On 10 May, 2010, The New York Times published an article by Donald McNeil Jr. with the startling but accurate title, “At Front Lines AIDS War is Falling Apart.” This report was reproduced in Uganda’s leading newspaper – The New Vision – today, 12 May, 2010. The article highlights what we, the health workers at the frontline, had feared all along what might happen if there was any loss of momentum in funding HIV care, particularly in countries with limited resources such as Uganda. McNeil uses Uganda as a case study where patients in urgent need of ARVs to save their lives are being turned away without treatment. I am convinced that similar scenarios are already happening in other countries, particularly across sub-Saharan Africa. If this is not happening yet, then it is just a matter of time. The articles raise one simple question: Why are we now losing a battle that we had fought so hard… and won? And where are the friends, including the G8 nations, that pledged to support universal access to HIV care in 2005?

The article points out that the G8 nations have not yet fulfilled their pledges; that PEPFAR, which gave so much hope to so many families who had death staring in their faces, would be focusing somewhere else; that contributions to the Global Fund are falling very short of expectations. Some of the common reasons offered for declining support from the donor communities have been around the global financial crisis. This may sound plausible until you learn that the world only needs US$27 billion a year to meet the universal access goal – yet just $10 billion is spent each year and the Global Fund is struggling to raise $20 billion for the next three years of its vital mission. The reality is that $27 billion is small amount of money for the G8 nations yet a welcome and essential lifeline for many in sub-Saharan Africa; it would save millions of patients from imminent death for many years to come. This is one reason why all of us should join forces and urge the G8 nations - and the G20 too - to honour their pledges and move beyond their current commitments.
 
The article also pointed out our irresponsibility as recipient countries in handling donor funds that target the poor, particularly those in need of life-saving medicines. For over a year Uganda has been in the news for mishandling funds from the Global Fund and GAVI. It is naïve to think that donor communities don’t come to know about these misappropriations and that these acts do not influence their donor spirits. As recipient countries, we need to convince the G8 nations and other donors that we are committed to caring for our patients by being transparent in the way we handle donor funds. In addition, we need to demonstrate clearly that we are investing more in the care of our people by devising and implementing strategies to sustain HIV care in our countries for many years to come. In 2001 in Abuja, Nigeria, all African nations pledged to commit 15% of their domestic budgets to health. Nine years later few, if any, have managed to do so. In my tribe, we have a saying “Nanyini mufu y’akwata awawunya” which means that the owner of the dead person is the one who handles the smelly part.