billion to HIV/AIDS, malaria and tuberculosis for fiscal years 2009-2013

The American PEPFAR funding program was renewed on 30th July, committing $48 billion to HIV/AIDS, malaria and tuberculosis for fiscal years 2009-2013A.²⁸ This was triple the amount of money that the fund had distributed in its initial five years, and was commended by international HIV/AIDS activists and organisations. However, they stressed that the bill only authorised the expenditure and the money would still need to be appropriated each year. ²⁹

The Reauthorization Act ³⁰ also repealed a policy that had received substantial criticism: the requirement that one third of funding be spent exclusively on the promotion of sexual abstinence. However, it was replaced with a ‘reporting requirement’ for recipients who spend less than 50 percent of prevention funds on abstinence-only programmes. It was argued that this perpetuated bias in PEPFAR spending.

The political and economic climate in Zimbabwe worsened dramatically in 2008, exacerbating an already severe AIDS epidemic. A cholera outbreak that began in August was so critical that by December, UK Prime Minister Gordon Brown was describing the crisis as an “international emergency”. ³¹ The effect of the outbreak on people living with HIV and AIDS was compounded by the collapse of the health system, the government’s block on foreign aid, and widespread malnutrition, leading to an equally devastating AIDS crisis. ^{32 33}

Medicines Sans Frontiers (MSF) estimated that in Bulawayo (the second largest city in Zimbabwe) there were 2,500 patients still waiting to receive antiretroviral drugs by the end of 2008. Even those who were able to access drugs were put at risk by the widespread lack of food, with 2008 producing the worst harvest Zimbabwe had experienced since the country gained independence in 1980. ³⁴ The government’s decision to ban most international aid groups, which was imposed at the beginning of June and lasted throughout July and August, exacerbated food and drug shortages farther. MSF called for an urgent increase in the humanitarian response to the crisis, and stressed the importance of HIV and AIDS being a prominent part of this respons