Africa struggles to spend AIDS billions

With billions of dollars pouring in to fight Africa's HIV/AIDS epidemic, Tanzanian AIDS counsellor Gandencia Bazil has a simple request.

"We need a bicycle," said Bazil, who heads the AIDS committee in this village near Lake Victoria, an area where an estimated 12 percent of people are infected with HIV.

"With a bicycle we could reach more people with health messages. But we cannot afford even that," said Bazil, as other members of her committee nodded grimly following a meeting in a makeshift shelter near the village center.

"We are not getting the support we need."

Welamasonga's predicament is repeated across Africa, where despite a huge jump in overseas assistance and government AIDS budgets, the cash earmarked to fight the epidemic is often not making it to the desperate people who need it most.

In Mozambique, officials say only a fraction of some 70,000 children eligible for AIDS drug treatment will get it this year because of a shortage of trained doctors and nurses.

In badly-hit South Africa, health departments report being unable to spend their AIDS budgets, while in Nigeria inefficient bureaucracy has been blamed for missed treatment targets and questionable data.

Aid agency officials agree that the surge in AIDS spending has created bottlenecks, with fragile healthcare systems, disorganised government departments and fledgling community groups often ill-prepared to absorb the money flowing in.

The scale of the AIDS crisis in Africa - where some 26 million people are infected with HIV, more than 2 million died of AIDS in 2005 and well over 12 million children have lost one or both parents to the disease - still dwarfs the assistance being made available.

Nevertheless, both governments and United Nations' agencies, which spent years fighting to raise AIDS funding, are now battling to develop new strategies to spend it.

"We all need to begin thinking out of the box," Peter Piot, executive director of the United Nations' AIDS agency UNAIDS, said during a recent inspection trip to Tanzania where he was often asked why cash was not reaching grassroots groups.

"Stopping the AIDS epidemic is going to require more than just a medical approach."

HALTING PROGRESS

Worldwide AIDS funding has jumped from $250 million in 1995 to more than $8 billion in 2005. UNAIDS says that will have to rise to $22 billion by 2008 if the HIV/AIDS disaster is to be contained.

The money has already had a major effect in Africa, and in the past two years is largely responsible for boosting the number of people receiving life-prolonging anti-retroviral (ARV) drug medication, often for free.

But officials say that despite the progress, only about 10 percent of Africans who need the ARVs are getting them, while other services, including help for AIDS orphans, are often equally limited.