UK government commits to further HIV and development aid for Southern Africa

Julian Meldrum, Julian Meldrum
Published: 14 November 2002

The UK’s Department for International Development (DfID) has recently updated its strategy for Southern Africa on supporting economic and social development (click here for pdf version). The report covers Botswana, Lesotho, Namibia, South Africa and Swaziland (the Southern Africa Customs Union) and regional work in the wider Southern African Development Community (SADC). The report is broadly optimistic about the prospects for progress, although it demonstrates that in some respects - such as life expectancy, uptake of education, incomes and rates of infant mortality - things have in fact been getting worse in several countries in recent years.

HIV/AIDS is clearly identified as a major challenge to economic and social development and the reduction of poverty. There is equally a continuing need for help in overcoming the legacy of apartheid and earlier forms of colonialism. The report is candid about the variable levels of political commitment to agreed priorities such as good governance, effective poverty reduction strategies and responding to HIV/AIDS. However, it observes that some countries – notably Botswana – have made exceptional efforts to respond to HIV/AIDS, and welcomes recent signs that the South African cabinet has increased the priority it is giving to responding to the epidemic.

The impact of HIV/AIDS

On HIV/AIDS specifically, quoting UNAIDS estimates from antenatal clinic surveys, DfID observes that 'HIV infection rates in 15-49 year olds are 38% in Botswana, 24% in Lesotho, 20% in Namibia, 22% in South Africa and 34% in Swaziland.'

'The death rate lags behind the infection rate by nearly a decade, and will increase rapidly in all countries over the next few years whatever happens to the rate of future transmission. Over the next decade some 5-7 million people will die during their prime years as a result of the disease, leaving some 2 million orphans, transforming family structures and social norms. The ability of government to provide services will come under increasing pressure as demand increases and staff losses increase, and HIV/AIDS will affect the competitiveness of business.

'HIV/AIDS is not restricted to the poorer sections of society – but the poor are most vulnerable to its consequences. Inadequate nutrition, poor living conditions and lack of access to effective treatment greatly increase the vulnerability of poor people to opportunistic infections such as tuberculosis.

'Although awareness about HIV/AIDS is nearly universal, this is not translating into behaviour change. Condom use is still low. Further work to slow the spread of transmission is needed urgently across the region. About 10% of new cases arise from mother to child transmission – perinatal use of anti-retroviral drugs could reduce the risk of transmission substantially.

'Systems for care and treatment of the sick, and for care of orphans need substantial strengthening. Traditional coping systems within the extended family are beginning to break down, given the scale of the problem. Improving access to the relatively simple treatments required for frequent opportunistic infections is a more immediate priority than provision of anti-retroviral drugs that delay the development of AIDS. Use of these drugs will increase however as prices come down, and operational research is required to address the constraints faced by health care systems to administer the complicated drug regimes safely.

'The inevitable impact of HIV/AIDS is still inadequately reflected in future planning by both public and private sectors across the region. More research and analysis is required to project impacts accurately.'

What DfID plans to do

Under its new strategy, DFID will spend £45 million (approx: R700 million) per year in South Africa, Botswana, Lesotho, Namibia and Swaziland. DFID will continue to support delivery of education, health and water services to poorer areas. But in future, DFID will give greater priority to the HIV/AIDS epidemic, jobs and growth, as well as to regional issues such as conflict, trade and food security.

In addition to work under this new strategy, DFID is responding to the current humanitarian crisis in Southern Africa. It has contributed £81 million (R1.2 billion) towards the emergency effort so far.

Clare Short, the UK's Secretary of State for International Development said: 'This new strategy is part of Britain's response to the new commitment and leadership by African leaders to address poverty in the continent, shown by the formation of the African Union and the launch of NEPAD.’

Sam Sharpe, Head of DFID Southern Africa, based in Pretoria, said: 'DFID's new strategy for Southern Africa outlines a new approach to British development cooperation in the region. It marks a move away from financing individual projects towards broader support for governments' national poverty strategies.'

Since 1994, DFID has spent £190 million (approx: R3 billion at today's exchange rates) in South Africa. This has mainly supported the extension of service delivery, particularly education, health, and water, to previously disadvantaged areas, as well as in capacity building for provincial and local government.

DFID's overall aim is the achievement of the United Nations Millennium Development Goals, including the halving of world poverty by 2015.

Of the five countries which make up the Southern Africa Customs Union, Lesotho is classified as a low-income country and the others as middle-income countries with very high levels of inequality. DfID’s role is therefore somewhat different in Lesotho - where it more of a direct donor - to its role in the other countries.

In the wealthier countries, it concentrates on technical assistance within frameworks set by the national governments themselves, such as the agreed goals of the Southern African Development Community and the African Union’s NEPAD initiative. The UK is also a funding contributor to European Union and World Bank programmes in Southern Africa and works closely with other donors including USAID.

Community Consensus Statement on Access to HIV Treatment and its Use for Prevention

Together, we can make it happen

We can end HIV soon if people have equal access to HIV drugs as treatment and as PrEP, and have free choice over whether to take them.

Launched today, the Community Consensus Statement is a basic set of principles aimed at making sure that happens.

The Community Consensus Statement is a joint initiative of AVAC, EATG, MSMGF, GNP+, HIV i-Base, the International HIV/AIDS Alliance, ITPC and NAM/aidsmap

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