GLOBAL: Mismatch between HIV spending and need

Photo: Allan Gichigi/IRIN

JOHANNESBURG,� – The global economic crisis may have the positive spinoff of forcing countries to allocate increasingly scare HIV/AIDS resources more efficiently.

A recent analysis of national spending on HIV/AIDS found a correlation between prevalence and the amount countries spent on the disease, but a mismatch between how the money was spent and the areas of greatest need.

Researchers from the AIDS Financing and Economics Division at UNAIDS and the Centre for Economic Governance and AIDS in Africa (CEGAA) used a tool developed by UNAIDS to track and report how much domestic and international funding was spent in eight different areas of HIV programming by 50 countries in 2006.

Their findings are published in a December supplement of the AIDS journal, which focuses on progress in achieving global HIV targets.

The data lends weight to recent calls by AIDS experts to concentrate dwindling resources for HIV/AIDS on well-managed interventions that have a strong evidence base.

Several countries with the highest HIV prevalence were found to be most dependent on external funding sources – and therefore the most vulnerable to potential cuts by donors in the economic downturn.

In the 17 low-income countries included in the analysis, 87 percent of HIV funding came from international donors, with bilateral assistance financing 53 percent of antiretroviral treatment.

Middle-income countries that rely mainly on domestic budgets to fund their HIV programmes, such as Botswana and Brazil, may also be forced to do more with less as their national revenues take a hit in the global financial crisis.

Botswana, with the second highest HIV prevalence in the world, had by the far the highest per capita spending on HIV in 2006 (US$70.40), followed by Swaziland ($17.30), while the remaining sub-Saharan African countries spent an average of $5.90 per capita.

Treatment and care absorbed large shares of overall HIV funding in many countries, leaving prevention initiatives underfunded; stigma and a lack of accurate HIV surveillance data on minority groups meant they were most often overlooked.

Countries with generalized epidemics (more than one percent of the population is HIV-positive) spent twice as much on treatment as on prevention, with about 30 percent of overall HIV expenditure going on prevention efforts.

Countries with concentrated epidemics (HIV infection is mainly confined to certain groups, such as injecting drug-users or sex workers) often spent most of their prevention budgets on broad programmes that missed the most at-risk populations.

In Latin American countries, for example, where an estimated 60 percent of people living with HIV are men who have sex with men, only 0.5 percent of funds for prevention were targeted at this group.

The researchers concluded that most governments were not basing the allocation of HIV resources on a thorough understanding of their country’s epidemic, nor were they opting for the most effective, evidence-based approaches.

“The global economic recession will force countries to rethink national strategies, especially in low-income countries with high aid dependency,” they commented. “More than ever, countries need to know their epidemic, and both resource allocations and their HIV programmes need to reflect those data and analyses.”

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President Obama�s special envoy on war crimes Stephen Rapp in Nairobi on Monday. Photo/HEZRON NJOROGE

Kenya, he added, had no choice but to cooperate with the ICC. He underscored the need for a local special tribunal as a first line remedy to end the culture of impunity. He criticised the Grand Coalition Government of reneging on an important promise they made to bring the suspects to book.

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ZAMBIA: Orphans grow up without cultural identity

Photo: Manoocher Deghati/IRIN

LUSAKA, 16 November 2009 (PlusNews) – Abigail Mwanashimba has been looking after her five siblings since the age of eight, when her parents died of AIDS-related illnesses. She is now 19 years old, and without relatives to represent her at her lobola (bride price) negotiations, she was forced to hire traditional counsellors to organise the process of marriage according to the tribal customs. They did a bad job.

“I don’t know anything about my tribe or its culture because there has never been anyone to teach or show me,” she told IRIN/PlusNews. “I got very little lobola, but the last straw was the humiliation I suffered at my in-laws’ home, when I embarrassed them by performing the wrong dance.”

Losing out on the bride price was one thing, but when she realised that the counsellors she had hired had taught her the wrong traditional dances, she refused to pay them their 500,000 Zambian kwacha (US$100) fee, and is now facing a lawsuit.

Agnes Ngubeni, from the central town of Kabwe, also knows this kind of humiliation; she has lived with the embarrassment of not having undergone an initiation ceremony when she came of age, and not being able to speak the language of her tribe.

“People called us goats … they said we were ‘cultureless’ and were not educated in the ways of our tribe. It never occurred to them that there was no-one to teach us – we lived without elders,” she said.

Ngubeni and her siblings were orphaned fifteen years ago when her oldest brother was just 10. A Norwegian family living in Zambia committed itself to looking after them, which meant they were clothed and fed, but this presented them with social problems.

Their neighbours ridiculed them for eating pasta, bread and rice, instead of the staple, nshima – thick maize-meal porridge – that neither she nor her three sisters can cook.

“The neighbours laughed at us for eating the white man’s food, which they said was not real food, but what are we supposed to do? We eat what we are given. That’s just how it is,” Ngubeni said.

Ngubeni recommends that people helping child-headed families should consider placing an adult relative or any other person of the same tribe among them to guide and mentor them in the ways of traditional society.

Out of touch with culture

We are so engrossed in keeping the children off drugs and alcohol, and the girls from getting pregnant … that we lsoe sight of the fact that children need to be socialised in the ways of their tribe

In its latest report on Orphans and Vulnerable Children (OVC), the UN Children’s Fund (UNICEF) found that about 20,000 households in Zambia were led by children, but the number is increasing.

