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Republic of Botswana - New Vice President, Cabinet and Appointments in the Civil Service

Wednesday, April 09, 2008

As has already been widely reported, yesterday a number of new appointments were made in both the formation of a new Cabinet and within the senior service. In addition Parliament overwhelmingly endorsed the nomination of Lt. Gen. Mompati Merafhe as the new Vice President. H.H. Vice President Merafhe has previously served as the Minister of Foreign Affairs and International Cooperation.

For the convenient reference of interested stakeholders, the following are consolidated listings of 1) members of the new Cabinet and 2) yesterday's Civil Service Appointments:

1) CABINET
PRESIDENT
H.E. the President, Lt. Gen. Seretse Khama Ian Khama
VICE PRESIDENT
H.H. Lt. Gen. Mompati S. Merafhe
MINISTERS:
Ministry of Foreign Affairs and International Cooperation
Hon. Phandu T.C. Skelemani - Minister
Ministry of Finance and Development Planning
Hon. Baledzi G. Gaolathe - Minister
Hon. Samson M. Guma - Assistant Minister
Ministry of State President - Presidential Affairs and Public Administration
Hon. Daniel K. Kwelagobe - Minister
Ministry of State President - Justice, Defence and Security
Hon. Dikgakgamatso R. Seretse
Ministry of Communications, Science and Technology
Hon. Pelonomi Venson-Moitoi - Minister
Ministry of Lands and Housing
Hon. Nonofo E. Molefi - Minister
Ministry of Labour & Home Affairs
Hon. Peter L. Siele - Minister
Ministry of Youth, Sports and Culture
Hon. Gladys K. Kokorwe - Minister
Ministry of Trade and Industry
Hon. Neo D. Moroka - Minister
Hon. Gobopang D. Lefhoko - Assistant Minister
Ministry of Local Government
Hon. Dr. Margaret N. Nasha - Minister
Hon. Ambrose B. Masalila - Assistant Minister
Hon. Olifant T. Mfa - Assistant Minister
Ministry of Agriculture
Hon. Christian De Graaff - Minister
Hon. Shaw Kgathi - Assistant Minister
Ministry of Works and Transport
Hon. Johnnie K. Swartz - Minister
Hon. Frank Ramsden - Assistant Minister
Ministry Minerals, Energy and Water Resources
Hon. Ponatshego H. Kedikilwe - Minister
Ministry of Education and Skill Development
Hon. Jacob D. Nkate - Minister
Hon. Lebonamang T. Mokalake - Assistant Minister
Ministry of Environment, Wildlife and Tourism
Hon. Kitso Onkokame Mokaila - Minister
Ministry of Health
Hon. Lesego E. Motsumi - Minister
Hon. Gaotlhaetse U. Matlhabaphiri - Assistant Minister
ADDITIONAL (ex officio) CABINET MEMBERS:
Dr. Athaliah Molokomme - Attorney General
Eric Molale - Secretary to Cabinet (and Permanent Secretary to the President)

2) APPOINTMENTS AND TRANSFERS IN THE SENIOR CIVIL SERVICE ON 1/4/08:
On the 1st of April 2008 the Permanent Secretary to the President, Mr. Eric Molale, was pleased to announce the following appointments and transfers of Permanent Secretaries, Deputy Permanent Secretaries and other senior members of the Civil Service:
Office of the President:
  Augustine Makgonatsotlhe is promoted and appointed Secretary for Defence, Justice and Security
  Mustaq Moorad transfers to become Deputy Secretary - Defence, Justice and Security
  Neo Asafo-Adjei transfers to become Deputy Permanent Secretary, Administration
  Samuel Rathedi is appointed Senior Private Secretary to the President
  Col. Duke Masilo is appointed Deputy Senior Private Secretary to the President
  Tefo Mokaila is appointed Private Secretary - State House
Ministry of Education:
  Badumetse Hobona appointed as Permanent Secretary
  Baeti Molake is promoted and appointed Deputy Permanent Secretary
Ministry of Environment Wildlife and Tourism:
  Mathias Chakalisa appointed as Permanent Secretary (from Ministry of Agriculture)
Ministry of Foreign Affairs and International Cooperation:
  Samuel Outlule is promoted and appointed as Permanent Secretary
  Sasara George is promoted and appointed Deputy Permanent Secretary
  Charles Ntwaagae is appointed Ambassador
  Mmamosadinyana Molefhe is re-designated Director
  Nkoloi Nkoloi is re-designated Director
  Daphne Kadiwa is promoted and appointed Chief of Protocol.
Ministry of Health:
  Newman Kahiya is promoted and appointed Permanent Secretary
  Matsae Balosang is promoted and appointed Deputy Permanent Secretary at Ministry of Health
Ministry of Local Government:
  Thato Raphaka is promoted and appointed Permanent Secretary
  Boipolelo Khumomatlhare is promoted to Deputy Permanent Secretary and Tsaone Thebe transfers as Deputy Permanent Secretary
Ministry of Minerals, Energy and Water Resources:
  Gabaake Gabaake appointed Permanent Secretary (transfer from Ministry of Local Government)
  Jacob Thamage is promoted to be Deputy Permanent Secretary
Ministry of Works and Transport:
  Kago Moshashane is promoted and appointed Permanent Secretary
  Terrence Siamisang and Lewis Malikongwa are appointed on promotion as Deputy Permanent Secretaries
Ministry of Communications, Science and Technology:
  Festina Bakwena appointed Permanent Secretary (on transfer from Ministry of Education)
Ministry of Agriculture:
  Lucas Gakale appointed Permanent Secretary (on transfer from Ministry of Environment, Wildlife and Tourism)
Ministry of Lands and Housing:
  Tutu Tsiang transfers as Deputy Permanent Secretary
Ministry of Youth, Sports, and Culture:
  Mothusi Nkgowe is promoted and appointed Deputy Permanent Secretary
Directorate on Intelligence and Security
  Isaac Kgosi is promoted and appointed Director
  Tefo Kgotlhane is appointed Deputy Director at Directorate on Intelligence and Security Services
Additional Appointments are as follows:
  Bridgette Poppy John as Coordinator of the Education Hub under the BEAC Strategy as well as Coordinating the Second University Project
  Marianne Nganunu takes over the Botswana Innovation Hub as Coordinator
  Akolang Tombale is appointed the Diamond Hub Coordinator under the BEAC Strategy
  Modise Modise is appointed the Coordinator - Mmamabula Project
  Gabolekwe Tlogelang is appointed the Coordinator, Medical School Project as well as being the Coordinator of the Medical Hub under the BEAC Strategy
  Gerald Thipe is appointed the Transport Hub Coordinator under the BEAC Strategy including the Coordination of the Kazungula Bridge Project
  Oteng Tebape is appointed Senior Private Secretary to Former President Mogae



