The South African government last week for the second time failed to sign an agreement that would provide the country $40 million in grants from the Global Fund to Fight AIDS, Tuberculosis, and Malaria for HIV/AIDS programs in the country. In April 2002 the global fund approved the grants to expand HIV/AIDS treatment to all hospitals and clinics in KwaZulu-Natal province, but the South African government intervened and claimed that all grant applications had to be approved by federal authorities, effectively blocking the grants. Richard Feachem, head of the Global Fund, was in South Africa last week to meet with federal officials over the grant agreement, which was expanded to cover all of South Africa's provinces, but federal officials again rejected the plan. Nono Simelela, head of the nation's AIDS directorate, said there were still some "outstanding legal issues" with the agreement. Health Minister Manto Tshabalala-Msimang blamed the delays on problems with the Switzerland-based Global Fund. "We had hoped to sign the agreement, but there are a few loose ends," she said. "The reason we have not moved with speed is because...Geneva was not ready."
Feachem said the fund will allow South Africa as much time as needed to work out the details of the grant agreement, but urged government officials to work as quickly as possible. "This is very disappointing," he said. "The money needs to flow. These are life-and-death issues. Delay is measured in human life and we have urged them to complete the steps they need to complete as quickly as they can."
AIDS activists in South Africa are outraged at the government's continued efforts to delay funding of HIV treatment programs through the Global Fund and say that the delays are part of the government's ongoing efforts to prevent the widespread use of anti-HIV drugs in the country. Zackie Achmat, head of the activist group Treatment Action Campaign, is threatening to take legal action against government officials if the grant agreement isn't signed soon. "This is costing lives, and if necessary, we will make an application to court to get the minister's reasons for it."