With large donor projects winding up and little bilateral support for HIV programmes in the Democratic Republic of Congo (DRC), the country is facing the possibility of ARV shortages and rising HIV mortality, say aid workers.
The World Bank's Multi-Country HIV/AIDS Programme (MAP) is in the last 10 months of its six-year run in the DRC. The US President's Emergency Plan for AIDS Relief, PEPFAR, which has been providing medication for opportunistic infections and laboratory support, is expected to halt this aid, while the international funding mechanism, UNITAID, which has been providing second-line medication and paediatric ARVs, is withdrawing in 2011.
That leaves the Global Fund to fight AIDS, Tuberculosis and Malaria as the only donor for HIV treatment in the country.
Yves Nicolas Alexandre, head of the UN Development Programme's Global Fund Programme Management Unit in the DRC, acknowledged that while the Global Fund's programmes are still treating new patients, the end of the World Bank's MAP project has put pressure on the Fund.
Only 10 percent of people – 35,000 people – in the DRC who need ARVs have access to them, Corinne Benazech, coordinator of the HIV/AIDS project for the medical charity, Médecins Sans Frontières, told IRIN/PlusNews. "The main reason for the low numbers on treatment is lack of funding," she noted.
"We are very worried about this situation; raising money has not been easy," said Adama Guindo, country representative for UNDP, which is the Global Fund's principal recipient for HIV grants for rounds three, seven and eight. "Most bilateral donors tell us that they donate funds for HIV through the Global Fund and do not want to do parallel funding - the government must put in more effort towards resource mobilization."
|Many patients...arrive at the MSF clinic when they are already extremely weak and close to death|
In future, “the priority would be to put in place a more effective donor coordination to ensure that the ARVs are distributed in areas where the capacity for treating patients is already developed", a World Bank spokesperson told IRIN/PlusNews.
According to MSF's Benazech, some programmes in the capital are no longer accepting new patients for HIV treatment.
"Many patients coming from the government hospital, which has run out of drugs, arrive at the MSF clinic when they are already extremely weak and close to death so their chances of survival are low," she said. "Patients on treatment are forced to pay for the CD-4 examination [which measures immune strength] follow-up... which is extremely expensive for the average Congolese person.
"HIV in the DRC is not chronic, like it is in many other African countries, where significant coverage is being reached; here it is acute," she added. "We urgently need more advocacy and mobilization for additional funding for treatment in the DRC; the situation is critical."
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