The report outlines the severe deprivations of food and shelter these children often face, and concludes that with more youngsters having to take on the responsibilities of running a household at an early age, there is every likelihood that more of them will end up on the street.

Joseph Banda heads Tisunge, a local organisation that assists child-headed households to deal with the trauma of loss, and teaches them income-generating and life skills, so that the children are able to fend for themselves and can continue their schooling.

Banda said it had never occurred to him that these children would struggle with cultural issues. “I am ashamed to say that I never saw the children’s situation in this way,” he admitted.

“We are so engrossed in keeping the children off drugs and alcohol, and the girls from getting pregnant, and making sure that they become good citizens, that we lose sight of the fact that children need to be socialised in the ways of their tribe.”

Child psychologist Trina Mayope warned that children growing up without the value of custom and tradition would have problems in future. “It’s about growing up with a cultural identity … The children feel isolation because the communities treat them as aliens, or as something not quite right because of their seeming lack of ‘traditional etiquette’.”

There is also the stigma attached to being orphaned by HIV/AIDS, as is mostly the case. “If these children don’t conform to the cultural norms of the society they live in they will suffer a double discrimination,” she noted.

Mayope acknowledged that urbanisation and the passing of time had caused people to discard many traditions, but the basics of culture were still important and largely defined how someone was perceived.

“It’s difficult for most people to comprehend how a child can grow up without knowing anything about his or culture. People think they [children] are trying to act like a muzungu [European], but when you have children whose mentor is a fellow child, how are they supposed to learn traditional norms and customs?”

zg/kn/he source.irinnews.org

By Saikou Jammeh-

Banjul, The Gambia:� In a discussion paper launched in Banjul today on the occasion of the 46^th Ordinary Session of the �African Commission on Human and Peoples� Rights, underway here� in The Gambia, a group of Sudanese human rights activists called for urgent reform of the public order regime in Sudan.

The paper entitled, Beyond Trousers: The Public Order Regime and the Human Right of Women and Girls in Sudan, reveals the dreadful state of Sudanese women amid the public order regime, which impedes on the personal, social, economic and professional lives of women in Sudan.

Presenting the report to the Commission, Dr. Albaqir Mukhtar of the Al-Khatim Centre for Enlightenment and Human Development described the public order regime in Sudan as, �a set of laws and mechanisms which in addition to dealing with matters of public security, prohibits and enforce a range of behavior ranging from �dancing at private parties�, to �indecent dress� and even intention to commit adultery.

These offences, the activist went on �can be interpreted with great latitude and are enforced by special police and court system with a reputation for violence and summery justice, noting that severe penalties including lashing and execution are attached to these crimes.

�The experience of women with the public order regime constitutes a litany of suffering and lost opportunity,� Dr. Albaqir Mukhtar quoted Hala Alkarib, the Executive Director of SIHA, as saying. �Women from all walks of life especially the most vulnerable and marginalized live under daily threat of arrest and brutal punishment for �ill-defined behaviors� that should never be the subject of criminal law in a democratic society�.

He reminds the participants of the high profile trial of a Sudanese Journalist MS. Lubna Hussein was arrested in a restaurant in Khartoum and charged with indecent and immoral acts �under the criminal Code of 1991.

According to him, Lubna though refused to submit to trail and demand a lawyer- a resistance which earned her a temporal reprieve, 10 other women who were arrested alongside her, were immediately tried. �they were denied legal representation, and all declared guilty and immediately lashed including a 16-year-old girl.

Lubna�s case was transferred from the Special Public Order courts to the normal courts; however she was still denied the right to present a defense or witnesses and was convicted.

�It�s not a question of trousers,� he said, �the public order regime expresses and enforces an ideology that considers that women should not have equal access to public and private freedoms including- the basic components of the right to liberty, security of person and fair trial as set out in articles 6 and 7 of the African Charter.

�The public order regime is an oppressive tool which does not impacts the lives of individuals but also the development of Sudan as a whole.

Dr. Albaqir Alafiff said: �there is need for courage. Reform of the public order regime requires a fundamental shift in the approach to the use of law and state power. But it is essential not just to fulfill the constitutional obligation to ensure of equal protection of the laws, but also ensure a real transformation in Sudan.

�Up till now this aspect, although acknowledged by the political parties, has not been made a priority. People should know that the public order law contravenes not only the African Charter and the interim constitution of Sudan, but also lacks cultural legitimacy. It is alien to the Sudanese culture and well entrenched religious traditions.

Meanwhile the paper presented contains series of recommendations for bringing Sudanese law into conformity with the requirements of the African� on human and peoples� rights in order to ensure the liberation of Sudanese People especially women.

As part of the recommendation the activist called on the Commission to recall Sudan�s obligation to implement the recommendations of the Commission with respect to reform of the Public Order Regime. He also called for the immediate amendment of the criminal Law of 1991 to be in conformity with its obligation under the African Charter.

�Sudan must implement the recommendations of the African Commission to Sudan to both abolish penalty of lashing,� he urged.� �We also call on the special rapporteur on the rights of women to offer assistance to the government of Sudan in the processes of law reform�.

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