Thursday, November 17, 2011
Uganda's Daily Vision claims that the "Global Fund [to fight HIV.AIDS, TB and malaria is withholding] Shs700b for ARV Treatment Over Gay Rights". There are plenty of things to criticize the fund for, but this article is just one of many that are really about African and Western politicians trying to use the issue of homosexuality and homophobia to drive their own agenda, whatever they may be.
There are several reasons why some of the funding Uganda applied for is being withheld. The government being "harsh on sexual minorities" is only a minor reason in a minor category of reasons. The rights of minorities are not derailing the fight against HIV, as the Ugandan AIDS control manager Dr Zainabl Akol claims. Rather, their rights are being used as a pawn, along with funding for HIV, HIV positive people and various other vulnerable minorities, in a complicated game for power and wealth.
One of the main reasons the Global Fund is withholding most of the Round 10 funding is because Uganda hasn't yet spent nearly 90% of the money they received in Round 7. In fact, despite receiving larger amounts of money than some countries with more serious HIV epidemics, Uganda has only managed to get a relatively small percentage of HIV positive people on antiretroviral treatment. Despite years of media praise, Uganda has done little to understand or control its HIV epidemic.
There are several other reasons why the Global Fund and other donors might withhold funding, in addition to their apparent inability to spend much of what they receive and to account for much of what they spend. For example, an article in the Uganda Monitor reports that it is inadequacies in the country's health system that is "derailing the fight against HIV/Aids". There are chronic shortages of health personnel and health supplies. These go back a long way, pre-dating the Global Fund itself by many years.
Apparently the Ministry of Health has even blamed gay rights for the country's stagnant prevalence rates. This is ludricous. Gay rights are far more important than the political pawn that politicians see them as being, but they are not 'responsible' for Uganda's epidemic. In fact, men having sex with men accounts for a pretty small proportion of HIV transmission in African countries.
Dr Akol is right to demand that gay rights be kept separate from HIV, to the extent that lumping them together is not going to further either interests. Both issues need to be addressed, but one, HIV, is a health issue. Homosexuality is not a health issue and it is not, or should not be, a determinant of health. But nor should either be used as mere political tools.
Another reason donors are likely to reconsider funding in Uganda is corruption, financial management and low standards. These are the reasons why the Dutch government is withdrawing 14 million Euro in funding for education. The Irish and UK governments have made similar moves in East Africa in recent months. These countries may have other reasons for cutting funding that they are not revealing, of course, but the Ugandan government and others are disingenuous to suggest that any funding has been denied purely on the grounds of poor human rights, for homosexuals or any other group.
It's convenient for the Ugandan government to blame gay rights. And stupid comments like those of David Cameron about withholding aid money if Uganda and other African countries don't play ball don't help at all. But these comments really were about playing (political) ball games, not about rights. Cameron and other Western leaders don't give a damn about Africans in general, not just African gays. Heterosexual Africans should not flatter themselves so.
I contacted a media officer at the Global Fund who confirmend that there were several reasons for withholding funding, some of which were very serious. In addition to the reasons mentioned above, the Fund said that the proposal "failed to adequately address equitable access of services especially with respect to particularly vulnerable populations". This would include gay people, but does not refer to them exclusively.
Cameron, Clinton and other Western politicians are as wrong as African political leaders to use funding for HIV or anything else as a bargaining tool when human rights are at stake. But the fact that funding is being used as a bargaining tool does not mean that the Global Fund are withholding money entirely because of how Uganda deals with gay rights. Both gay rights and HIV need to be addressed, not conflated, confused or kicked around by homophobes or other kinds of bigot.