Donor mistrust multiplies Zimbabwe Aids losses

Donor mistrust multiplies Zimbabwe Aids losses

AN HIV/Aids victim lies on his death bed in Zimbabwe. At least 1,8 Zimbabweans have HIV

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By Sharon LaFraniere

MABVUKU, Zimbabwe Edson Muchenjekwa says he spent three weeks persuading Alista Bhero to overcome her rage at her husband, Khemist, for infecting her with HIV, which has rendered her all but immobile at 42. He does not intend to waste her time discussing a treatment.
.
In Zimbabwe, where 1.8 million people are HIV positive and 360,000 need life-prolonging antiretroviral drugs, virtually the only ones who get them are the 5,000 who can afford them. The Bheros are not among that select few.
.
So instead, said Muchenjekwa, a local charity worker, he will help the Bheros draft a will disposing of their home, a four-room concrete-block cube in this teeming township outside Harare, Zimbabwe's capital. Then he will try to steel them to tell the six Bhero children that they are about to become orphans.
.
He does not relish the task. "It is not easy to face death," he said.
.
In fact, the Bhero family is facing the sort of tragedy that unfolds daily throughout southern Africa, the region hardest hit by a growing AIDS epidemic. Zimbabwe, however, is different. Relief workers estimate that fewer than 1,000 Zimbabweans receive antiretroviral drugs free through government or charitable programs, with little hope of expanding that number.
.
Every neighboring country is giving antiretrovirals to two to 15 times as many people and planning to expand treatment to tens of thousands more within a year.
.
The principal reason Zimbabwe is falling behind is that President Robert Mugabe's increasingly repressive government has lost foreign donors' trust that it will fairly or honestly channel money for antiretroviral drugs to those who need it. Major foreign supporters in the battle against the disease - the Global Fund to Fight AIDS, Tuberculosis and Malaria, the World Bank, the United States and Britain - are skirting Zimbabwe or giving it a trickle of aid compared with the torrent they are unleashing on governments they deem more reliable.
.
That, many in Zimbabwe say, poses a wrenching question: Is it right to withhold lifesaving aid from a population because its rulers are viewed as likely to manipulate that aid for political ends - or worse, to steal it?
.
In Zimbabwe, where roughly one in four adults is infected with HIV and more than 2,500 people a week die of AIDS, relief workers do not consider the question academic.
.
The plight of this nation of more than 11 million people is evident at Harare Central Hospital, where workers say just 23 patients are receiving antiretroviral treatment and no more can be started until next year because of lack on money. It is obvious at the Parirenyatwa city hospital, where, local news reports say, the morgue reeks of bodies of AIDS victims whose relatives cannot afford to bury them.
.
And it can be seen at one seven-year-old cemetery south of Harare, where more than 14,000 people have already been buried, and workers say they dig about 25 graves each day.
.
On the crowded, trash-strewn streets of Mabvuku, Muchenjekwa said, 50 people a day go to Island Hospice, where he works, to seek help for the dying.
.
A neighbor, he said, alerted the organization to the Bheros' case.
.
Alista Bhero tried to sum up the situation last week in her tiny living room, her 2-year-old son on her lap: "Our life is just falling apart. We don't know what to do. We are panicking."
.
So, to some degree, are Zimbabwean health officials. Last month, they lost in a bid for $218 million from the Global Fund to Fight AIDS, Tuberculosis and Malaria. One United Nations official said evaluations had raised concerns, including whether Zimbabwe's government could be trusted to enlist independent groups in its AIDS fight.
.
"I am very angry about it because many people are going to die because of these heartless people," David Parirenyatwa, Zimbabwe's minister of health, said in an interview last month with The Standard, an independent weekly.
.
The government has refused to comment to foreign reporters.
.
Officials from the Global Fund and other relief agencies say heartlessness has nothing to do with it. Rather, they say, they are trying to save as many lives as possible without channeling money to untrustworthy governments. Critics of Mugabe note that his government has persecuted political opponents, all but shut down the independent news media and seized land from white farmers, shriveling farm output and driving the economy into the ground.
