Prof Alan Whiteside: Observer article Health vs. AIDS Funding

 

On Sunday 24th October the Observer newspaper and guardian.co.uk published an article under an appalling banner headline ‘Experts want African aids funds channeled away from HIV: Focus on Aids, they say has led to neglect of other fatal conditions killing young children'.

The article had bore little resemblance to the headline and was riddled with contradictions. It quoted myself, Daniel Halperin, Dr Medaro in Uganda and activist Elvis Bassudde of Uganda.

I was deeply upset by this gross misrepresentation of my views and on Monday 25th October sent a letter to the Editor of the Observer saying:

Dear Editor,

Last Sunday you published an article headed ‘Experts want African aid funds channeled away from HIV’. The story bears little resemblance to the title, which is sensational and certainly does not reflect my views.

There are an estimated 33 million people living with HIV across the world and numbers are rising. Only 30 percent of people needing treatment have access to drugs. It is misleading at best and thoroughly dangerous at worst to publish such bold headlines that I, nor the majority of those working in this field ascribe to. In the article itself, I state that AIDS spending is vital ‘for those already on or requiring treatment.’

The unmet health needs for those in the developing world, be it for malaria, diarrhea or AIDS highlight the importance of and obligation to greater funding. It is not HIV/AIDS funding that is the problem but rather that funding for global health is wholly insufficient. A recent conference on ‘Global Responsibilities for Global Health Rights’ in Brussels stressed the failings of donor countries in fulfilling their aid pledges. If only 0.7% of the gross domestic product of developed countries was committed and 15% of this used for health, then $38 billion would be raised instantly. This would go a long way to reaching the Millennium Development Goals.

Corruption is a problem. But can we promise if funds for HIV were reallocated that this would still not be the case? I believe the big capital projects and arms deals attract greater corruption. Rather than focusing on this as an excuse for truncating AIDS funding, the inefficiencies both in recipient and donor governments, should be explored.
Global health is critical. Prevention is critical. I do not regard one above the other. Neglect of funding and health has created the conditions where children are dying unnecessarily. AIDS activists held governments to account, and considerable sums of money to AIDS and health more broadly. Their ingenuity, innovation and tenacity should be replicated for better health for all.

Your sincerely
Alan Whiteside

There is no guarantee that this letter will be published, but we have posted it on the HEARD website www.heard.org.za and my site www.alanwhiteside.com .Please feel free to link to this.

On Monday I was a guest on the BBC Programme World have your say and again reiterated my views. This podcast is available at the websites.

Below there is a longer description of what actually happened and we are going to post this to the discussion groups that picked up the story. Being busy you may not want to read this.

I am sorry this happened, unfortunately as you will appreciate, we do not control the press or the sub-editors and the story that ran bore little resemblance to what was discussed with the journalist.

How the 'African Experts' story came to be written (I think). I believe the journalist was following up on a number of stories. These were:

1. The BBC report on a child being hit by a car in Uganda taken to a government facility which had no resources and the child dying while across the road was a well equipped  facility dedicated to AIDS treatment which would not (could not provide treatment. See www.bbc.co.uk/focusonafricamagazine/news/story/2009/10/091005_uganda_hiv.shtml
2. Reports of people taking the governments of Botswana and Uganda to court because they had been told they were HIV positive and even put on treatment when this was not the case and they felt their lives had been ruined
3. A report in The East African which stated "Hundreds — or even thousands — of Kenyans and Ugandans may have been told that they are infected with HIV when they are not, thanks to faulty rapid, 15-minute tests administered at VCT centres. Many others may have wrongly been declared negative, clearing them for unprotected sex, when they actually are HIV-positive. That is the worrying conclusion of a study involving 6,255 people carried out in Uganda and Kenya, which bluntly says that the misuse of rapid tests at most VCT centres makes them fraught with error and that they cannot by themselves alone determine whether one is HIV-positive or not." The newspaper says its information comes from The East African Medical Journal is published by the Kenya Medical Association, but we have not been able to find it online yet. The news report is at www.afrika.no/Detailed/18066.html

Let me state clearly and unequivocally on the record what my views are.

• AIDS is exceptional and must be treated as such but with nuance. For a greater analysis of this see the paper prepared for the 2031 project and posted at www.aids2031.org/pdfs/aids exceptionalism_paper25.pdf

• Health and AIDS in the resource poor world is underfunded. This was the subject of a meeting in Brussels a couple of weeks ago.

• Antiretroviral therapy keeps people alive. In Swaziland in May 2009 there were over 39 000 people on treatment across the country, without these drugs they would be dead or dying.

• Prevention needs more attention. At an MSF meeting in Swaziland last week on treating MDR and XDR TB, we were reminded that the expensive and complex diseases only come about because of failure to deal with ordinary TB. Somehow we need the same prevention advocacy that treatment enjoys (and I don’t mean either or, I mean both need advocacy). The challenge to develop advocacy for something people don't get! A problem our colleagues in vaccine development have faced.

• Development assistance is under threat – I can’t attribute this but I was told that in a number of western capitals ODA is seen as 'a hobby for the left', the book Dead Aid, by Zambian woman author Dambisa Moyo, has contributed to this. We need to push back, in order to do this we must show value for money.

It is critical we show value for money, and make informed choices, see Stefanno Bertozzi's brilliant presentation at the IAS Cape Town meeting.
 
Prof Alan Whiteside
Director
Health Economics & HIV/AIDS Research Division
Internet: www.heard.org.za

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