Posted by: blog4globalhealth | 08/30/2009

Economic situation, corruption allegations trouble Zambian advocate

GHC Policy Communications Coordinator Vince Blaser is traveling in Zambia and Tanzania to visit member programs and report on policy connections. This is the first of his reports.

LUSAKA, Zambia – Winstone Zulu has been at the forefront of discussions on health issues here for years, and he is worried. Zulu was diagnosed with polio as a child, has been living with HIV/AIDS since 1990 and was diagnosed with tuberculosis in 1997. Four of his brothers have passed because of TB.

Zulu’s experiences have led him to be a tireless advocate on HIV/AIDS and TB both here in Zambia and around the world. He became the first Zambian to publicly state he is HIV-positive. He also has been very active for a greater worldwide response to TB – including an appearance at this year’s International Conference on Global Health, where I first met him earlier this year.

We met again this weekend at the Lusaka Airport, where he and a couple colleagues were kind enough to give me a ride into town. Zulu said he and other advocates around Zambia are concerned, specifically about treatment access. He said that for years, people who once would have “resigned themselves” to die now hope to live for decades because of the increased availability of antiretroviral drugs and other treatments. However, he added that the worldwide economic situation and recent questions over missing money in the Zambian Ministry of Health have given advocates growing cause for worry about the future of treatment availability.

According to Reuters, Sweden and the Netherlands in May froze assistance funding to Zambia after reports surfaced about the alleged stolen money. According to Zulu, the missing money is of added distress for advocates because it potentially came from the Global Fund to Fight AIDS, TB and Malaria. Zulu said he and others have been arguing that the Global Fund has worked very well and has been more transparent than some bilateral arrangements. According to the Times of Zambia, Henry Kapoko, former Zambian Ministry of Health human resources officer, and eight others have been charged with obtaining money under false pretenses.

While the investigation is still ongoing, I’m not sure that the outcome will affect the reputation of the Global Fund among its donors, regardless of whether the money came from the Fund or not. In fact, because these allegations have led to charges, it could increase the viability of arguments from Zulu and others.

However, it is still news about corruption and donor investments, which is not good news for advocates like Zulu who have seen lives saved by these investments. Zulu said that cases of corruption are far less likely under the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) than other bilateral agreements because of the many stipulations placed on PEPFAR grants, as well as the “large number” of Americans directly involved. But PEPFAR does not come without its own problems, according to Zulu. He said that PEPFAR is perceived to bring too much benefit to organizations in the U.S.

Zulu was unsure yet how recent statements made in the U.S. – such as President Obama’s call for a comprehensive global health strategy and Secretary Clinton’s statement in Kenya this month that “too little” U.S. foreign assistance “has reached the intended target or contributed to lasting progress” – will translate here in Zambia. I am hoping to find out this week what some of the successes and challenges of programs funded by the U.S. and other donors have been and how that can relate to the policy discussions the U.S. and other donors are currently engaged in.

In the morning, I will visit a site of the Infant and Young Child Nutrition Project, which USAID partners with PATH and our other partners on. As always, I welcome your thoughts and comments.

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