Southern African Development Community

BOTSWANA: Safari operators alleviating AIDS crisis

BOTSWANA: Safari operators all...BOTSWANA: Safari operators all...
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Monday, February 25, 2008

Small charter planes fly tourists from all over the world to safari camps in Botswana's Okavango Delta, where they view wildlife by day and pay up to US$1,000 a night to stay in luxury lodges or rough it in five-star tents.

The safari camps are mainly expatriate owned and managed, but guests are waited on, cooked for and guided through the bush by people from Maun, the largest town in the district and the gateway to the Okavango. After the government, safari camp operators are the biggest employers.

Most of the camps are only reachable by air, so employees spend three months at a time in the bush, working and living together. Many are young and single, while those who are married are rarely employed as couples and usually leave their spouses behind in Maun.

In other parts of the world, after-hours boredom would not be considered a dangerous occupational hazard, but this is Botswana, where one in four adults is infected with HIV.

"Let's say a camp has 12 staff and you're there for three months. You finish work and it's boring and it's quiet," said Bonti Botunile, a relief manager who has worked at a number of safari camps. "People are social creatures; they're going to get together and then break up and move on, and some won't disclose their [HIV] status because they fear rejection."

Companies have to foot the bill for HIV/AIDS-related absenteeism; sick employees must be flown out and relief workers flown in. A few years ago, safari camp operators began waking up to the fact that HIV/AIDS was bad for business.

"A lot of people died, a lot had to be flown to hospital; they were constantly having to retrain," said Botunile. "They realised that if we don't do something, our businesses are going to suffer."

A number of the companies met with local health authorities to form a committee that now meets every two months to coordinate HIV/AIDS programmes for camp employees.

"Companies do their best"

The companies pay the costs of regularly flying doctors, nurses and counsellors from the Maun District Health Team into the camps to attend to staff members' health needs and to conduct voluntary counselling and HIV testing. Many companies also employ full-time welfare officers and have a nurse on call to provide medical advice.

Before becoming a welfare officer for A&K Safaris, Mary Hastag worked for 10 different safari camp operators between 2004 and 2006, providing HIV/AIDS education. "At the time, there wasn't much happening, but now most companies have workplace policies, welfare officers and lay counsellors. It's a big improvement," she told IRIN/PlusNews.

Lecco Masoko, a welfare officer and AIDS councillor for a company that operates three camps in the Okavango, gives employees information on how to stay healthy and encourages them to be tested. "By October last year, virtually all of our staff knew their status," he said.

Although he knows that about 36 percent of employees are HIV positive, he doesn't know an individual's status unless they decide to disclose it, but said many employees were open about being HIV positive.

"People tend to be more open about their HIV status in the camps than they are in town," commented Allison Brown, a nurse contracted by 25 safari operators to provide medical advice and evaluations.

By special arrangement with Maun Hospital, camp employees who are on antiretroviral (ARV) treatment and have been declared stable by a doctor can pick up a three-month supply of the drugs when they come home on leave, but Brown said the HIV/AIDS clinic at the hospital did not always have enough stock to give them medicine for three months at a time.

Hastag said the safari operators' good intentions often came up against the limitations of the local public health service. "There's a shortage of medical staff and drugs, so even if the companies do their best, at times the District Health Team doesn't go to the camps every month because of staff shortages." February was one such month, when A&K had to fly employees in need of medical attention to Maun.

According to Brown, newly arrived expatriate managers also sometimes lacked sufficient support and information to help them deal with HIV and AIDS.  "Management is under a lot of pressure," she said. "They've got busy lodges, guests who're paying a lot of money, and staff who are sometimes sick."

Behaviour change a challenge

Ensuring that HIV-positive employees receive all the medical care and healthy food that they need is one thing; making sure that HIV-negative employees stay that way is more difficult.

