AIDS in Africa: The Question of Money
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Third: accountability. It would be little short of tragic if funds were misused, tasks unimplemented, results unmonitored. At the same time, for NGO and faith-based participation to be effective, processes must not be so cumbersome as to delay the activities for which the funds are provided. The most effective medium for many AIDS-related tasks may well be the civil society structure least skilled in international bureaucracy.
Fourth: eligibility. Aid programs have sometimes avoided African governments on the grounds that they were corrupt, and so aid has been given instead to NGOs. Here there is a place for both. Appropriate NGOs must be included – and the definition of appropriate is not one for a government itself to define – but similarly, the crisis is national, and support for government programs must not be neglected either. Both are temptations among some in this debate.
Fifth: treatment and prevention. We’ve noted this point in both of our previous newsletters, but the debate continues. The Global Fund appears to us as the principal avenue for the provision of drugs. Pharmaceutical company negotiations over price, country by country, drug by drug, company by company, are inadequate at best. Bilateral assistance seems too restrictive and insufficient. Moreover, without access to medicine, prevention programs tend to plateau at a rather low level of effectiveness. Drugs will save lives. Bulk procurement and rapid distribution are key.
Our role in the fight against AIDS should be one of stewardship
Why do these points matter to us? Why not regard them as details about a Global Fund best left to the negotiators? Because our response to the AIDS pandemic in Africa really is a stewardship issue.
Our nation needs to be contributing $1 billion annually to this Global Fund. Even if that figure were combined with bilateral assistance and development aid that approached another $1 billion, we would still not be reaching the proportion of total global costs to address AIDS and health care in Africa that is generally held to be appropriate in terms of U.S. contributions to international initiatives and structures.
The moment we press for such financial commitments, we are immediately called into that faithful discipline of discerning not simply what our money is to be used for, but also how we proceed together in a manner than affirms community and honors human dignity.
If our African brothers and sisters are reduced to mere recipients of whatever is to be done in their name; if they are denied a role in decision-making, unaware of what is happening; if they are kept from participating in implementation and left to trust that accountability is demanded somewhere other than among themselves, then the world community will have dishonored the fundamentals of community itself, and the effort to confront AIDS is likely to fail. We in the faith communities need to be a voice to see that that does not happen.
South African Christians, meeting in August to plan strategies to confront the AIDS pandemic, began their communiqué by saying simply, “We are living with AIDS.” All of us. And how we marshal our resources to fight is key to our faithful response. Money may not be everything, but in the wealthiest nation on earth, it is at the center of our being stewards when our African sisters and brothers are suffering.
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