International funding for India’s HIV/AIDS programme is drying up at a time when the country’s drive to curb the deadly disease prepares to enter its fourth phase beginning 2012, as the global financial crisis in 2008 prompted several donors to tighten budgets and shift their commitments to other public health issues.
The Bill and Melinda Gates Foundation has said its funding commitment to its AIDS initiative in India called Avahan will continue only up to 2014. The foundation is one of the biggest funders to India’s AIDS programme at Rs.1,425 crore.Donors such as the Clinton HIV/AIDS Initiative, the US Agency for International Development (USAID), the UK’s Department for International Development (DFID) and some other bilateral agencies have made no further financial commitments, National AIDS Control Organisation (Naco) officials say.
“Donor funding is reducing because of the meltdown. Also, from the global perspective, India is seen today as a global power that can now make contribution to other nations in need,” said a Naco official, who declined to be identified. “Apart from the World Bank, no donor has come forward to fund (India’s AIDS programme) after 2012.”
The Gates foundation is handing over HIV protection programmes it runs in six states in India to initiatives run by local authorities as it renews its development strategy. Other high-profile donors are also branching into new organizations; in January 2010, the Clinton HIV/AIDS Initiative became a new entity called the Clinton Health Access Initiative, according to its website.
Worldwide, HIV/AIDS has drawn celebrity attention, with several powerful personalities backing causes against the disease, including Microsoft Corp. chairman Bill Gates and former US president Bill Clinton . But many of those afflicted with the disease are desperately poor without the means to support treatment, and removal of social stigma attached to the illness remains one of the biggest challenges.
The flight of funds from AIDS may be the result of preventive programmes that have been able to control the disease from becoming a full-scale epidemic.
As many as 2.5 million people live with HIV/AIDS in India, according to a 2006 Naco estimate, down from around 5.2 million a decade earlier. About 1.2 million people have registered for treatment in public facilities. In May, 420,000 people, including industrial workers in the steel, railways and defence sectors, received treatment.
The Gates foundation, which scaled up its budget for Avahan to $338 million (Rs.1,507 crore today) in 2009, is gradually shifting attention to more fundamental issues plaguing India: maternal and child healthcare. In March, Gates and his wife Melinda visited Bihar, where their foundation has pledged $80 million towards health services in partnership with the state government.
“We are in a period of transition,” said Ashok Alexander, director of the Bill and Melinda Gates Foundation.
Like any blueprint for a large business, Avahan targets ”consumers”, or so-called high-prevalence groups living on the fringe, such as sex workers.
Alexander said the foundation’s AIDS initiative was designed like a build-operate-transfer model, and hoped all the techniques it employed to mobilize communities—helping sex workers set up beauty saloons, pushing the use of contraceptives, and introducing paan-flavoured condoms—will be adopted and continued by the government.
But like any takeover, the transfer is fraught with uncertainties and risks. The Avahan model, according to the Naco official, is unlikely to be accepted in its totality. “The project has to align with the national strategy, and beauty parlour is not one of them,” said the official.
The reduction in foreign donations has opened a debate on giving by India’s new billionaires.
According to Bain and Co.’s India Philanthropy Report 2011, corporate giving grew fivefold to $1.5 billion since 2006. A survey of 300 wealthy people showed donations by individual Indians have also risen—to $5-6 billion.
In the space of AIDS though, giving hasn’t come easy at home. Only 10 out of the 306 antiretroviral centres that Naco runs are supported by corporate houses under public-private partnerships, according to government data. Those who have committed a sum of Rs.15 lakh per centre every year include Reliance Industries Ltd (for three centres), Larsen and Toubro Ltd (one), Ballarpur Industries Ltd (two) and ACC Ltd (two).
Development is not a priority for Indian billionaires, said Indrani Gupta, head of the health policy unit at New Delhi-based Institute of Economic Growth, who has researched on the economic aspects of HIV/AIDS. “With a few exceptions, Indians are not greatly into philanthropy. Health is not a priority. Part of the reason could be there are no visible quick outcomes.”
As reported in: http://www.livemint.com/2011/07/18215121/Foreign-funding-for-India821.html?atype=tp