Male and female condoms are available at all the camps, and some companies have built sports fields and installed satellite television to combat the boredom factor, but convincing employees to change their behaviour is not easy.

Staff receive information about how to minimise their HIV risk, but "most are single, and there's a habit of having one partner in camp and one in Maun," said Hastag. 

Source: PlusNews

SOUTHERN AFRICA: A winning recipe for PMTCT but few follow it

Friday, September 21, 2007

A success story, at last: Botswana has lowered the rate of mother-to-child transmission of HIV to less than four percent, coming close to developed countries that have almost eliminated paediatric AIDS.

In Europe and the USA, fewer than two percent of babies with HIV-positive mothers are born with the virus; without intervention, the risk of an HIV-positive pregnant woman passing on the virus to her baby is between 30 percent and 35 percent, according to health specialists.

In Lesotho, transmission rates from mother to child are still as high as 37 percent; in Zimbabwe, 100 babies become HIV infected every day.

So how did Botswana do it? It was one of the first countries in Africa to establish a national antiretroviral therapy programme in 2002, and with a population of over 1.7 million people, optimal use of existing resources and a relatively sound health infrastructure, it was always going to be easier to get results.

Dr William Jimbo, chief advisor on prevention of mother-to-child transmission (PMTCT) of HIV at the Botswana/USA health partnership (BOTUSA), also attributed the low rate of transmission to an effective cocktail of political commitment and bold policy decisions.

More than three years ago, the government introduced a policy of routine testing for HIV as part of its strategy for encouraging more people to be tested and access treatment.

All pregnant women attending a health facility are now routinely offered an HIV test unless they decline; those found to be HIV-positive receive immediate counselling and are put on a long course of zidovudine, also known as AZT, at 28 weeks, and given a single dose of nevirapine during labour. The infant is given four weeks of AZT and a single dose of nevirapine.

"Most other countries in the region are still piloting the programmes," Jimbo told IRIN. The World Health Organisation guidelines for PMTCT advise using combination therapy where possible, but the rest of southern Africa has been slow to move away from using mono-therapy, in which mother and child are each given a single dose of nevirapine.

Governments have only recently begun to introduce the newer and more effective combination medication, which can reduce the risk of transmission to as little as five percent.

In Zambia, for example, combination therapy for PMTCT is only available in urban areas, while rural areas continue using mono-therapy. Dr Max Bweupe, national coordinator for the government's PMTCT programme, told IRIN that the new drug regimen was being rolled out in phases, as healthcare workers require training on the new dosages.

Malawi will be switching to a triple combination drug regimen in October 2007, while South Africa has yet to indicate when it will make the change.

According to Jimbo, implementing a new method of collecting and testing blood samples from infants as early as six weeks of age, has also helped. The most commonly used HIV-antibody test - the rapid test - cannot distinguish between maternal and child antibodies in infants, because HIV antibodies can cross the placenta and stay in the child's bloodstream for 18 months.

Babies need a Polymerase Chain Reaction (PCR) test, which can detect small quantities of viral protein in the blood, to establish their status. Although the PCR technology has been available in Botswana since 2002, it could only be performed at the two referral hospitals where specially trained doctors are available to perform phlebotomy (draw whole blood from veins) on infants.

However, the introduction of the dried blood spot test has made it possible to train health workers at all clinics to obtain blood from infants, using a simple method of pricking the heel, toe or finger. The dried blood spot is cheaper and faster, and requires less skill than the liquid blood PCR tests. One a child is identified as HIV-positive, it's health can be better managed.

"There is no refrigeration required and there are no blood samples to carry in vials over long distances, and samples can be collected from a clinic anywhere in the country and transported immediately to remote laboratories," said Jimbo.

"During the past two years, we have been working on early infant diagnosis, taking it out to all rural districts in the country, so that even the most distant health post can effectively collect a sample for testing and send it through to a central laboratory for testing," said Dr Molly Smit, a BOTUSA PMTCT advisor in the northern town of Francistown.

Last week, health minister Sheila Tlou said that if the country kept at the same pace, their PMTCT programme could eventually reach levels of HIV transmission of below one percent.

"For the rest of Africa - they are still struggling. In some African countries the uptake is only 30 percent, and they often wonder how we managed to do it."

What about the rest of the region?

Across the border in South Africa there is little to celebrate. In KwaZulu-Natal province up to 30,000 infants are being infected with the virus by their mothers each year, while the rate of HIV transmission remains unacceptably high in other parts of the country.

According to UNICEF, of about 1.2 million women who visited antenatal facilities in 2006, 708,000 were tested for HIV and 27 percent of those were positive, but only 59 percent received treatment to prevent passing on the virus to their infants.

Nathan Geffen, spokesman for the AIDS lobby group, Treatment Action Campaign, described these figures as "absolutely pathetic". "The MTCT programme is being implemented poorly in many parts of the country, the government is still using the sub-optimal single-dose regimen and far too few people are taking up the programme. The opportunity to treat women who present with AIDS is not being sufficiently used."

Frustration has been mounting in South Africa over the government's delay in rolling out combination therapy. Apart from the Western Cape Province, where a combination of drugs for PMTCT has been used for several years, the country is still using single-dose nevirapine.

"On the positive side, there are new draft guidelines and, if these are adopted, the policy will be in place and will go a long way to improving things," Geffen added.

