Mmegi Online :: Seeking a way out of HIV donor fatigue
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Wednesday 17 October 2018, 15:48 pm.
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Seeking a way out of HIV donor fatigue

After the discovery of the first Botswana HIV/AIDS diagnosed case in 1985 scientists, around the globe, especially in the Americas and Europe, tripped over each other to fund HIV/AIDS vaccine trials using Africa as research territory.
By Zolani Kraai Fri 01 Dec 2017, 15:46 pm (GMT +2)
Mmegi Online :: Seeking a way out of HIV donor fatigue








At the brink of a population wipe out due to what had become the scourge, the country saw funding pouring in for the HIV/AIDS cause. Donor funding was at its highest levels ever globally, in terms of both domestic and international contributions. 

Following the global financial crisis in 2008, and, what some termed ‘donor fatigue’ regarding HIV, spending from donor governments, fell from $7.7 billion in 2009 to $6.9 billion in 2010. In that period it became important to recognise the dip in disbursements from donor governments, which largely occurred in 2010.

Although some trials had already begun in many countries, especially among gay men, some high income countries would over the years, particularly towards 2000s, prove their scientific capabilities and produce the best trial methods.  Botswana was in no position to lose out on these medical developments, as that was the focus of the battle against HIV/AIDS then.

Through donor funding agents from abroad, and with leadership and governance mentoring from Botswana’s AIDS/STDs Unit, organisations such as Coping Centre for People Living with HIV and AIDS (COCEPWA) and Botswana Network of People Living with HIV and AIDS (BONEPWA+) were formed. 

The roles of these NGOs, founded by the then executive directors, Helen Ditsebe-Mhone and David Ngele, were to mobilise PLwHIV who were either in denial, or living in fear of the stigma surrounding the scourge. 

There were also some financial implications in the strengthening and expansion of many other mushrooming NGOs. Allowances for community mobilisers and adherence volunteers were a priority for the successes of the implementation programmes of such NGOs.

With the leadership of former President Festus Mogae and the then Minister of Health Joy Phumaphi, huge financial support headed to Botswana either for ARV programmes and human

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resources capacity in the HIV/AIDS programming.

Not only did HIV treatment including PMTCT attract that funding, but the Human Rights aspect also became the central primary lobby tool for funding.  Paediatric treatment literacy, care and support also attracted huge funding with the establishment of Baylor Children Clinic and many other centers.

With the HIV/AIDS programming NGOs mushrooming, some applying the founding member syndrome that saw some centres winding up due to maladministration and funds embezzlement, a new problem emerged.

Issues of lack of governance and inefficiency in leadership led to some donors pulling out of the country followed by what was described by some experts as ‘donor fatigue’.

Botswana’s recognition scale of becoming a middle-income country compounded this donor drain changing the landscape of HIV/AIDS funding.  Government had to fill in the gap left open by donors where the challenge of funding HIV treatment prevention and care in Botswana has since created a new play field for NGOs diverting their core mandate. Those that were initially dealing with Gender Based Violence (GBV) moved into HIV treatment, while those that were directly dealing with Christian-oriented approaches now sensitise people on condom use.

A question that surfaces and continues to raise eyebrows is what does sustainability means in the HIV and AIDS response? Gemma Oberth and Alan Whiteside of the University of Cape Town and the University of KwaZulu-Natal in South Africa, respectively, both argue that immense progress has been made in the fight against HIV/ AIDS.

They say targets for the Millennium Development Goals (MDGs) were accomplished. In fact, they go as far as saying that the targets were not only achieved but were exceeded, in large part, due to an unprecedented financial investment from the international community.

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