Between Self-help and Dependence: Donor Funding and the Fight Against HIV/AIDS in South Africa

Abstract

This article examines funding for HIV/AIDS in South Africa, and the relationship between foreign donors and the South African government. The recognition of the AIDS pandemic as an epochal crisis has led to a proliferation of international and donor organizations now directly involved in the governance, tracking and management of the pandemic in many African countries. In many ways, the heavy donor hand that is increasingly defining the pandemic and the global response to it feeds into a new imperialist logic that subordinates pan-African agendas, masks broader issues of access central to the fight against the pandemic, and strengthens traditional relationships of dependence between wealthy Western nations and poorer African nations. The South African government's relationship with foreign donors, however, has been shaped by its efforts to develop an African response to the pandemic not determined nor primarily funded by foreign aid. This article highlights the positive and negative implications of the sometimes contentious relationship between the South African government and foreign donors, as well as the Africa-centred, self-help agenda it pursues, highlighting the opportunities as well as challenges for African governments to define the global response to the pandemic.

Drug Policies and Development

“…As South Africa is heavily reliant on international funders, their agendas also shape local health policies in ways that are not necessarily aligned with local needs. This has been particularly evident in the hiv response (Johnson, 2008). Investments in the health of people who use drugs have been relatively small and focused on hiv prevention.…”