.
"They are not spending their money well, so why would they spend ours well?" asked a European diplomat whose government had restricted aid.
.
The Bush administration came to much the same conclusion, excluding Zimbabwe last year from the president's five-year, $15-billion emergency AIDS plan, which focuses on 12 African countries, plus Haiti, Vietnam and Guyana.
.
The United States is spending just $20 million a year to battle AIDS in Zimbabwe, one-third less than it has devoted to Botswana, a nation with less than one-sixth Zimbabwe's population. The British government gives about $11 million a year - and would give more, a spokesman suggested, if Mugabe made political and economic changes.
.
The World Bank, which has granted more than $1 billion to other African countries to fight AIDS, pulled out of Zimbabwe four years ago after the government defaulted on its debts. So did the International Monetary Fund and the Danes, who had given millions every year to humanitarian and development projects in Zimbabwe.
.
But it was the rejection from the Global Fund, designed to pool contributions from all foreign donors and to distribute them apolitically, that brought home Zimbabwe's isolation. Zimbabwe sought money to provide antiretroviral drugs to 70,000 people - less than one-fifth of those in need.
.
Although Global Fund officials insisted that the rejection was not politically motivated and could be appealed, many relief workers in Zimbabwe took it as a sign that international donors had dealt Zimbabwe a death sentence.
.
"I personally feel this is very unfair," said Bernard Mokam, local program director for the United Nations' development agency. "I personally do not comprehend that the donor community could continue to refuse to support people in need for political reasons. HIV-AIDS should be dealt with as a humanitarian issue. This is just unacceptable."

"The principal reason Zimbabwe is falling behind is that President Robert Mugabe's increasingly repressive government has lost foreign donors' trust"

Sharon LaFraniere

Still, no one, including Mokam, disputes that Zimbabwe's government is making life difficult for donors and the charities they subsidize even when, as in the case of AIDS, the government pledges its full cooperation. Fear that the government will misspend the money has delayed release of a $10 million AIDS grant from the Global Fund that was approved two years ago.
.
That sort of mistrust permeates relations between the government and outsiders seeking to help it. For example, Mugabe's government not only forced the United Nations in the spring to scale back a general feeding program that has sustained millions during three years of crop failures, but it barred UN specialists from measuring the fall harvest that ended in June.
.
The government insists a bumper crop will more than cover the nation's needs. But foreign specialists say they suspect that Mugabe is reducing foreign food aid in advance of next year's national election so that he can reward supporters with warehoused stocks of government corn, and withhold it from opponents.
.
Mugabe also keeps nongovernmental organizations on a short leash - and intends to restrain them further. Zimbabwe's few remaining donors of drugs and medical services tend to bypass the Harare government by channeling AIDS donations to local nongovernmental organizations or giving them directly to clinics or laboratories. But in July, Mugabe announced that the government would rein in nongovernmental organizations that are "conduits or instruments of interference in our national affairs."
.
The New York Times MABVUKU, Zimbabwe Edson Muchenjekwa says he spent three weeks persuading Alista Bhero to overcome her rage at her husband, Khemist, for infecting her with HIV, which has rendered her all but immobile at 42. He does not intend to waste her time discussing a treatment.
.
In Zimbabwe, where 1.8 million people are HIV positive and 360,000 need life-prolonging antiretroviral drugs, virtually the only ones who get them are the 5,000 who can afford them. The Bheros are not among that select few.
.
So instead, said Muchenjekwa, a local charity worker, he will help the Bheros draft a will disposing of their home, a four-room concrete-block cube in this teeming township outside Harare, Zimbabwe's capital. Then he will try to steel them to tell the six Bhero children that they are about to become orphans.
.
He does not relish the task. "It is not easy to face death," he said.
.
In fact, the Bhero family is facing the sort of tragedy that unfolds daily throughout southern Africa, the region hardest hit by a growing AIDS epidemic. Zimbabwe, however, is different. Relief workers estimate that fewer than 1,000 Zimbabweans receive antiretroviral drugs free through government or charitable programs, with little hope of expanding that number.
