KIRUKU: When AIDS comes knocking, better have a fat wallet

Ministers of Finance and Health from the East African Community partner states have finally noted what was all along obvious to the rest of us: That reduced funding for HIV/Aids programmes was greatly hampering the fight against the scourge.

So far, such funding has largely been left to well-wishers and donor organisations, with governments largely taking a backseat – the devastating effects of the scourge notwithstanding.

It is disheartening that all our governments are experiencing challenges in operationalising the Abuja Declaration, which calls for allocation of 15 per cent of government budgets to the health sector. This has resulted in the combined health and HIV resource gap remaining unacceptably high.

The region must now reprioritise public spending towards health to reach the recommended threshold set by the Abuja Declaration if at all we are to nurture a healthy population.

The devastating effects of HIV/Aids cannot be over-emphasized. The burden of HIV/Aids on families and households is staggering.  During the long period of illness that is often involved, the loss of income and cost of caring for the sick has impoverished many households.  Deaths of parents and break-ups of households have forced children to live with relatives or become homeless.

According to United Nations reports, HIV/Aids has already killed over 20 million people worldwide.  Between 1980, when the epidemic started emerging, and 2025, HIV/Aids will have caused about 100 million out of 500 million deaths in sub-Saharan Africa.

These are not mere statistics; they represent deaths of the prime workforce, family breadwinners and business entrepreneurs.  The pandemic weakens economies and stalls development.  Experienced workers are lost and funds for investment diverted to pay for healthcare and support of afflicted families.

It is now upon the region to find a lasting solution to funding and management of HIV/Aids-related programmes. The current regional health financing arrangement, whereby 65 per cent is domestically sourced and 35 per cent externally funded, is unrealistic.

To fight the spread of HIV/Aids, governments must appreciate the population dynamics in the region that create vulnerabilities to health and HIV. For example, studies across sub-Saharan Africa show that relationships between young women and older men are commonplace and that they are associated with unsafe sexual behaviour and low condom use, which heightens the risk of HIV infection.

Again, the rate of HIV/Aids infection among married couples is on the rise. It is prudent for the government to act on HIV/Aids infection dynamics and initiate specific programmes in response to these new trends so as to contain the situation.

The regional governments would also do well to enhance tax administration efficiency so as to raise sufficient funds for the health sector. A good solution may involve earmarking specific taxes for the financing of health and HIV programmes.

This has been done successfully elsewhere in the world, where taxes from industries that have a negative impact on public health are specifically used to finance the health budget. The most prominent of these industries, naturally, are tobacco and alcohol, both of which must take responsibility for the health problems and budgetary constraints that they cause.

The rest of the world is using Information Communication Technologies (ICTs) to advance research that can inform the management of HIV/Aids; the EAC region should not be left behind in this effort. The health sector should promote the use of ICTs in research on health and HIV financing as well as advocacy for Universal Health Care financing.

The region is now making good progress in social integration, with intermarriages on the rise. This and other forms of exchange, including mutual cultural influences, have been enhanced by the opening up of borders. This presents opportunities as well as dangers; all the various sectors of our economies – both public and private – will need to work harmoniously together in fighting HIV/Aids and other health challenges.

In this regard, the EAC partner states must support and participate in convening of the first EAC Summit on Investment in Health, with the aim of attaining health-related Sustainable Development Goals (SDGs) by 2030.

In order to achieve sustainable economic growth and generate wealth, investing in health is not an option; it is imperative. The benefits are plenty, but there is much to be done before they can be realised.