Hostname: page-component-8448b6f56d-c47g7 Total loading time: 0 Render date: 2024-04-19T17:24:08.961Z Has data issue: false hasContentIssue false
  • English
  • Français

Between Self-help and Dependence: Donor Funding and the Fight Against HIV/AIDS in South Africa

Published online by Cambridge University Press:  19 May 2011

Krista Johnson
Get access Rights & Permissions [Opens in a new window]

Abstract

This article examines funding for HIV/AIDS in South Africa, and the relationship between foreign donors and the South African government. The recognition of the AIDS pandemic as an epochal crisis has led to a proliferation of international and donor organizations now directly involved in the governance, tracking and management of the pandemic in many African countries. In many ways, the heavy donor hand that is increasingly defining the pandemic and the global response to it feeds into a new imperialist logic that subordinates pan-African agendas, masks broader issues of access central to the fight against the pandemic, and strengthens traditional relationships of dependence between wealthy Western nations and poorer African nations. The South African government's relationship with foreign donors, however, has been shaped by its efforts to develop an African response to the pandemic not determined nor primarily funded by foreign aid. This article highlights the positive and negative implications of the sometimes contentious relationship between the South African government and foreign donors, as well as the Africa-centred, self-help agenda it pursues, highlighting the opportunities as well as challenges for African governments to define the global response to the pandemic.

Cet article examine le financement de la lutte contre le VIH/SIDA en Afrique du Sud, et la relation entre les bailleurs de fonds étrangers et le gouvernement sud-africain. La reconnaissance de la pandémie du SIDA en tant que crise époquale a conduit à une prolifération d'organisations internationales et bailleurs de fonds aujourd'hui directement impliqués dans la gouvernance, le suivi et la gestion de la pandémie dans de nombreux pays africains. À plusieurs égards, le poids des bailleurs de fonds qui définit de plus en plus la pandémie et la réponse globale qui lui est donnée s'inscrit dans une nouvelle logique impérialiste qui subordonne les programmes panafricains, masque des questions plus larges d'accès qui sont au centre de la lutte contre la pandémie, et renforce les relations traditionnelles de dépendance entre les nations occidentales riches et les nations africaines pauvres. Cependant, la relation qu'entretient le gouvernement sud-africain avec les bailleurs de fonds étrangers a été façonnée par ses efforts d'élaborer une réponse africaine à la pandémie qui ne soit pas déterminée ni essentiellement financée par l'aide étrangère. Cet article met en lumière les implications positives et négatives de la relation parfois difficile entre le gouvernement sud-africain et les bailleurs de fonds étrangers, ainsi que les objectifs d'entraide axés sur l'Afrique qu'il poursuit, en soulignant les opportunités et les défis qui se posent aux gouvernements africains pour définir la réponse globale à la pandémie.

Type
Research Article
Information
Africa , Volume 78 , Issue 4 , November 2008 , pp. 496 - 517
Copyright
Copyright © International African Institute 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

