Q: Have we been caught napping?
A: Yes. There have been questions for many months about Pepfar [the US President’s Emergency Plan for Aids Relief] reauthorisation. We could have done more to consider this possibility and prepare for it.
Q: How dependent are we on this funding?
A: In quantum of money terms it’s 17% of our expenditure on HIV programmes, but in terms of its impact and influence on the overall programme it is key.
Q: Should we have allowed ourselves to become so dependent?
A: Yes and no. HIV is a global pandemic and preventing it is a global responsibility. Developed countries with wealth and resources have a particular responsibility. On the no side, we’ve been cutting per capita expenditure on health for 10 years. The government is negligent of our public health-care system.
Q: Should we have been able by now to fund our own HIV/Aids response, if push came to shove?
A: Yes. HIV is a global pandemic and every country depends on some degree of global solidarity, but we certainly should have plan Bs.
Q: How well have we been using the billions we've got from the US every year?
A: The HIV epidemic is one of the few places where money is used efficiently and has had an impact.
Q: So why are 50,000 people still dying here of Aids every year?
A: Because we don't have the political commitment to throw every resource possible at it. Pepfar has helped us to get 5.8-million people on treatment, but that still leaves 2.2-million people not on treatment, and that is not acceptable. We still have far too many people dying every year of Aids.
Q: Our prevalence rate is the highest in the world, isn’t it?
A: Yes, because it takes into account all the people who were infected years ago. But the number of new infections is also one of the highest in the world.
Q: Should there have been more focus on prevention?
A: Yes. We have let down our guard. We know our health department is broken, corrupted, incapable in many respects. You can’t separate a broken health department from an inadequate response to disease threats. And HIV is not alone.
Q: Would you say it’s still not addressing our HIV/Aids crisis with the urgency it demands?
A: Absolutely. We know that HIV is wholly preventable, we know that if we get more people onto treatment, and they stay on treatment, they no longer infect other people because their viral load goes down to near zero. Government thinks we can live with tens of thousands of deaths a year from HIV when in a better society we should not have those deaths, we don’t need to be having them. We can’t say, “Well, we’ve got 75% or 80% of people on treatment, we’re cool with that.”
Q: How advanced are we in terms of research?
A: We’re acknowledged as having the most advanced HIV researchers in the world. Many of them are in the institutions that are losing their funding.
Q: So why have we been having over 1,000 new HIV infections among adolescent girls and young women every week?
A: Because research has to be joined up to a functional, committed health department.
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