US-Africa Leaders' Summit: Why aid for AIDS may take centrestage

trueBy Mpaata Owagage

Between August 4-6, 2014, US President Barack Obama will be hosting African heads of state for the inaugural US-Africa Leaders’ Summit.

The first such engagement between the American Government and African leaders. The Summit and, especially its timing, has prompted a significant global debate between many political commentators.

Some perceive it as a fire-fighting strategy by the Obama administration to salvage its waning relations with the continent. The threat to said relations being China - a country that has consistently engaged with Africa more than any other in recent times. The Chinese have been meeting African leaders within the Forum on China–Africa Cooperation every two years since 2000.

Notwithstanding, there are others who contend that the US-Africa Summit could have legitimate objectives unrelated to scrambling for the African pie. For this group, it makes perfect sense that a country that invests so much in the African continent as the American government does must pick interest in such a forum.

In the face of undeniable facts, and specifically on the US government’s role in combatting AIDS, whichever side you pick should not matter.

Many countries and a host of international development organisations donate towards combatting the HIV epidemic in Africa. However, the American approach has been both unique and arguably consistent. For illustration, the US President’s Emergency Plan for AIDS Relief (PEPFAR) is the single biggest source of funding for the AIDS response worldwide, with the Global Fund, which runs a close second, being funded by up to 33% by the US Government through PEPFAR.

Aside from the significant amounts being contributed by the American tax payer, PEPFAR is unlike any other fund or programme. Its existence was authorised by the US Congress.

The significance is that while other partners base their AIDS contributions on the often flexible tenets of altruism, Americans have a deliberate, predictable and consistent congressional process that ensures the availability of the much-needed funds. It follows that PEPFAR’s legal framework should be reassuring to the African leader.

However, the most recent amendments to this authorization encoded in the PEPFAR Stewardship and Oversight Act of 2013, should give many of the continent’s leaders plenty to ponder aboard their presidential jets to Washington. From this law, it is apparent that PEPFAR and indeed the entire global AIDS movement are pushing more towards increased countries’ domestic investments and ownership of their respective AIDS responses.

The shift has been rightly billed to nurture the sustainability of the AIDS response. Unsurprisingly, the United Nations Joint Programme on HIV/AIDS (UNAIDS) sees this strategy as critical to ending the AIDS epidemic by 2030. UNAIDS is already mobilising all stakeholders towards this common goal as demonstrated at the recently concluded International AIDS Conference in Melbourne.

In line with this vision, major funders are initiating a process that has been technically dubbed ‘price tagging’. The idea is to estimate how much, in monetary terms, it might cost the world to achieve the vision of an AIDS free generation by 2030. While donors may finance a significant chunk of the expected quotation, governments, especially those in sub-Saharan Africa, are being called upon to own and lead their programmes for their own people.

Indeed, if the recent amendment is anything to go by, the American tax payer intends to see the most affected countries embrace more ownership. The PEPFAR reauthorisation bill specifically contains a provision that demands a ‘strategy for appropriately timed transitions to country ownership with an explanation of metrics used to determine the pace of transitions’.

That this is donor-initiated is good, but it is also in any country’s best interests to invest in and own their country’s AIDS response. Whenever donor behaviour changes for one reason or the other (as has been the case several times), the beneficiary country’s response to the epidemic must not suffer as a consequence.

It is possible that the US President will attempt to impress this upon his guests. While many may come nursing the expectation of sealing multibillion dollar US investments in other sectors, AIDS may be brought up at a dinner table at the Summit.

African heads of state heading to Washington should, hence, not expect to only wine and dine as they seal colossal deals in oil, gas and related sectors but must be prepared to articulate clear road maps of how they intend to invest in their AIDS responses. For without ending AIDS, any other investment cannot be sustainable.

I hope that the continent’s leaders are open to this realisation, and that they embrace this opportunity to show case commitment to ending the AIDS epidemic and considering it as an investment in itself, capable of returning profit and improving livelihoods.

I further dare to hope that our Heads of State leave Washington with ending AIDS as the number one priority for the continent’s development agenda and people’s wellbeing.

The writer is a Global Health Corps Fellow, a private Washington-based consultant on Health and Medical Law and a former Assistant Director of the Medicines and Health Services Delivery Monitoring Unit of State House


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