ADDIS ABABA, 9 January 2013 (PLUSNEWS) - Major projected cuts in US government funding for Ethiopia's health sector could greatly undermine the progress the country has made in the fight against HIV, authorities and experts say.
"There's an AIDS spending cliff in Ethiopia, and the government is already in free fall. Next year, Ethiopia will experience a 79 percent reduction in US HIV financing from PEPFAR [the US President's Emergency Plan For AIDS Relief]," wrote Amanda Glassman [ http://healthworkscollective.com/amanda-glassman/49746/ethiopia-s-aids-s... ], a director at Global Health Policy [ http://www.globalhealthpolicy.net/ ] and a senior fellow at the Center for Global Development.
Ethiopian government officials, however, told IRIN/PlusNews that, while they were concerned about the funding cuts, they had been expecting them.
"We are a bit concerned, but considering the current global financial crisis and the budget deficit in the US, we had anticipated this," said Kesetebirhan Admassu, the new minister of health.
"Most of the cuts are going to be around softer programmatic activities that can be taken care of by mobilizing internal resources as well as using some innovative approaches like the health development army and so on," Admassu added.
Aid to Ethiopia's health sector would, according to the US government-run web portal ForeignAssistance.gov [ http://foreignassistance.gov/OU.aspx?OUID=171&FY=2013&AgencyID=0&budTab=... ], fall to US$171 million in 2013 from $390.6 million in 2012. A major cut would be felt in HIV/AIDS programmes, which would receive only $54.1 million, a dramatic cut from the $254.1 million allocated in 2012.
However, a US government official in Ethiopia downplayed the likelihood of such steep funding cuts in an interview [ http://www.capitalethiopia.com/index.php?option=com_content&view=article... ] with Capital, a local daily.
"We don't have a budget for 2013 right now. We are not seeing those major reductions. Even though the prevalence rate of HIV/AIDS is coming down, there are still over 800,000 [people] on ART [antiretroviral therapy]; those still require investments and being cared for," Dennis Weller, the director of the US Agency for International Development (USAID) in Ethiopia, told Capital.
But he did call for a transition from direct donor support to greater in-country funding for health programmes.
"Because we have been directly supporting health for so many years, the real focus now is transition to much more country ownership and looking at the sustainability of these investments. So things like health financing and community health insurance will be important," he explained.
Growing government contribution
The government says it has done just that.
"If you look at the trend of government contribution, it is growing year by year. Our government has also passed a law and regulation to establish a social health insurance. So starting from the next budget year [July 2013] all employees will be covered with a social health insurance scheme," Admassu said.
A recent report, however, warned that careful management of such a transition would be necessary to avoid creating gaps in areas such as "mentoring health centre staff now charged with ART delivery; prevention programmes to reach commercial sex workers and men who have sex with men; and programmes to benefit orphans and other vulnerable children on mass scale."
According to UNAIDS, while Ethiopia has made significant strides in reducing new adult HIV infections, it has is yet to do so for new paediatric infections. Just 24 percent of pregnant women living with HIV receive ART to prevent mother-to-child transmission of the virus.
Between 2006 and 2011, Ethiopia received an estimated $1.4 billion from PEPFAR. Since 2004, Ethiopia has also received $1.23 billion from the Global Fund [http://portfolio.theglobalfund.org/en/Country/Index/ETH ], making it one of the Fund's biggest recipients globally.
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