South African Government, Global Fund Fail To Sign Grant Agreement for Second Time in One Week
The South African government and the Global Fund to Fight AIDS, Tuberculosis and Malaria on Friday failed to sign an agreement that would provide more than $40 million in grants to KwaZulu-Natal, one of the country's provinces hardest hit by the epidemic, Reuters reports (Reuters, 4/11). Richard Feachem, head of the Global Fund, arrived in South Africa early last week to sign the deal to release the first distribution of a five-year, $165 million grant (Associated Press, 4/11). In April 2002, the fund approved a one-year, multimillion-dollar grant to KwaZulu-Natal to expand an HIV/AIDS treatment program to all of the province's clinics. In June 2002, the South African government tried to block the grant, stating that the grant application did not go through the national government before being submitted to the fund as specified in the application guidelines. KwaZulu-Natal officials said that they applied directly to the fund because South Africa had not yet established a Country Coordinating Mechanism at the time of application. The South African National AIDS Committee has since been designated as the nation's CCM. In a statement released in July 2002, KwaZulu-Natal Health Minister Zweli Mkhize said that he and South African Health Minister Manto Tshabalala-Msimang had agreed to pool the funds under the National AIDS Council, which would use the money "in a manner that will benefit all the provinces equitably and within programs contained within the proposals submitted to the Global Fund." Fund officials would not allow South Africa to reallocate the funds and said that the country should reapply for the grant in order to alter the arrangement (Kaiser Daily HIV/AIDS Report, 11/4/02).
Dr. Nono Simelela, head of the health department's AIDS directorate, on Thursday night said that there were still "some outstanding issues" with the agreement. This was the second time in a week that officials failed to approve the agreement, the Cape Times/Independent Online reports. The first time, officials said all that remained to work out were "technical details," including which government department would be responsible for the grant money. Feachem said at that time that the officials were simply "dotting the i's and crossing the t's" (Altenroxel/Majors, Cape Times/Independent Online, 4/11). However, government officials on Friday released a statement saying that there were going to be "further delays" due to "relatively complex legal processes," Reuters reports. Feachem said he would allow South Africa as much time as it needed, but added, "This is very disappointing. The money needs to flow. These are life and death issues. Delay is measured in human life ... and we have urged them to complete the steps they need to complete as quickly as they can" (Reuters, 4/11).
Treatment Action Campaign Chair Zackie Achmat, who has threatened to take legal action if the agreement is not approved, said, "This is costing lives and if necessary we will make an application to court to get the minister's reasons for it" (Cape Times/Independent Online, 4/11). Speaking on Tuesday at a formal gala event to welcome Feachem to South Africa, Tshabalala-Msimang said that the Global Fund was to blame for the delays in the agreement, according to the Mail & Guardian. She said, "We had hoped to sign the agreement, but there are a few loose ends. The reason we have not moved with speed is because the Global Fund had to set their house in order and not that SANAC was not ready. Geneva was not ready." Speaking after the health minister, Feachem did not address her comments but called on "all sectors to apply to the fund" for grants to help provide antiretroviral therapy to those who need it, according to the Mail & Guardian (Deane, Mail & Guardian, 4/11). Anglican Archbishop Njongonkulu Ndungane at a joint news conference with Feachem said, "I have no words to express my dismay. It seems that the health ministry or whoever is responsible for [the agreement is] fiddling while Rome is burning. People are dying" (Associated Press, 4/11).