Cheat-Seeking Missles

Sunday, August 28, 2005

Ugandan AIDS Cut Unprecedented

A review of 122 news releases issued by the Global Fund to Fight AIDS, Tuberculosis and Malaria dating back to the beginning of that organization in 2001 reveals that no country except Uganda has had its grant funds suspended due to concerns about financial mismanagement -- even though the fund gives money to a rogue's gallery of corrupt governments.

The Global Fund announced last week it was suspending all its aid to Uganda, citing a PricewaterhouseCoopers report alleging financial improprieties in the implementation of Uganda's Round 1 HIV/AIDS grant. The Global Fund cut all five grants -- suspending care for tuberculosis and malaria, putting innocents at risk for no apparent reason, even though no allegations have been made regarding mismanagement of those grants. (The Global Fund explains the across the board cuts by saying all are managed by the same unit of the Ugandan government.)

The cuts follow sharp criticism of Uganda's program -- not because it is failing; it is one of Africa's most successful -- but because it puts morality (monogamy and abstinence) first and condoms second.

No other country has ever been sanctioned by Global Fund in this manner for financial mismanagement. And in the only case where problems with a grant led to its cancellation -- a malaria grant in Senegal that was not meeting performance expectations -- the other grants to that country remained in place.

This underscores the harshness of the Global Fund action. If there are alleged problems with the HIV/AIDS grant, why should grants for malaria -- which is also a huge killer in sub-Saharan Africa -- and tuberculosis also be cut prior to proof of misdeeds? There is no precedence for so irresponsible and inhumane an action.

Only One Corrupt Nation?

While it is possible that corruption exists in the Uganda program, it is even more likely that it is just as rampant elsewhere in less successful programs, given the host of corrupt countries receiving grants: Congo, Zimbabwe, Cuba, Haiti, Iran, Venezuela, Sudan, Vietnam and many more.

That is why I've theorized that the true cause for the suspension is pressure from anti-abstinence, morality and monogamy groups like George Soros' Human Rights Watch, which said:
Human Rights Watch accused[Ugandan] President Yoweri Museveni and his wife, Janet Museveni, of falling under the influence of U.S. Christian conservatives and placing millions of young Ugandans at risk of contracting HIV, the virus that causes AIDS.
Christian-influenced or not, the results of Uganda's AIDS/HIV program are hard to ignore:

Incidence of AIDS/HIV in Uganda. Source:

Global Watch itself acknowledged this success in a February 2003 news release announcing its original grants to Uganda.
Uganda, one of first countries in Africa to experience the impact of HIV/AIDS and still one of the countries most affected by the virus, is also one of the continent’s great success stories in terms of reducing high HIV infection rates. HIV prevalence among pregnant women in urban areas has declined from a peak of 30 per cent in 1992 to 6 per cent in 2001. This and other successes in the field are widely acknowledged to be the result of high-level political commitment to HIV prevention and care, involving a wide range of partners and effected through an aggressive anti-HIV/AIDS campaign involving virtually all sections of society. Nevertheless, Uganda is still confronted with a serious HIV/AIDS epidemic, including rising numbers of people needing care and support.
The release seems to acknowledge the different approach Uganda was taking, even then.

Compare Uganda's success performance with what is going on in many of Uganda's neighbors which follow the UN/Global Fund protocols of "safe sex" education:
Very high HIV prevalence—often exceeding 30% among pregnant women—is still being recorded in four other countries in the region, all with small populations: Botswana, Lesotho, Namibia and Swaziland. There, comparisons of prevalence levels at selected antenatal clinics have shown no evidence of a decline. In Swaziland, for example, HIV prevalence among pregnant women was 39% in 2002, up from 34% in 2000 and only 4% in 1992. Elsewhere in the subregion, HIV infections in pregnant women appear to be stabilizing at lower levels—around 18% in Malawi (2003), 16% in Zambia (2003), and 25% in Zimbabwe (2003)—but there is little evidence of an impending decline. (source)
No Comparable Actions

A review of the 122 news releases posted by Global Fund reveals only two other cases of grants being phased out or not renewed (not supspended), and one case where it appears grants were in jeopardy, but were not suspended.
  • On August 19 this year, Global Fund issued a news release stating that three grants to Myanmar totalling $35.7 million for HIV/AIDS, tuberculosis and malaria will be phased out by the end of the year. The action followed new travel and medical import review proceedures that, in the Global Fund's view, made it impossible to adequately implement the grants. The grants' termination wasn't immediate; they will be phased out.

  • In March of this year, a five-year, $7.1 million malaria grant to Senegal was not extended into a new year because of "systemic issues that resulted in poor performance." This is only an allegation of poor performance, however, not corruption -- a word that did not appear in the news release. Further, Global Fund left in place other grants and made it clear that the action "in no way reflects a rejection of this country’s future resource needs, or of ongoing support for other grants in Senegal." (news release)

  • Last May, a cryptic news releasewas issued to "clarify" the Global Fund's position on South Africa, "given substantial media attention around comments made by the Global Fund Executive Director Richard Feachem...." The release said that speculation about a threat to South Africa's $234 million in Global Fund grants was not true.

The May news release came nearly two years after a June, 2002 statement clarifying negotiations with South Africa.

Both parties were satisfied with the outcome of the meeting and agreed to keep the public and all relevant stakeholders informed regarding progress on the issues, and to work tirelessly to find quick and lasting solutions to these challenges, but not to conduct these discussions via the media.
Obviously, things have been sour between the Global Fund and South Africa for some time. Yet despite South Africa's poorer performance, its grants remain in place while Uganda's were cancelled. (South Africa's infection rate is about five times higher than Uganda's.)

The Ugandan cancellation came immediately upon publication of the Pricewaterhouse report, whereas Global Fund has seen fit to negotiate for at least three years with South Africa to work out problems there. This is strong evidence that PC politics, not corruption, is behind the Ugandan grant cancellation.

The first link below shows that the US is by far the largest contributor to the Global Fund. The Bush Administration should use its clout to force the Fund to drop the suspension until an independent review of the situation can be completed.

See also:
Uganda AIDS Cut More Suspicious
Uganda Punished for Abstinence?