Nevertheless, political commitment was still a major obstacle. "The continuous delays in making simple policy changes are a consequence of the minister of health's incompetence," he said.

Malawi is also struggling: only 28 percent of the 544 clinics that provide maternal services offer PMTCT services. Miriam Chipimo, Reproductive Health and HIV/AIDS manager for UNICEF, told IRIN that the government was hoping to roll out the programme at all clinics by the end of 2008.

The rollout has also been constrained by budget shortfalls related to bottlenecks in donor fund flows, and severe staff shortages that have crippled the health sector.

But Chipimo is optimistic about the potential for reducing mother-to-child transmission: "The political will in Malawi is tremendous ... and there's a lot of momentum to scale up. They're getting a lot of support from partners and donors."

Source: IRIN

SOUTHERN AFRICA: The effect of migration on HIV rates

Sunday, September 16, 2007

Trying to measure the impact of the Zimbabwean exodus on HIV/AIDS rates in the region is so fraught with ifs, buts and maybes that the only reasonable assumption is that, like other migrants, economic migrants may run a higher risk of infection than they would have if they had not left their homes.

The scale of Zimbabwean migration to neighbouring states is disputed, with estimates ranging from more than three million people to a few hundred thousand, making an overall assessment of the actual spike in transference of the disease, if any, in the region difficult to assess, but it is accepted that the act of migration tends to increase HIV/AIDS infections.

The Southern African Migration Project (SAMP), a non-governmental organisation researching regional migration issues, found that migration was one of many social factors contributing to the sub-continent's HIV/AIDS pandemic.

In a 2004 research paper, Migration, Sexuality, and the Spread of HIV/AIDS in Rural South Africa, SAMP commented: "previous studies have shown that people who are more mobile, or who have recently changed residence, tend to be at higher risk of HIV infection than people in more stable living arrangements.

"In Uganda, for example, people who have moved within the last five years are three times more likely to be infected with HIV than those who have lived in the same place for more than 10 years," the researchers said.

"In a South African study, people who had recently changed their residence were three times more likely to be infected with HIV than those who had not. It is not so much movement per se, but the social and economic conditions that characterise migration processes that puts people at risk for HIV."

Gang rape

Zimbabwe's economic meltdown is seen as the main driver of the upswing in undocumented migrancy to neighbouring states. The country is in the throes of a recession that has already lasted for seven years, shortages of basic commodities, fuel and electricity are commonplace, the official inflation rate has topped 7,000 percent - the highest in the world - and unemployment is at 80 percent.

In the first quarter of 2008, more than a third of the population is expected to face severe food shortages, according to international aid agencies.

Undocumented Zimbabwean migrants travelling to neighbouring South Africa or Botswana, the preferred destinations of the majority because of the size of their economies and their proximity, risk contracting HIV even before arriving.

Nick van der Vyver, programme officer at the Reception and Support Centre of the International Organisation for Migration (IOM) in Beitbridge, the Zimbabwean town nearest the border with South Africa, told IRIN/PlusNews that "irregular migration has served as a magnet for illegal migration, with seriously organised and nasty gangs operating within the first 10km of the border [in South Africa]."

Known as as the "magumaguma" (scavengers), the gangs ferry undocumented migrants across the border for a fee, said to be about R1,500 (US$140), and often rob and rape those who have paid them for their "service"; other illegal migrants crossing the border independently are often ambushed by the gangs.

Since the IOM reception centre opened on 31 May 2006, the protection unit has had  incidents of rape reported, either while undocumented migrants were crossing the border or in police custody, but Van Der Vyver suspects that rape has been under-reported. He gave an example of a woman who was gang-raped by six men, along with two other women, but she was the only victim who reported the assault.

In another incident, Van Der Vyver said a "Zimbabwean boy told us he was forced to rape women after the bandits he was travelling across the border with had first gang-raped them."

In the first seven months of 2007, the IOM processed 117,737 people repatriated from South Africa at its Beitbridge centre - about 40,000 more than in the last six months of 2006. Four out of five people passing through the IOM reception centre after repatriation by South Africa are young Zimbabwean men in their early twenties.

The centre was established to assist repatriated Zimbabweans who arrived destitute in their home country, often forcing women to turn to sex work, while men engaged in crime. Among other services, the reception centre provides free transport home and food packs.

Reiko Matsuyama, the IOM's HIV/AIDS project officer, based in Pretoria, South Africa, told IRIN/PlusNews that "anecdotal evidence suggests undocumented migrants are more vulnerable to HIV infections because of such practices as survival or transactional sexual relations", which meant that people would engage in sex for some sort of benefit, like accommodation or getting across a border.

Undocumented migrants were wary of engaging with officials in their adopted country for fear of deportation, and "they are less likely to seek medical services, not just for HIV/AIDS, but also for STDs [sexually transmitted diseases]," Matsuyama said, which also increased their risk of HIV infection.

The IOM said there were reasons why migrants, both undocumented and documented, displayed higher incidents of HIV/AIDS infections: migrants tended to engage in risky sex because of extended separation from their wives or partners; they experienced isolation, which made it difficult to reach or stay in conact with health services, or have access to condoms and health education.

These factors might be compounded by unfamiliarity with customs or languages. The IOM has also pointed out that the incidence of HIV/AIDS was often higher along major transport routes on which not only goods and people moved, but also disease.

