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Urgent Joint Statement On Global Fund Allocation To KwaZulu-Natal 2 August 2002

The following is a joint statement by the following organisations and individuals:
Archbishop Njongonkulu Ndungane
South African Medical Association
Southern African HIV Clinicians Society
South African Academy of Family Practice/Primary Care
Diakonia Council of Churches
AIDS ConsortiumAIDS Law Project
Children's Rights Centre
Durban Gay and Lesbian Community and Health Centre
Southern African Fogarty AIDS Training Programme
Professor Hoosen Coovadia,
Victor Daitz Professor of HIV/AIDS Research,University of Natal Durban
Professor Quarraisha Abdool-Karim, University of Natal Durban
SANGOCO - KZN
Treatment Action Campaign

DECLARATION OF SUPPORT FOR FUNDING OF THE KWAZULU-NATAL ENHANCING CARE INITIATIVE HIV/AIDS IN KWAZULU-NATAL (KZN)

One in 4 people in KZN live with HIV/AIDS. It is the worst-affected province in South Africa and one of the worst in the world. Already there is immense suffering and death, especially among poor people, and the public health system in the province is struggling to cope with the burden of this disease. If nothing is done, the situation will become much worse.

ENHANCING CARE INITIATIVE KZN IS A CRUCIAL STEP TOWARDS ALLEVIATING THE HIV/AIDS EPIDEMIC

The Enhancing Care Initiative KwaZulu-Natal (ECI KZN), in response to two years of research performed in the communities of KZN, brought forward a comprehensive proposal for prevention, care and support for people with HIV/AIDS in the province. It is a joint project by researchers from the Nelson Mandela Medical School of the University of Natal Durban, the KZN Department of Health, the Durban Chamber of Commerce, the National Association of People Living with AIDS (NAPWA) and many other organisations and institutions, both local and international. It includes a comprehensive range of prevention, care and support interventions for combating the HIV epidemic, including vertical transmission prevention of the virus, and highly active antiretroviral therapy. These crucial interventions will save lives and help prevent new infections.

During its initial stages, the ECI KZN project will offer antiretroviral therapy to a fraction of people with HIV who need treatment, but its most important value will be to establish an example of how such treatment can be carried out in South Africa and other developing countries, so that ultimately millions of people in need of life-saving medicines for HIV/AIDS will receive them. To facilitate this, part of the ECI KZN proposal is to assist other provinces and neighbouring countries to apply for funding from the Global Fund in the next call for proposals due on the 27th September2002. The antiretroviral projects established by the ECI KZN will be a necessary part of the implementation of a treatment plan for HIV/AIDS and will be a first step to secure the comprehensive provision of antiretrovirals in the province and country-wide. By the fifth year of the ECI KZN implementation, it is envisaged that most public health care facilities in the province will offer antiretroviral treatment via clinics treating Tuberculosis and vertical transmission prevention programmes. This is therefore a critical step in the effort to reverse the HIV/AIDS epidemic.

GLOBAL FUND TO FIGHT AIDS, TUBERCULOSIS AND MALARIA
The Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) is an unprecedented international effort to raise funds for developing countries to fight these diseases. The Global Fund has agreed to fund the ECI KZN approximately R700 million (U$D 72 million) over five years. Unfortunately, there is a dispute between the National Minister of Health, the Global Fund and the ECI KZN over this funding. This is an unnecessary controversy that is damaging South Africa's reputation with the Global Fund and the international community. More importantly, it is causing a delay in the implementation of the ECI KZN which will result in further unnecessary AIDS deaths and new HIV infections. We, the undersigned organisations and individuals are deeply concerned and desire that a just end be brought to this controversy immediately.

END THE CONTROVERSY. ENSURE GLOBAL FUND MONEY GOES TO ECI KZN .
We welcome the Global Fund's acceptance of the ECI KZN proposal and congratulate all parties involved in the ECI KZN for the effort they have made to bring it about. In particular, we welcome the leadership role played by the KZN Department of Health with regard to the ECI KZN. We are satisfied that given the constraints under which the proposal was made, it was developed through a reasonable consultative process. When the proposal was sent to the Global Fund for approval, no legally or materially functioning country co-ordinating mechanism representing the interests of people with HIV/AIDS existed in South Africa for managing the epidemic. Such a mechanism still does not exist. If it did exist this controversy might have been avoided.

The Cabinet statement of 17 April on HIV/AIDS was welcomed by all sectors of South African society and by the international community as a clear indication that the National Government will lead the fight against HIV/AIDS. It is now necessary for the National Department of Health to demonstrate its commitment to the implementation of the Cabinet statement

It can do this by:
* Unconditionally endorsing the ECI KZN and allowing the proposal to be implemented as it stands.
* Reconstituting the South African National AIDS Council (SANAC) as a legal, functioning, independent entity that truly represents the interests of people with HIV/AIDS and seeks representation from all sectors of South African society with a real interest in alleviating the HIV/AIDS epidemic.
* Facilitating further proposals to the Global Fund from South Africa and each of its provinces.

LET US WORK TOGETHER AGAINST THE HIV/AIDS EPIDEMIC

For further information, please contact:

Loraine Tulleken (Archbishop Ndungane's media liason officer) 011 839 1058
Nkosi Khumalo (TAC Executive Secretary) 072 2311 422 or 021 788 3507