US Puts Locals in Charge of AIDS Spending. 4/2/10

U.S. and South African AIDS workers say putting more of the decision-making in local hands can help stretch donor money, amid concerns international giving will be limited because of the global recession.

Times Live

4 February 2010
By DONNA BRYSON, Sapa-AP

U.S. and South African AIDS workers say putting more of the decision-making in local hands can help stretch donor money, amid concerns international giving will be limited because of the global recession.

Since 2004, the U.S. government has funded a project for AIDS patients in rural South Africa through Catholic Relief Services, the charity arm of the Catholic Church in the United States.

In a significant shift made official this week, the U.S. will now directly pay South Africans with whom the U.S. Catholics have been working.

What may seem like a small bureaucratic step is significant, said Ruth Stark, head of CRS in South Africa. She said that instead of channeling U.S. funds to South Africans, CRS would now serve as a partner for monitoring, clinical and other services, and would now be paid by the South Africans.

"The person in charge, who is the local partner now, they decide what they need and they pay for it," Stark said in an interview Thursday.

Stark said she has already seen savings as officials prepared for the hand-over. Local instead of international experts were tapped for some jobs, for example.

"The cost difference is huge," Stark said.

In the future, the overhead costs of an international organization's branch office - salaries at international level, housing and education benefits - would be saved.

South Africa, a nation of about 50 million, has an estimated 5.7 million people infected with HIV, the virus that causes AIDS, more than any other country. It is the largest recipient of funds from the President's Emergency Plan for AIDS Relief, PEPFAR, the main U.S. program for international AIDS programs.

After years of foot-dragging on AIDS, South Africa last year set a target of getting 80 percent of those who need AIDS drugs on them by 2011. The government also has called for earlier and expanded treatment for HIV-positive South Africans, and pledged to step up testing for HIV.

The CRS project has reached 73,000 people since 2004, of whom 35,000 have received AIDS drugs, Stark said. Other services include support for children orphaned by AIDS.

The South African groups who have been working with CRS are in some of the poorest and hardest to reach areas of the country. They include the AIDS office of the Southern African Catholic Bishops' Conference, the Institute of Youth Development of South Africa, which operates in southeastern South Africa, and St. Mary's Hospital in KwaZulu-Natal, the South African province hardest hit by AIDS.

These groups received more than $25 million PEPFAR funds last year channeled through CRS, and will get about the same directly this year, Stark said.

Connie Kganyaka, chief director of the AIDS office of the South African government's social development office, said the possibility of foreign funding dropping was "a big concern for South Africa."

She told The Associated Press that the South African government has thus increased their funding to AIDS organizations. Money to help children orphaned by AIDS had increased from 7 million rand when she first joined her department in 2004 to almost 1 billion rand (about $130,000) today.

She said South Africa also was looking for sources beyond the U.S., including its own entrepreneurs in a country seen as the continent's economic hub.

"We think our private sector has the capacity," she said. But she added the day when South Africa could do without foreign funding was a long way off.

At the hand-over ceremony in Johannesburg Wednesday, Alison Munro, a nun who directs the Southern African Catholic Bishops' Conference AIDS office, said the partnership between donors and groups like hers was crucial.

"We have the people," Munro said. "They have the money."

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