing life-saving treatment.

"At the same time, more robust and better-tolerated treatments -- widely prescribed in wealthy countries -- are not reaching patients."

MSF said the funding deficit was a glaring sign of lack of political commitment to fight the scourge.

"The Global Fund to Fight Aids, Tuberculosis and Malaria Board is considering a motion to cancel the funding of Round 10 for 2010, if accepted, no new proposals will be considered until 2011.

"Similarly, the US President's Emergency Plan for Aids Relief (PEPFAR) plans to "flat-fund" its programmes for the next two years, reneging on promises made last year to support expanded treatment access," said MSF.

The Global Fund and the US government's HIV/Aids programme, PEPFAR, are the two most significant supporters of Aids programmes in developing countries.

In March, the Global Fund announced that it was facing an "alarming funding gap of US$4 billion" based on budget needs of up to 2010.

MSF says increasing calls for a diversion of foreign aid away from HIV/Aids to other health priorities had also contributed to reduced donor funding.

"Reducing funding at this juncture would not only undermine the goal of reducing maternal and child mortality, but it could also lead to the interruption of treatment for people with HIV/Aids already on ART and leave those still in need of access to treatment to die premature, avoidable deaths," the report says.

HIV/Aids is the leading cause of mortality among women of child-bearing age worldwide.

Zimbabwe is among the top five countries with the highest HIV prevalence with new estimates showing that at least 13,7% of the population is living with the disease.

"The crisis is not over," MSF said.

"In the 10 highest HIV prevalence countries, Aids is the leading cause of death: 80% of all deaths in Botswana and two-thirds of all deaths in Lesotho, Swaziland and Zimbabwe are due to Aids."

"Less than a quarter of HIV-positive pregnant women have access to Prevention of Mother to Child Transmission (PMTCT).