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Submitted by Chris Wyatt on
Your article is certainly appropriate and hopefully will draw attention to global overdependence on donor aid for combating HIV. However although it may not be intentional, this article glosses over a number of hard realities and also offers nothing in the way of informing the reader of just how perilous the situation is by omitting the sheer size of donor aid and the exact time of the South African response to HIV. You laude South Africa for its "strongest response to HIV, since 2003." In reality Pretoria blamed HIV on "white people," was sued repeatedly for preventing the use of neverapine for delivering mothers, neglected prevention campaigns and allowed untold South African to die needless deaths all because Thabo Mbeki took offense to the fact that HIV is transmitted by behavior when "everyone" know the root cause is poverty. Just ask the communist rained drunken health minister who jumped to the front of the queue to get a new kidney after she drank her own into oblivion. In reality South Africa's inept execution, intense bigotry and hate filled response to the HIV pandemic led to the direct infection of tens of thousands of infants and shortened the life spans of millions. The "ramp up" you mention occurred only after intense domestic pressure and South Africa had become a joke in international circles over its bizarre stance on HIV and -- most importantly -- after George Bush pushed for PEPFAR. The ramp up is the result of external actors providing resources and domestic actors embarrassing the government at each turn. In failing to mention external aid you do a disservice to the reader. The amount of money Pretoria spends on HIV is very little in comparison to donor aid. And all external donor aid is a pittance compared to the largesse of the American government. In the timeframe you discuss in this article the Global Fund has provided: US$ 306,742,976 By comparison PEPFAR has provided South Africans with $3,233 Billion in direct HIV aid. PEPFAR Bilateral Funding for South Africa (US$ in millions) FY 2004 FY 2005 FY 2006 FY 2007 FY 2008 FY 2009 FY 2010 FY 2011 ARV's 2009-10 TOTAL FY 2004-2011 $89.3 $143.3 $221.6 $397.8 $590.9 $561.3 $560.4 $549.1 $120.0 $3233.7 Additionally, officials in Pretoria complained incessantly about the price of anti-retro virals. But a closer look will make it more apparent that this “Concern” had far more to do with developing a market for South Africa based Aspen Pharmaceuticals than it did with negations to reduce prices. Aspen was not competitive with generic manufacturers in India when Pretoria was most vocal about lowering prices.