Stealing from those in need
You may think that an Aids column is the wrong place to lambast the wanton, greedy selfish and depraved acts of the cashgate millionaires, but it certainly is because 500 000 people are in need of lifesaving antiretroviral treatment.
In addition, Malawi is way overdue on the important switch from stavudine to tenofovir and existing Global Fund grant which pays for drugs expires in early 2014. Looting of government coffers directly impacts people past, present and future.
An article that appeared in The Nation newspaper recently put in context what K110 billion (from two government eras) means to the health and agriculture sector: training 40 000 doctors over five years, building 12 district hospitals, training 200 000 nurse-mid wife technicians, 314 health centres with five staff houses, 440 years of health service in Nsanje.
Another article on IRIN news titled “Government corruption “cripples” Malawi’s health sector” reported about strikes at district hospitals following delays in salary payments.
Let us put this in perspective of Aids treatment and care. The fixed dose combination of efavirenz, tenofovir and FTC, which is the World Health Organisation recommended treatment, can be sourced at $219 [about K94 170] per person per year. That is lifesaving treatment for 50 000 people for 25 years if we assume K110 billion.
Corruption negatively impacts patients due to reduced availability of medicines and health services. Lost resources cripple the ability of health-care institutions to provide adequate care. Donors and the public lose confidence in public institutions.
Malawi’s HIV and Aids budget covers treatment, care, institutional support, prevention and behaviour change.
The HIV and Aids budget is mainly donor-funded, the biggest contributors in 2011 to the HIV and Aids budget were the Global Fund followed by the World Bank, Norway/Sida and the UK’s Department for International Development.
Some donors have withheld funding pending full investigations of the cashgate scandal. What will happen to Malawi’s Aids programme which is heavily donor funded?
The nurses who provide care? HIV counsellors? The 400 000 persons currently on life saving treatment and the 500 000 in need of treatment?