Refugee's access to ARVs

Registered refugees have access to ARVs in many countries in the region, although Botswana, which pioneered the mass rollout of ARVs in 2002, does not dispense the life-prolonging medication to its refugee population.

The Botswanan refugee camp of Dukwi, about 150km north of Francistown, Botswana's second city, was established by the Lutheran World Federation in 1978 but since then has fallen under the aegis of the Office of the President.

Dukwi currently houses about 3,500 people: 1,200 Namibians from the Caprivi Strip and 1,200 refugees from Angola. The remainder include refugees from Burundi, the Democratic Republic of Congo, Rwanda, Somalia, Sudan and Uganda.

Since 2004 the Roman Catholic Church in Francistown has filled the gap left by the exclusion of refugees from Botswana's ARV programme by offering assistance to refugees and foreigners requiring treatment for HIV/AIDS.

Sister Bernadette Tembo, of the Catholic Church, told IRIN/PlusNews there were 79 people excluded from government ARV treatment on their books, among them refugees from Dukwi, although the programme was designed for only 50.

She said everyone, regardless of origin, could be tested for HIV free of charge in Botswana, but further tests, such as CD4 counts (which measure the strength of the immune system) were only available at no cost to Botswana nationals.

Dr Ndwapi Ndwapi, operational manager for the government's Masa (New Dawn) ARV programme, commented that the exclusion of non-nationals, including registered refugees, was based on the philosophy that citizens were part of "government health insurance" and "the qualifying criterion is to be a national".

However, the provision of ARVs to registered refugees would occur "probably before the end of this year," Ndwapi said, and dispensing would fall under the Office of the President of Botswana.

Five years after Botswana began its ARV rollout, 90 percent of citizens requiring the treatment have access to it or, to put it another way, Ndwapi said, of the 95,000 to 110,000 people needing treatment, 90,000 were receiving it.

Botswana's citizens are eligible for ARV treatment if they have a CD4 count below 200 or are living with an AIDS-related illness.

New strategies required

Laurie Bruns, regional HIV/AIDS coordinator for the UN Refugee Agency (UNHCR), told IRIN/PlusNews that although many countries in the region had policies allowing refugees access to free ARVs, there were still some instances where asylum seekers requiring ARVs were denied the medication.

Bruns conceded that the very nature of undocumented migrants, in that they were clandestine in their activities, crossed borders illegally or were repatriated to their home countries, made the provision of ARVs, or even HIV/AIDS education, very challenging.

"HIV/AIDS does not respect economic decline or conflict," she said. Strategies to provide universal access to ARV medication, regardless of a person's legal domicile or nationality, needed to be developed because "there are economically driven migrations, and the region needs to evolve [a common policy on HIV/AIDS], to address the changing nature of it."


Source: IRIN

AFRICA: Donors call the shots in HIV/AIDS sector

Monday, February 26, 2007
Large international donor agencies have become major players in Africa's response to the HIV/AIDS pandemic. Despite talk of 'partnering' with their recipients, they have usually called the shots.

Unsurprisingly, considering the millions of dollars in play, the donors have insisted on high levels of transparency and accountability from recipients and have punished perceived corruption or mismanagement by hasty withdrawals of funds.

But after several breaking news stories in recent months, the conduct and accountability of donors themselves has come under similar scrutiny.

Reports in late 2006 said a USAID audit of President Bush's Emergency Plan for AIDS Relief (PEPFAR) had brought to light shoddy record-keeping, in which large numbers of beneficiaries were miscounted.

Next came revelations by the Los Angeles Times that the Bill & Melinda Gates Foundation had invested heavily in the pharmaceutical companies responsible for pricing life-prolonging antiretroviral drugs out of reach of most Africans.

In February 2007 it was the turn of the Global Fund to Fight AIDS, Tuberculosis and Malaria, when The Boston Globe newspaper revealed that an internal investigation had found the Fund's outgoing executive director, Richard Feacham, guilty of making extravagant use of his business expense account.

These stories may signal that the days of donor agency impunity are numbered. The Washington-based Centre for Global Development is researching HIV/AIDS funding in a project called the 'HIV/AIDS Monitor' which is investigating the widely varying practices of three major donor agencies: the US President's Emergency Plan for AIDS Relief (PEPFAR), the Global Fund and the World Bank's Multi-Country HIV/AIDS Program (MAP).

Local researchers in four countries receiving aid - Ethiopia, Mozambique, Uganda and Zambia - will look at how programmes are designed and implemented, funds are delivered and managed, and what impact they have on local health systems.

"Donors have really been stringent about how their money is used, but what's interesting is that we know very little about whether donors [agencies] are using money effectively," said project director Nandini Oomman. "Part of our goal is to make donors more accountable and more open."

Such initiatives are vital, not only for informing the American and European public about how their tax dollars are being spent, but for raising questions that recipients in Africa are rarely in a position to ask. Partners or dictators?

Most African nations depend heavily on donors to respond adequately to HIV/AIDS epidemics that have overwhelmed their own budgets. In Malawi, 55 percent of the health budget comes from donor agencies; most of it earmarked for HIV/AIDS programmes. But a 2005 study of the impact of Global Fund grants on the health system found that the Fund's focus had not always been in line with national programmes and priorities, and had actually hampered government efforts to decentralise health services.

