Domestic funding for HIV a game changer

Robin Muchetu, Lifestyle, Health and Gender Editor

HIV and Tuberculosis (TB) are an important health concern in Zimbabwe, more importantly now, when there are issues of funding regarding the country’s response to the virus.

Zimbabwe requires at least US$500 million to respond to HIV and TB annually and this has been made possible through the assistance of international partners like the Global Fund, who have been funding this response. From the domestic side, the country has been injecting at least 25 percent of funds via the Aids Levy but this is not enough, pushing the country to rely on donor funds.

The HIV response in Zimbabwe is categorised under four pillars/thematic areas namely Prevention, Care and treatment, Programme Co-ordination and Monitoring as well as programme logistics and support.

However, since the announcement by the US Government that they are reviewing all donor funding that various countries have been benefitting from, there have been calls to improve domestic funding towards the fight against HIV, TB and malaria.

Experts say the withdrawal by the Trump Administration is also a wake-up call for beneficiaries to increase domestic funding in order to prevent devastating effects of withdrawal of donor funding.

“Though it is an open secret that foreign aid will not continue in perpetuity, little action was taken to guarantee local financing of our own health systems and build resilience in the event of the imminent withdrawal of external funding. The Covid-19 pandemic exposed the weaknesses of solely depending on external support for health. The USaid funding withdrawal came as a wakeup call for all USaid recipient countries to domestically fund their own health systems,” says Mr Lemson Machibiza, principal Consultant of the African Centre for Global Health Innovation and Research (ACGHIR).

In 2001, African countries converged in Abuja, Nigeria and came up with a binding resolution for African countries to ensure that at least 15 percent of their national budgets be channelled towards health funding so as to build resilience.

“This famous resolution to self-finance our health system which became known as the Abuja Declaration, if wholly adopted timeously would have formed a foundational bedrock upon which domestic funding mechanisms are adopted by African member states,” he added.

Public health experts have, for several years, called for this increased domestic funding and fulfilling the resolutions made in the Abuja Declaration to ensure that individual countries do much for themselves via their own national budgets in times of crisis.

Mr Machibiza, highlights that sadly, now over 20 years since this noble initiative was agreed, only eight African countries have managed to meet this commitment.

“This highlights a worrying implementational gap scourge among African nations, which needs to be nipped in the bud earlier, if meaningful milestones are to be attained,” he says.

Mr Machibiza highlights that in the absence of this USaid funding support, a health catastrophe is looming if no meaningful domestic health funding models are adopted.

In a recent engagement with editors from various media houses in Zimbabwe, the National Aids Council (NAC) highlighted that they were seeking new and indigenous financing models to cover that gap that the pull out of USaid will leave as they seek to preserve the gains made in the country so far.

Various ideas were proposed and they seek to be expanded and kick-start the pooling of funds as an urgent matter to ensure the country remains on track regarding the momentum gathered over the years, where the response to HIV, TB and Malaria in Zimbabwe is concerned.

Commendably, Zimbabwe is one of the few African countries, which have successfully attained the 95-95-95 UNaids goals ahead of time and even surpassed the 95 targets. The country has registered excellent health milestones in as far as Malaria, HIV/Aids and TB is concerned.

The USaid funding has been instrumental in the procurement of essential medicines for HIV, TB, Malaria, including some communicable and non-communicable diseases and most importantly technical support in various health developmental projects.

Fears of increased morbidity and mortality from both communicable and non-communicable diseases, which were previously under control were highlighted as a major concern while the country seeks adequate funding to respond to the crisis.

Uninterrupted medicines supply, poor adherence to therapy and possible proliferation of resistant disease strains due to potential stock ruptures and increased funding gaps are also feared.

Fears of a decline in community-based health programmes were also highlighted despite their instrumental impact to attaining the nation’s health goals as espoused in the National Community-Based Health Worker Strategy, a key pillar of national health systems.

The Minister of Health and Child Care Dr Douglas Mombeshora, last week announced that the country had stocks of up to six months supply of antiretrovirals that are required in the country, urging the public not to panic as they were securing more supplies.

The Ministry has also warned the public against hoarding ARVs, as this will create artificial shortages, which will push recipients of care into panic mode.

Efforts are being made to ensure that more supplies are stocked up while the country finds a lasting solution. — @NyembeziMu