.
Every neighboring country is giving antiretrovirals to two to 15 times as many people and planning to expand treatment to tens of thousands more within a year.
.
The principal reason Zimbabwe is falling behind is that President Robert Mugabe's increasingly repressive government has lost foreign donors' trust that it will fairly or honestly channel money for antiretroviral drugs to those who need it. Major foreign supporters in the battle against the disease - the Global Fund to Fight AIDS, Tuberculosis and Malaria, the World Bank, the United States and Britain - are skirting Zimbabwe or giving it a trickle of aid compared with the torrent they are unleashing on governments they deem more reliable.
.
That, many in Zimbabwe say, poses a wrenching question: Is it right to withhold lifesaving aid from a population because its rulers are viewed as likely to manipulate that aid for political ends - or worse, to steal it?
.
In Zimbabwe, where roughly one in four adults is infected with HIV and more than 2,500 people a week die of AIDS, relief workers do not consider the question academic.
.
The plight of this nation of more than 11 million people is evident at Harare Central Hospital, where workers say just 23 patients are receiving antiretroviral treatment and no more can be started until next year because of lack on money. It is obvious at the Parirenyatwa city hospital, where, local news reports say, the morgue reeks of bodies of AIDS victims whose relatives cannot afford to bury them.
.
And it can be seen at one seven-year-old cemetery south of Harare, where more than 14,000 people have already been buried, and workers say they dig about 25 graves each day.
.
On the crowded, trash-strewn streets of Mabvuku, Muchenjekwa said, 50 people a day go to Island Hospice, where he works, to seek help for the dying.
.
A neighbor, he said, alerted the organization to the Bheros' case.
.
Alista Bhero tried to sum up the situation last week in her tiny living room, her 2-year-old son on her lap: "Our life is just falling apart. We don't know what to do. We are panicking."
.
So, to some degree, are Zimbabwean health officials. Last month, they lost in a bid for $218 million from the Global Fund to Fight AIDS, Tuberculosis and Malaria. One United Nations official said evaluations had raised concerns, including whether Zimbabwe's government could be trusted to enlist independent groups in its AIDS fight.
.
"I am very angry about it because many people are going to die because of these heartless people," David Parirenyatwa, Zimbabwe's minister of health, said in an interview last month with The Standard, an independent weekly.
.
The government has refused to comment to foreign reporters.
.
Officials from the Global Fund and other relief agencies say heartlessness has nothing to do with it. Rather, they say, they are trying to save as many lives as possible without channeling money to untrustworthy governments. Critics of Mugabe note that his government has persecuted political opponents, all but shut down the independent news media and seized land from white farmers, shriveling farm output and driving the economy into the ground.
.
"They are not spending their money well, so why would they spend ours well?" asked a European diplomat whose government had restricted aid.
.
The Bush administration came to much the same conclusion, excluding Zimbabwe last year from the president's five-year, $15-billion emergency AIDS plan, which focuses on 12 African countries, plus Haiti, Vietnam and Guyana.
.
The United States is spending just $20 million a year to battle AIDS in Zimbabwe, one-third less than it has devoted to Botswana, a nation with less than one-sixth Zimbabwe's population. The British government gives about $11 million a year - and would give more, a spokesman suggested, if Mugabe made political and economic changes.
.
The World Bank, which has granted more than $1 billion to other African countries to fight AIDS, pulled out of Zimbabwe four years ago after the government defaulted on its debts. So did the International Monetary Fund and the Danes, who had given millions every year to humanitarian and development projects in Zimbabwe.
.
But it was the rejection from the Global Fund, designed to pool contributions from all foreign donors and to distribute them apolitically, that brought home Zimbabwe's isolation. Zimbabwe sought money to provide antiretroviral drugs to 70,000 people - less than one-fifth of those in need.
.
Although Global Fund officials insisted that the rejection was not politically motivated and could be appealed, many relief workers in Zimbabwe took it as a sign that international donors had dealt Zimbabwe a death sentence.
