State boosts AIDS spending

by Wyndham Hartley

In sharp contrast to President Thabo Mbeki's views on HIV/AIDS, government grants to the provinces to combat the pandemic are set to increase sharply from R1 10m this year to almost R550m in the 2004/5 financial year.

Government spending across all departments and provinces has in the past been criticised by experts and opposition parties as being an insufficient response to the pandemic.

Recent research by the Medical Research Council on the exponential increases to be expected in both infection rates and adult mortality over the next 10 years has put government spending on HIV/AIDS under the spotlight, particularly after Mbeki asked for a revision of health spending on the basis of 1995 World Health Organisation data.

Finance Minister Trevor Manuel's medium-term budget policy statement announced that conditional grants specifically to combat HIV/AIDS in the provinces through the departments of health, education and welfare would increase 400% from those budgeted this year.

Speculation is that the size of the increase comes off a low base and is a result of low spending in the past.

HIV/AIDS spending gets a boost in the additional estimates of revenue also tabled yesterday. The additional appropriations provide R20m for the pilot projects to prevent mother to child transmission of HIV through the use of the drug Nevirapine.

A further R25m goes to the LoveLife programmes that are run jointly by the Kaiser Family Foundation and the government to raise youth awareness of HIV/AIDS.

The policy statement also warns that provincial health spending at the moment on AIDS-related illnesses was a massive R4bn. This was in addition to funds allocated specifically for prevention programmes. Manuel acknowledged at a press briefing that this was a huge amount of money and that the reality was that much of the spending was embedded in health budgets.

Government recognises the steadily increasing impact of HIV/AIDS, particularly on the living standards of the poor and vulnerable. The statement pointed out that R190m was also spent on government's AIDS Action Plan, and R125m on an integrated AIDS strategy.

Over the next three years additional resources will be targeted towards improving control of the epidemic in line with the enhanced response to HIV/AIDS strategy developed by the department of health.

The statement said that the conditional grants were to strengthen home and community based care; support voluntary counselling and testing; and strengthen life skills programmes in schools.

Other interventions that could be funded through either the national department or the equitable share to the provinces could also be on the cards.

The HIV/AIDS spending comes in the context of social service spending, which will rise R5,5bn in 2002/03 and R7,5bn in 2003/04. This will allow the Unemployment Insurance Fund to be strengthened and to increase access to social services for the marginalised and poor.

Additional resources over the next three years (will) enable provinces to increase the numbers of children benefiting from the child support grant from 1,5million to 3-million by the end of 2002/03, as well as making provision for inflation-related increases in the value of all social grants.

It would also enable the size of housing grants to be increased so that the quality and pace of housing delivery was enhanced.

Business Day, 31 October 2001