ANC (African National Congress) (2007) ‘The South African child: UNICEF born to serve children?’, ANC Today 7 (41) (19–25 October).Google Scholar
Attaran, A. and Sachs, J. (2001) ‘Defining and redefining international donor support for combating the AIDS pandemic’, Lancet 357: 57–61.CrossRefGoogle Scholar
Bartsch, S. and Kohlmorgen, L. (2007) ‘The role of southern actors in global governance: the fight against HIV/AIDS’, GIGA Working Paper No. 46 (March). (http://papers.ssrn.com/sol3/papers.cfm?abstract_id=978178), accessed 10 November 2008.Google Scholar
Compernolle, P. (2007) ‘Impact of increased AIDS flows for HIV/AIDS in developing countries: working towards a sustainable response’, research paper, University of KwaZulu-Natal. (http://www.ukzn.ac.za/heard/research/ResearchReports/2007/SustainableAidforAIDSFINAL.pdf), accessed 8 April 2008.Google Scholar
Cullinan, K. (2006) ‘SA wants more say on AIDS spending’, Mail and Guardian Online, June 2006.Google Scholar
Department of Health, South Africa (2004) ‘National HIV and syphilis antenatal sero-prevalence survey’. (http://www.doh.gov.za/docs/reports/2004/hiv-syphilis.pdf), accessed 11 June 2006.Google Scholar
Department of Health, South Africa (2005) Partnerships for the Delivery of Primary Health Care Including HIV and AIDS. Annual report, 2004/5.Google Scholar
Department of Health, South Africa (2006) Republic of South Africa: progress report on declaration of commitment on HIV and AIDS 2005. Department of Health, Republic of South Africa.Google Scholar
Engler, M. (2006) ‘Politicizing aid’, article on website ‘Foreign Policy in Focus’. (http://www.fpif.org/fpifoped/3203), accessed 23 October 2008.Google Scholar
Fassin, D. (2007) When Bodies Remember: experiences and politics of AIDS in South Africa. Berkeley CA: University of California Press.CrossRefGoogle Scholar
Gellman, B. (2000) ‘An unequal calculus of life and death’, Washington Post, 27 December.Google Scholar
Gevisser, M. (2007) Thabo Mbeki: a dream deferred. Johannesburg: Jonathan Ball Publishers.Google Scholar
Global Fund to Fight AIDS, Tuberculosis and Malaria (2008) ‘Global Fund Disbursements’, 16 April. (http://www.theglobalfund.org/en/files/disbursementdetails.pdf), accessed 22 April 2008.Google Scholar
Global HIV Prevention Working Group (2007) ‘Bringing HIV prevention to scale: an urgent global priority’. June. (http://www.globalhivprevention.org/reports.html), accessed 15 April 2008.Google Scholar
Guthrie, T. and Hickey, A. (2004) Funding the Fight: budgeting for HIV/AIDS in developing countries. Johannesburg: Institute for Democracy in South Africa (IDASA).Google Scholar
Heywood, M. (2001) ‘Debunking “conglomo-talk”: a case study of the Amicus Curiae as an instrument for advocacy, investigation and mobilisation’, paper presented at the conference on ‘Health, Law and Human Rights: Exploring the Connections’, 29 September-1 October 2001, Philadelphia PA.Google Scholar
Hickey, A. (2003) International AIDS Economics Network Meeting. Washington DC: Research Unit on AIDS and Public Finance.Google Scholar
Hodgson, I. (2005) ‘Loaded but lonely: the moralisation of US AID policy’, Internet article on the website Open Democracy: Free Thinking for the World. (http://www.opendemocracy.net/globalization-hiv/us_aids_3078.jsp), accessed 10 November 2007.Google Scholar
Hodgson, I. (2006) ‘Dazed and confused: the reality of AIDS treatment in South Africa’, Internet article on the website Open Democracy: Free Thinking for the World. (http://www.opendemocracy.net/globalization-hiv/southafrica_3170.jsp), accessed 10 November 2007.Google Scholar
Johnson, K. (2005) ‘Globalization and social policy in South Africa’, New Political Science, 27 (3) (September).CrossRefGoogle Scholar
Johnson, K. (2006) ‘Framing AIDS mobilization and human rights in post-apartheid South Africa’, Perspectives on Politics 4 (4) (December 2006).CrossRefGoogle Scholar
Kahn, T. (2008) ‘Aspen queries HIV treatment numbers’, Business Day, 26 February.Google Scholar
Kates, J. and Lief, E. (2006) ‘International assistance for HIV/AIDS in the developing world: taking stock of the G8, other donor governments, and the European Commission’. July. (http://data.unaids.org/pub/BaseDocument/2006/20060731-KFF-international-assistance_en.ppt-), accessed 11 April 2007.Google Scholar
Kelly, K., Birdsall, K., Tshose, P., Banati, P. and Low-Beer, D. (2005) ‘Community perspectives on systems effects of HIV/AIDS funding in South Africa’, report, Centre for Development, Research and Evaluation (CADRE).Google Scholar
Lewis, M. (2005) ‘A war chest for fighting HIV/AIDS’, Finance and Development 42 (4).Google Scholar
Lewis, M. (2007) ‘Opinion piece by Stephen Lewis following the firing of the South African Deputy Minister of Health, Cape Argus, 17 August’. (http://www.stephenlewisfoundation.ca/news_item.cfm?news=1948), accessed 15 November 2007.Google Scholar
