Has HIV/AIDS fueled donor ‘funding’ dependency in Africa?

“We cannot hope to formulate adequate development theory and policy for the majority of the world’s population who suffer from underdevelopment without first learning how their past economic and social history gave rise to their present underdevelopment” – Andre Gunder Frank, “The Development of Underdevelopment” (1966).

This week marks the convening of the 18^th International AIDS Conference in Vienna that assesses the progress made in the fight against the disease. This convening’s keynote speaker was former US President Bill Clinton whose speech called for efficient spending in the face of dwindling resources to address the pandemic. Mr. Clinton while stressing that every wasted dollar put a life at risk said “In too many countries too much money goes to pay for too many people to go to too many meetings, get on too many airplanes,”. He also added that too much money is spent on studies and reports that remain on the shelves.

But how did it come to this? Not that the funding coffers are drying up, but that 28 years after AIDS was discovered, and billions of dollars being spent annually, that HIV/AIDS still looms large on our horizon.

Well, the blame rests on both sides of the so-called development game: non governmental agencies (donors) as well as the beneficiaries. Dealing with HIV/AIDS in sub-Saharan Africa has become a long term mutually beneficial relationship among the two.

With all those meetings and carbon emissions generated in attending the meetings, the overall goal for these HIV/AIDS projects (probably long forgotten in the NGOs proposal logical framework) of assisting the beneficiaries has dropped lower down the agenda.

In turn the beneficiaries due to having these agencies around for so long (for some AIDS orphans, all their lives) lack the drive to solve their own problems without external assistance (funding).

And indeed why should it be any different when the number of NGOs continue to rise. Just visit Kibera, Africa’s second largest urban slum and you can almost trip over the number of agencies working in HIV/AIDS, water and sanitation and any other baseline survey assessed need.

Last year while visiting with some young entrepreneurs in Kibera, we at YIPE heard some pretty horrific stories in how donor dependency for “funding” has impacted their lives. These youth were all born in the slum and for the most part of their lives, there were always NGOs providing whatever assistance was required.

As a result where HIV/AIDS stigmatization existed in other areas, in Kibera it was not as bad. But that is not just a reflection of the numerous Voluntary Counseling and Testing Centres (VCT) that abound. The real pay off is that if an individual tests HIV positive, they then not only receive free anti-retrovirals, but also receive assistance, be it in the form of food, clothes or maybe rent money. Thus apart from the implementing agency carrying out the HIV/AIDS project, the beneficiaries also became recipients of what they call “funding”.

One of the Kibera youth told us the story of a young man that visited a VCT centre and “sadly” tested negative. Crestfallen that he could not receive “funding”, the young man set out on a mission to reverse that diagnosis.

Not an ideal marriage

This symbiotic dependency between NGOs and their beneficiaries really needs to be further interrogated. It’s a shame that this is the 18^th International AIDS conference and it seems that apart from the condom and abstinence, there is no other readily available and inexpensive way to prevent HIV infections.

Why is it that after all these years Uganda which was a best practice case in how to combat the disease which almost decimated the country’s future economic development prospects now has a rising infection rate? Why is it that the majority of these new cases are not among the red zone population segments such as commercial sex workers and ling distance truck drivers but among married couples? Or is it that there are absolutely no HIV/AIDS focused non governmental organisations in that country?

Those questions are for the INGO, NGO, FBO, CSO and any other “O” professing to have made an impact all these years. Now here’s one for the beneficiaries, particularly the youth. Why do we have to suffer one more AIDS related death on top of the 71 million people Africa has lost since the disease was discovered?

A new approach – People, Planet, Project

This year when countries have to renew their commitments to the Global Fund for AIDS, TB and Malaria, in the face of the global economic crisis, activists are calling for new approaches for raising funds, including airline ticket taxes.

However this will still lead to the same scenario with communities being put on the back burner in their zeal to raise funding for projects.

The solution here is to encourage social entrepreneurs to enter into the fray. The difference between a social enterprise and an NGO is that the entrepreneur has to be ultimately concerned with having community acceptance (if not involvement as employees, distributors …). Their models are sustainable and unlike NGOs they have to be accountable to shareholders and the community (market) they operate in.

Social enterprises also by virtue of their type of entity have to be transparent in terms of finance and corporate governance. Profit also would be a useful tool to assess the uptake of socially marketed products such as female condoms. Maybe some unsuccessful NGO projects could have been abandoned sooner if there was a price tag to measure success.

In retail speak, once a consumer buys into the story behind the product, they own it. Isn’t that sustainability?

The best outcome of this 18^th AIDS Conference would be a new approach in ensuring that the implementing agencies do have the “moral standing” as Bill Clinton put it to ask for funding to do their “jobs faster, better and cheaper” – something most entrepreneurs do on a daily basis.