"Donors claim they're looking for partnerships with governments but that patently isn't the case," said Prof Alan Whiteside, director of the Health Economics & HIV/AIDS Research Division at the University of KwaZulu-Natal in South Africa. "For governments, it can be a real issue of relative powerlessness, because they're reliant on donor money."

The Washington-based Center for Public Integrity, a nonprofit research organisation that concentrates on ethics and public service issues, recently looked at the practices of PEPFAR and concluded that instead of partnering with and empowering local stakeholders, the agency's overly "simplistic and narrow" framework for dealing with the epidemic had resulted in a prescriptive approach to allocating funds.

Investigators cited PEPFAR's insistence on the ABC (Abstain, Be Faithful, and Condomise) approach to prevention, with particular emphasis on A and B.

The US Global AIDS Coordinator, Dr Mark Dybul, responsible for implementing PEFPAR, described the ABC approach as evidence-based, and a continuation of policies in place before PEPFAR came into existence in 2003.

But Dean Peacock, former country director for the South African office of Engender Health, a nonprofit agency working to improve the quality of reproductive health and family planning services in developing countries, a recipient of PEPFAR funding, insisted that there was no evidence to support the abstinence approach.

"Part of [donor agency] accountability is not just how resources are used, but how the ideology behind it fits with the context."

Peacock, now co-director of Sonke Gender Justice, a South Africa-based nongovernmental organisation (NGO) advocating for gender equality to reduce the spread of HIV, shares the view of many experts that the promotion of abstinence and fidelity is often too simplistic in the African context of gender violence and inequity, in which many women are not in a position to negotiate the terms and conditions of sex.

Ideally, organisations should challenge donor agencies when funding came with strings attached that did not match their mandates, but in reality this rarely happened. "If you're sitting there as a programme director, and you've got someone's salary on the line, it's very difficult to say 'no' to funding," said Peacock.

"There is a sense of being held to ransom," agreed Denise Hunt, executive director of the AIDS Consortium, an umbrella organisation of South African AIDS service organisations. "People are wary to speak out because they're reliant on those funds."

More money than capacity

Part of the apparent reluctance of donors to partner with local organisations and governments stems from the very real lack of capacity in many countries to manage large sums of donated cash.

"There's more money committed to the AIDS response than there is capacity to disperse it in Botswana," commented Daniel Motsatsing, executive director of the Botswana Network of AIDS Service Organisations (BONASO).

The same is true in many countries, where weak health systems often cannot expand at the same pace as donor-inflated budgets.

A 2005 report on the potential for corruption in the HIV/AIDS sector by anti-corruption organisation Transparency International, noted that the "performance" of a grant is often assessed by how rapidly it is disbursed, providing an incentive to donors and recipients to allocate money carelessly, or even to siphon off significant amounts without anyone noticing.

Many donors had tried to solve the problem by running costly parallel systems that either imported 'experts' or recruited scarce local talent.

The Global Fund broke new ground by setting up 'Country Coordinating Mechanisms' (CCMs) of local stakeholders to oversee its grants, but after evidence of corruption surfaced in Uganda and Chad, and of poor performance in Nigeria, the Fund has had to rethink its 'hands-off' approach and invest more in strengthening the capacity of the CCMs. "I think it was a rather idealistic approach to take - there wasn't an organised network of technical and managerial assistance available," said spokesperson Jon Liden.

Global health commentator Laurie Garrett is among those who have argued that donors should focus on strengthening public health systems instead of "stove-piping" large amounts of aid into HIV/AIDS programmes.

"Stove piping tends to reflect the interests and concerns of the donors, not the recipients," wrote Garrett, adding that "efforts to combat HIV/AIDS have so far managed to bring more money to the field, but have not always had much beneficial impact on public health outside their own niche."

Liden disagreed, arguing that AIDS, tuberculosis and malaria dominate health systems in many African countries, and that tackling them inevitably benefited public health more broadly.

Keeping promises

Most donors commit to five-year funding cycles, leaving recipients in a constant state of uncertainty about the future of their organisations and beneficiaries. Even when a commitment has been made, it can take several months for the money to arrive.

"Their own inefficiency becomes your crisis," said Denise Hunt of the AIDS Consortium, noting that it was not uncommon to receive funding late while the deadline for spending it remained the same. "I'm in a situation now where I'm going to have to give a donor some money back because it wasn't spent by the deadline, but if it had been, it would have been spent recklessly."

An even bigger problem was donors who failed to honour pledges. In the HIV/AIDS sector, "[the importance of] predictability is huge", said Whiteside, especially when it came to antiretroviral treatment programmes, which had to be sustained uninterruptedly and indefinitely.

This means ensuring that the amounts received matched commitments, and that administrative fees and other deductions were taken into account.

Peacock said it was common practice for US-based international NGOs receiving PEPFAR funding to charge 30 percent of their grants to overheads, plus 15 percent to administration, thus spending nearly 50 percent of their budgets on ill-defined organisational costs that often included plush offices in New York and Washington.

With "bloated executive salaries, well in excess of what President Mbeki earns, for flying around the world, business class, and dropping in on the developing world to offer prescriptive 'technical assistance' devoid of any substantive understanding of local realities", he added.

