France & the fight against HIV and AIDS in South Africa
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France & the fight against HIV and AIDS in South Africa
The HIV and AIDS pandemic is currently one of the most challenging global public health issues. Although all continents have been affected, Sub-Saharan Africa has suffered more than any other region from these diseases: two thirds of the 33.4 million HIV-positive people worldwide are Sub-Saharan Africans and one out of six is South African.
With 5.2 million people living with HIV, South Africa has the largest HIV-positive population in the world. The national prevalence is over 10.6% and reaches 17% of the adult population between 15-49 years . As a result of this generalized epidemic, the disease is not only a major health crisis but also a heavy burden on the country’s socioeconomic development. Fighting HIV/AIDS has therefore become a top priority of the South African government.
As part of its support to the Millennium Development Goals, France has been constantly increasing its efforts to promote access to health in developing and emerging nations, with a specific focus on the fight against HIV/AIDS. Its commitments have had direct impacts on the lives of thousand of people worldwide, including in South Africa.
France is fully committed to implement in South Africa the recommendations of the Paris and Accra declarations on aid effectiveness. Thus, not to overlap with other donors, France does not intend to develop major bilateral health programs.
In South Africa, France’s financial support to the fight against HIV/AIDS and other related disease such as Tuberculosis (TB) is mainly channelled through multilateral initiatives such as the Global Fund against HIV/AIDS, Malaria and Tuberculosis. South Africa also indirectly benefits from the French diplomatic efforts to develop innovative financing systems against HIV/AIDS such as UNITAID.
I. Joining forces against aids in SA: France and the Global Fund. 
The Global Fund to Fight AIDS, Tuberculosis and Malaria was set up in 2002, with an active support of France. It has since become one of the main international sources of funding for health programmes, with over $ 19 billion committed to finance health programs in 144 countries . The Global Fund has been widely praised for its achievements and has been described as the “most successful innovation in foreign assistance over the past decade” .
Over the last three years, France has committed € 300 million per annum to the fund and has remained its second largest contributor behind the United States .
In 2009, programs supported by the Global Fund provided antiretroviral therapy (ART) to 2.5 million people, i.e. a target group equivalent to nearly 50% of the South African HIV-positive population. Thanks to these programs, 6 million people also benefited from TB treatment and 104 million mosquito nets to prevent malaria were distributed.
In South Africa, the Global Fund has committed $ 367.5 million to support 6 programs against HIV/ AIDS and TB . These programs have been carried out by national and provincial government departments and by civil society organisations. They aim at expending services and strengthening capacities in prevention and treatment of HIV and TB. 43% of the South Africans currently treated in state hospitals benefits from the Global Fund’s support .
II. Unlocking resources against HIV/AIDS through innovative financing: France & UNITAID
Among the major obstacles to the fight against poverty and diseases are the unpredictable variations of aid flows. France has therefore been striving to design and promote innovative financing mechanisms which create steady and growing flows of resources. It has, for instance, been instrumental in the setting up of UNITAID.
Focused on the fight against HIV/AIDS, TB and Malaria, UNITAID, the International Drug Purchase Facility, aims at reducing the cost of quality medicines and diagnostics. UNITAID’s financing model is based on the purchase of high volumes of medicines and diagnostics in order to reduce prices. More medicines and treatments can then be provided with the same budget.
To implement this strategy, UNITAID has raised more than $ 1 billion over the last three years .
UNITAID funding comes from two reliable and stable resources: the multi-annual commitments of donors as well as a solidarity levy on airline tickets. This levy, implemented in 11 countries, contributes to more than 70% of UNITAID’s finances. Through this mechanism, France was able to raise more than € 140 millions in 2009 and remained the first contributor to UNITAID.
Although UNITAID does not directly work in South Africa, it is a significant funder of the Global Fund and contributes to an overall decrease of medicine prices which should eventually benefit to South Africa.
France remains a leading force to advance the innovative financing agenda. It is for instance in charge of the secretariat of the Leading Group on Innovative Financing for Development, the main international forum seeking to scale up innovative financing. France’s commitment is also illustrated by its pledge to provide € 1.2 billion over 20 years to the International Finance Facility for Immunisation (IFFIm).
III. French & South Africans against AIDS, success stories
In February 2008, President Nicolas Sarkozy committed to provide a direct support to priority health projects in South Africa. The French Development Agency (AFD) has subsequently funded two different programmes, implemented by the Desmond Tutu HIV Foundation and the Western Cape Province:
AFD granted € 300,000 to the Desmond Tutu HIV Foundation to increase its capacity to diagnostic and treat HIV/AIDS and TB in the Western Cape. This support will enable the Foundation to purchase a mobile testing unit and to build two additional consulting rooms.
The Western Cape Province benefited from a € 1.2 million grant provided by AFD to extend and renovate the Grabouw Community Health Centre and the Inzame Zabantu clinic in Mitchell’s Plain.
A number of Franco-South-African research partnerships on HIV/AIDS have also been set up, involving French organizations such as IRD, ANRS, CNRS, INSERM and the Pasteur Institute. ANRS (the French National Research Agency on Aids) has for instance supported a significant pilot a project on male circumcision and HIV prevention in the Orange Farm Township, Gauteng.
Lastly, a number of French Non Governmental Organizations are also involved in the fight against HIV/AIDS in South Africa, including le Secours populaire francais, Sidaction and le Comité Catholique contre la Faim et pour le Développement.