.
"I personally feel this is very unfair," said Bernard Mokam, local program director for the United Nations' development agency. "I personally do not comprehend that the donor community could continue to refuse to support people in need for political reasons. HIV-AIDS should be dealt with as a humanitarian issue. This is just unacceptable."
.
Still, no one, including Mokam, disputes that Zimbabwe's government is making life difficult for donors and the charities they subsidize even when, as in the case of AIDS, the government pledges its full cooperation. Fear that the government will misspend the money has delayed release of a $10 million AIDS grant from the Global Fund that was approved two years ago.
.
That sort of mistrust permeates relations between the government and outsiders seeking to help it. For example, Mugabe's government not only forced the United Nations in the spring to scale back a general feeding program that has sustained millions during three years of crop failures, but it barred UN specialists from measuring the fall harvest that ended in June.
.
The government insists a bumper crop will more than cover the nation's needs. But foreign specialists say they suspect that Mugabe is reducing foreign food aid in advance of next year's national election so that he can reward supporters with warehoused stocks of government corn, and withhold it from opponents.
.
Mugabe also keeps nongovernmental organizations on a short leash - and intends to restrain them further. Zimbabwe's few remaining donors of drugs and medical services tend to bypass the Harare government by channeling AIDS donations to local nongovernmental organizations or giving them directly to clinics or laboratories. But in July, Mugabe announced that the government would rein in nongovernmental organizations that are "conduits or instruments of interference in our national affairs."
.
The New York Times MABVUKU, Zimbabwe Edson Muchenjekwa says he spent three weeks persuading Alista Bhero to overcome her rage at her husband, Khemist, for infecting her with HIV, which has rendered her all but immobile at 42. He does not intend to waste her time discussing a treatment.
.
In Zimbabwe, where 1.8 million people are HIV positive and 360,000 need life-prolonging antiretroviral drugs, virtually the only ones who get them are the 5,000 who can afford them. The Bheros are not among that select few.
.
So instead, said Muchenjekwa, a local charity worker, he will help the Bheros draft a will disposing of their home, a four-room concrete-block cube in this teeming township outside Harare, Zimbabwe's capital. Then he will try to steel them to tell the six Bhero children that they are about to become orphans.
.
He does not relish the task. "It is not easy to face death," he said.
.
In fact, the Bhero family is facing the sort of tragedy that unfolds daily throughout southern Africa, the region hardest hit by a growing AIDS epidemic. Zimbabwe, however, is different. Relief workers estimate that fewer than 1,000 Zimbabweans receive antiretroviral drugs free through government or charitable programs, with little hope of expanding that number.
.
Every neighboring country is giving antiretrovirals to two to 15 times as many people and planning to expand treatment to tens of thousands more within a year.
.
The principal reason Zimbabwe is falling behind is that President Robert Mugabe's increasingly repressive government has lost foreign donors' trust that it will fairly or honestly channel money for antiretroviral drugs to those who need it. Major foreign supporters in the battle against the disease - the Global Fund to Fight AIDS, Tuberculosis and Malaria, the World Bank, the United States and Britain - are skirting Zimbabwe or giving it a trickle of aid compared with the torrent they are unleashing on governments they deem more reliable.
.
That, many in Zimbabwe say, poses a wrenching question: Is it right to withhold lifesaving aid from a population because its rulers are viewed as likely to manipulate that aid for political ends - or worse, to steal it?
.
In Zimbabwe, where roughly one in four adults is infected with HIV and more than 2,500 people a week die of AIDS, relief workers do not consider the question academic.
.
The plight of this nation of more than 11 million people is evident at Harare Central Hospital, where workers say just 23 patients are receiving antiretroviral treatment and no more can be started until next year because of lack on money. It is obvious at the Parirenyatwa city hospital, where, local news reports say, the morgue reeks of bodies of AIDS victims whose relatives cannot afford to bury them.
.
And it can be seen at one seven-year-old cemetery south of Harare, where more than 14,000 people have already been buried, and workers say they dig about 25 graves each day.
