PEPFAR's South African Role Disputed

Nongovernmental organisations (NGOs) have continued to criticise the role of the US government's PEPFAR initiative on HIV/AIDS in Africa. Several South African lobbyists have claimed that the scheme undermines the Global Fund, set up to combat AIDS, tuberculosis and malaria in 2002.

A key complaint is that a third of PEPFAR's funding is allocated toward promoting sexual abstinence rather than alternative prevention efforts. However, the US ambassador to the country, Jendayi Frazer, has chosen to highlight the initiative's positive impact in South Africa.

South Africa received some US$90mn from PEPFAR in the 2004 financial year, and expects to receive nearly US$150mn more in October 2005 through September 2006. The government directly receives roughly 12% of the funds, with the remainder distributed to local and US NGOs, academic institutions and private sector partners. By the end of 2006, the scheme hopes to treat 70,000 HIV positive South Africans and allow 50,000 access to combined antiretrovirals and tuberculosis treatment.

Nevertheless, even this effort is virtually insignificant in view of the scale of the problem. Although the South African government's own tender for low-cost HIV/AIDS drugs is expected to assist at least a further 40,000 sufferers by the end of the year, it is estimated that more than 20% of the country's 45mn-strong population is HIV positive.