According to a US Congressional report, at least two-thirds of US foreign aid never leaves the United States. The money is used to pay for American salaries, American-made vehicles, office expenses and other 'overheads'.

Dybul conceded that some international NGOs had inappropriately allocated items as US-based overheads and had under-used local expertise and capacity: "We're now requiring line items to separate out [American] overheads and putting language into grant contracts that requires international organisations to start turning over what they're doing to local organisations."

Lack of coordination

Besides unpredictability and the programme planning challenges this created, donors have different disbursement cycles, and the lack of coordination between them extends to different reporting formats and administrative procedures. The resulting administrative burden takes significant time and resources away from the core business of smaller NGOs, especially when they receive funding from several donors.

Poor communication between donor agencies can also lead to project duplication or even competing programmes. "Donors really need to start talking to each other about coordinating their efforts," said Oomman. "But the incentives for that are not great."

Liden agreed: "Everyone wants the kudos of the quick result, so it's difficult to argue that one donor should do the more visible stuff while another does the back-office stuff."

Nevertheless, Liden, of the Global Fund, and Dybul, of PEPFAR, both claimed to be working towards greater coordination. "Everyone we know has the same goals," said Dybul. "In some places the Global Fund is supplying ARV drugs and PEPFAR is supplying the training and infrastructure to deliver them."

The Global Fund's highly transparent model of posting details of all of its grants on a publicly accessible website has also reduced the possibility of duplication while increasing accountability. "It is scary to expose your work to the scrutiny of the entire world," commented Liden. "But it has engendered very constructive debates about how best to use funds for development."

Recipients are also starting to recognise the need for greater advocacy in their relationships with donors. Hunt advised local NGOs to view such relationships as "a two-way street", and to be more selective about whom they accepted funds from, "because it can't come at any cost".

"In some cases," agreed Peacock, "we should just say, 'no, we can't do this'."
Author: IRINPlusNews

BOTSWANA: San look set to return home

Friday, January 12, 2007
Botswana's displaced San finally look set to return home this week after winning a long-fought court battle to be allowed back to their ancestral land in the Central Kgalagadi Game Reserve (CKGR), in the Kalahari Desert.

In December 2006 the High Court of Botswana ruled that a group of San, also known as Bushmen, had been wrongfully evicted four years earlier from the remote CKGR.

Two weeks after the court ruling, some 20 Bushmen were refused entry into the reserve. "We have since held meetings with the park officials and they said they will allow us in," said Jumanda Gakelebone, a former CKGR resident and spokesman for the First People of the Kalahari (FPK), an advocacy group for the San community. "About 60 of us will move in tomorrow [Friday] with our families."

The Botswana government said it intended setting aside the protected area for wildlife and tourism development and began relocating roughly 2,500 San from the CKGR in 1997. Rights groups claimed the San were forcibly removed to make way for diamond exploration in the reserve, and assisted 244 former CKGR residents to mount a legal challenge in 2002.

The government has maintained its emphasis was on voluntary relocation, aimed at providing development opportunities to the former CKGR residents. They were resettled in New Xade and Kaudwane, depressing villages where the San are dependent on handouts. Only a small hardcore group remained in the reserve after the government cut off water, food rations, health and social services to the CKGR in 2002.

Surprised that the San had not been allowed into the reserve, Abraham Keetshabe, head of the civil litigation division at the Botswana attorney-general's chambers, told IRIN the court had been very explicit about the Bushmen moving back to the CKGR. "The judgment said the 189 applicants [in the court case], along with their minor children, can return [to the CKGR] without being issued with any permits, but the returning families must have their identification papers with them."

According to the FPK, the judgment applies to all the 50,000 San in the country and cannot be confined to the 189 applicants involved in the litigation. "Our lawyers have written a letter to the attorney-general on the matter; we have not heard from them yet," added Gakelebone.

Botswana is rich in diamonds and cattle, with a population of just 1.6 million. But as an ethnic minority, the San experience both poverty and allegedly discrimination. They are called "Basarwa" (those who don't raise cattle, in the Tswana language), a term they feel is demeaning.

The government of Botswana provides free education but the San have problems in accessing it. Teaching is done in Tswana and English, which many San children do not speak. Through its longstanding Remote Area Dwellers initiative, the government has provided roads, potable water, primary schools, hostels and health posts in San areas. Its Economic Promotion Fund supports income-generation and training projects.

In spite of these efforts, rural poverty is endemic and the San remain the poorest of the poor, exploited as farm labourers, plagued by alcoholism, perceived as backward, silent in politics.

The landmark judgment in favour of the San, which ruled that the government had acted "unconstitutionally" and "unlawfully", was hailed as a model for other legal challenges being mounted by indigenous communities removed from their ancestral land in other countries.

The CKGR is a reserve about the size of Togo or Denmark, created in the last days of British colonial rule before Botswana's independence in 1966, in which the San were guaranteed continued occupation of land their forefathers had lived on for thousands of years.
Author: IRIN
Source: IRIN

BOTSWANA: The San can return home now

Sunday, December 17, 2006
After a hard-fought court battle - billed as the longest and most expensive in Botswana's legal history - on Wednesday the San won their right to return to their ancestral home in the Central Kgalagadi Game Reserve (CKGR), in the Kalahari Desert.