.
On the crowded, trash-strewn streets of Mabvuku, Muchenjekwa said, 50 people a day go to Island Hospice, where he works, to seek help for the dying.
.
A neighbor, he said, alerted the organization to the Bheros' case.
.
Alista Bhero tried to sum up the situation last week in her tiny living room, her 2-year-old son on her lap: "Our life is just falling apart. We don't know what to do. We are panicking."
.
So, to some degree, are Zimbabwean health officials. Last month, they lost in a bid for $218 million from the Global Fund to Fight AIDS, Tuberculosis and Malaria. One United Nations official said evaluations had raised concerns, including whether Zimbabwe's government could be trusted to enlist independent groups in its AIDS fight.
.
"I am very angry about it because many people are going to die because of these heartless people," David Parirenyatwa, Zimbabwe's minister of health, said in an interview last month with The Standard, an independent weekly.
.
The government has refused to comment to foreign reporters.
.
Officials from the Global Fund and other relief agencies say heartlessness has nothing to do with it. Rather, they say, they are trying to save as many lives as possible without channeling money to untrustworthy governments. Critics of Mugabe note that his government has persecuted political opponents, all but shut down the independent news media and seized land from white farmers, shriveling farm output and driving the economy into the ground.
.
"They are not spending their money well, so why would they spend ours well?" asked a European diplomat whose government had restricted aid.
.
The Bush administration came to much the same conclusion, excluding Zimbabwe last year from the president's five-year, $15-billion emergency AIDS plan, which focuses on 12 African countries, plus Haiti, Vietnam and Guyana.
.
The United States is spending just $20 million a year to battle AIDS in Zimbabwe, one-third less than it has devoted to Botswana, a nation with less than one-sixth Zimbabwe's population. The British government gives about $11 million a year - and would give more, a spokesman suggested, if Mugabe made political and economic changes.
.
The World Bank, which has granted more than $1 billion to other African countries to fight AIDS, pulled out of Zimbabwe four years ago after the government defaulted on its debts. So did the International Monetary Fund and the Danes, who had given millions every year to humanitarian and development projects in Zimbabwe.
.
But it was the rejection from the Global Fund, designed to pool contributions from all foreign donors and to distribute them apolitically, that brought home Zimbabwe's isolation. Zimbabwe sought money to provide antiretroviral drugs to 70,000 people - less than one-fifth of those in need.
.
Although Global Fund officials insisted that the rejection was not politically motivated and could be appealed, many relief workers in Zimbabwe took it as a sign that international donors had dealt Zimbabwe a death sentence.
.
"I personally feel this is very unfair," said Bernard Mokam, local program director for the United Nations' development agency. "I personally do not comprehend that the donor community could continue to refuse to support people in need for political reasons. HIV-AIDS should be dealt with as a humanitarian issue. This is just unacceptable."
.
Still, no one, including Mokam, disputes that Zimbabwe's government is making life difficult for donors and the charities they subsidize even when, as in the case of AIDS, the government pledges its full cooperation. Fear that the government will misspend the money has delayed release of a $10 million AIDS grant from the Global Fund that was approved two years ago.
.
That sort of mistrust permeates relations between the government and outsiders seeking to help it. For example, Mugabe's government not only forced the United Nations in the spring to scale back a general feeding program that has sustained millions during three years of crop failures, but it barred UN specialists from measuring the fall harvest that ended in June.
.
The government insists a bumper crop will more than cover the nation's needs. But foreign specialists say they suspect that Mugabe is reducing foreign food aid in advance of next year's national election so that he can reward supporters with warehoused stocks of government corn, and withhold it from opponents.
.
Mugabe also keeps nongovernmental organizations on a short leash - and intends to restrain them further. Zimbabwe's few remaining donors of drugs and medical services tend to bypass the Harare government by channeling AIDS donations to local nongovernmental organizations or giving them directly to clinics or laboratories. But in July, Mugabe announced that the government would rein in nongovernmental organizations that are "conduits or instruments of interference in our national affairs."
The New York Times
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