Manuel, T. (2008) ‘2008/9 Budget Speech’. South African Parliament, 20 February.Google Scholar
Martin, H. G. (2003) ‘A comparative analysis of the financing of HIV/AIDS programmes in Botswana, Lesotho, Mozambique, South Africa, Swaziland, and Zimbabwe’ in Social Aspects of HIV/AIDS and Health Research Programme of the Human Sciences Research Council (HSRC). Johannesburg: HSRC.Google Scholar
Mbeki, T. (2000) ‘South African President Thabo Mbeki's letter to world leaders on AIDS in Africa’. April. (http://www.virusmyth.com/aids/news/lettermbeki.htm), accessed 22 May 2005.Google Scholar
Mbeki, T. (2004) ‘Accepting goodwill should not make us subservient’, ANC Today, 28 May 2004. (www.anc.org.za), accessed 15 October 2007.Google Scholar
Mbali, M. (2002) ‘Mbeki's denialism and the ghosts of Apartheid and colonialism for post-apartheid AIDS policy making’. (www.ukzn.ac.za/ccs/files/mbeki.pdf)Google Scholar
McGreal, C. (2007) ‘Six years on: Mbeki the AIDS dissident’, Mail and Guardian, November, 6.Google Scholar
Mukotsanjera, V. (2008) ‘HIV/AIDS domestic financing in South Africa’, report, IDASA, February. National Treasury, South Africa (2005) ‘National estimates of expenditure’. (www.treasury.gov.za), accessed 12 September 2007.Google Scholar
Mukotsanjera, V. (2006) ‘Adjusted estimates of national expenditure 2006’, p. 336. (http://www.treasury.gov.za/documents/mtbps/2006/adjustments%5C0%20title.pdf), accessed 23 March 2008.Google Scholar
Nattrass, N. (2004) The Moral Economy of AIDS in South Africa. Cambridge: Cambridge University Press.Google Scholar
Ndlovu, N. (2005) ‘Monitoring AIDS treatment rollout in South Africa: lessons from the Joint Civil Society Monitoring Forum’, Budget Brief No. 161, IDASA Budget Information Service, Institute for Democracy in South Africa.Google Scholar
Ndlovu, N. (2006a) ‘A glimpse at HIV and AIDS funding in budget 2006’ report, AIDS Budget Unit, Institute for Democracy in South Africa.Google Scholar
Ndlovu, N. (2006b) ‘An exploratory analysis of HIV and AIDS donor funding in South Africa’, Budget Brief No. 155, IDASA Budget Information Service, Institute for Democracy in South Africa.Google Scholar
Ndlovu, N. and Daswa, R. (2006) ‘Review of progress and expenditure on the comprehensive plan for HIV and AIDS in South Africa’, report, AIDS Budget Unit, Institute for Democracy in South Africa.Google Scholar
OECD/UNAIDS. (2004) ‘Measuring aid in support of HIV/AIDS control’. (www.oecd.org/stats/dac/crs/hivaids), accessed 13 November 2007. PEPFAR (President's Emergency Plan for AIDS Relief)Google Scholar
OECD/UNAIDS. (2008a) ‘South Africa Fiscal Year 2008 Country PEPFAR Operational Plan’. (http://www.pepfar.gov/about/opplan08/102012.htm), accessed 22 April 2008.Google Scholar
OECD/UNAIDS. (2008b) ‘2008 Country Profile-SouthAfrica’. (http://www.pepfar.gov/documents/organization/81668.pdf), accessed 22 April 2008.Google Scholar
Quinn, A. (2006) ‘South Africa youth AIDS program faces cash crunch’, Reuters news report, 4 January. (http://www.alertnet.org), accessed 4 November 2007. Reuters (2007) ‘SA's forgotten children’, news report, 12 October. (http://www.news24.com/News24/South_Africa/Aids_Focus/0”2–7-659_2198823,00.html), accessed 22 April 2008.Google Scholar
Shisana, O. and Zungu-Dirwayi, N. (2003) ‘Government's changing responses to HIV/AIDS’, Development Update: the (Real) State of the Nation: South Africa after 1990 4 (3): 165–87. (http://www.interfund.org.za/pdffiles/vol4_three/Chapter%207.pdf), accessed 22 May 2005.Google Scholar
South African Government (2008) Progress Report on Declaration of Commitment on HIV and AIDS. Prepared for the United Nations General Assembly Special Session on HIV and AIDS (March).Google Scholar
TAC (Treatment Action Campaign) (2008) ‘Key HIV Statistics’. (http://www.tac.org.za/community/keystatistics), accessed 22 April 2008.Google Scholar
Tshabalala-Msimang, M. (2006) Opening address, at the Global Fund Replenishment Conference, Durban, South Africa, 4–5 July 2006.Google Scholar
UNAIDS (2006a) 2006 Report on the Global AIDS Epidemic. (www.unaids.org), accessed 20 June 2007.Google Scholar
UNAIDS (2006b) 2006 Annual Report-Making the Money Work. (www.unaids.org), accessed 15 February 2008.Google Scholar
UNAIDS (2007) ‘Financial resources required to achieve universal access to HIV prevention, treatment, care and support’, report, September. (www.unaids.org), accessed 8 April 2008.Google Scholar
van der Vliet, V. (2003) ‘Full roll-out on the cards?’, news report, News24. com. (http://www.news24.com/News24/South_Africa/Aids_Focus/0”2–7-659_1453740,00.html), accessed 5 May 2006.Google Scholar
WHO (World Health Organization)/UNAIDS (2007) ‘Towards universal access: scaling up priority HIV/AIDS interventions in the health sector’, progress report, April 2007. (http://www.who.int/hiv/mediacentre/universal_access_progress_report_en.pdf), accessed 15 November 2007.Google Scholar