The High Court of Botswana in Lobatse, about 70km south of the capital, Gaborone, ruled that the San, also known as the Bushmen, had been wrongfully evicted from their ancestral homeland in 2002.

The government intended setting aside the protected area for wildlife and tourism development and began relocating the San outside the CKGR in 1997. Rights groups claimed that the San community was forcibly removed from their ancestral land to make way for diamond exploration in the CKGR, and assisted 244 former CKGR residents to mount a legal challenge in 2002. The government has maintained that the emphasis has always been on persuasion and voluntary relocation.

"Today is the happiest day for us Bushmen. We have been crying for so long, but today we are crying with happiness. Finally, we have been set free. The evictions have been very, very painful for my people. I hope that now we can go home to our land," said Roy Sesana, a former CKGR resident and spokesman for the First People of the Kalahari (FPK), an advocacy group for the San community.

"We are pleased", said an elated Jumanda Gakelebone, another FPK spokesman.

A panel of three judges ruled two to one in favour of the main issues raised by the San during the case, which is being perceived as a model for other legal challenges being mounted by indigenous communities removed from their ancestral land in other countries.

Stephen Corry, director of the advocacy group, Survival International, described the ruling as a "victory for indigenous peoples everywhere in Africa. It is also a victory for Botswana. If the government quickly enacts the court ruling, then the campaign [to return the San to their land] will end and the country really will have something to be proud of".

The only dissenting voice on the bench, Maruping Dibotelo, chief justice of the high court and the first to deliver a verdict, ruled in favour of the government, sending an air of despondency across the court room packed with hundreds of members of the San community, many of whom had trekked for long distances to hear the historic judgment.

When the second judge, Unity Dow, ruled that the government had acted "unconstitutionally" and "unlawfully", the San were visibly pleased. "The respondent [the government] did not inquire into the consequences of the relocation. In some cases, wives who wished to relocate were turned against their husbands who did not want to do so, and children were also turned against their families," she said.

Judge Mpaphi Phumaphi, who delivered the deciding ruling, took an even harder line and said the refusal to issue hunting licences to the San was "tantamount to condemning the remaining residents of the Central Kgalagadi Game Reserve to death by starvation".

Dibotelo, the presiding judge, then read out the final verdict: "Prior to January 31, 2002, the applicants were in possession of the land which they lawfully occupied in the CKGR [Central Kgalagadi Game Reserve]. The applicants were deprived of such possessions forcibly or wrongly and without their consent."

The government's subsequent refusal to allow the San a permit to return to their land was "unlawful and unconstitutional", he said.

The CKGR is a reserve about the size of Switzerland, created in the last days of British colonial rule before Botswana's independence in 1966, in which the San were guaranteed continued occupation of land their ancestors had lived on for thousands of years.

The lawyer representing the San, Gordon Bennett, had told the court that the San "have a right of use and occupation", and pointed out that neither the British colonial system nor the Botswana government had passed legislation to remove this right.

During the relocation, the community's water tanks and livestock had been confiscated, Bennett said, and they had been prevented from hunting, making them "trespassers on their own land".

After the water tanks were removed, the Bushmen had used donkeys to ferry water, but these had also been taken away because the government said the donkeys threatened the wildlife with disease.

Thousands of San seemed set to relocate to CKGR after the verdict, which also said the government was not obliged to provide basic services, such as water, to anyone returning to the reserve.

The government is reportedly considering whether to appeal the judgment.
Source: IRIN

AFRICA: Continent will miss millennium goals - IMF

Thursday, November 16, 2006
Most countries in sub-Saharan Africa are not on track to meet the millennium development goal of eradicating extreme poverty by 2015, the International Monetary Fund (IMF) said in its regional economic outlook for Africa, released in Dakar on Tuesday.

The IMF has estimated that Africa needs to accelerate annual GDP growth to seven percent to attain the goal of reducing by half the proportion of people living on less than one dollar a day by 2015.

Africa’s economy as a whole is growing at around 5.5 percent in 2006, although South Africa and the continent’s oil-rich countries are responsible for most of the growth, according to the IMF report.

“The critical thing for the economic poverty goal is growth,” Sanjeev Gupta, assistant director of the Africa Department at the IMF told IRIN. “There is no substitute for higher rates of growth to reduce poverty and achieve all the (millennium development goals) in the long-run.”

“Africa needs more external resources, and at the moment that means more aid. The IMF strongly favours scaling up aid flows along the lines of the Gleneagles commitments, but so far that has not really occurred,” Gupta said.

The Gleneagles commitments were made by G8 members in Scotland in 2005, and included the promise of an extra US $25 billion a year in aid to the African continent before 2010.

IMF officials speaking at a ceremony for the report’s launch also said Africa needs to improve its terms of trade both with industrialised countries and within the continent.

The IMF report notes that countries which have benefited from multilateral debt relief are using the resources released - between 2.5 and 7 percent of GDP - to boost poverty-reducing investments.

It also finds that Botswana, Cameroon, Ghana, Kenya, Malawi, Nigeria and Zambia are attracting a growing amount of investor interest, and that remittances from industrialised countries are increasingly important in balancing current accounts.

Recorded remittances account for almost 40 percent of Lesotho’s GDP, and between 12 and 20 percent of GDP in Cape Verde, Guinea Bissau, Senegal and Togo, the IMF said, although the real figure, including unregistered transfers, may be as much as twice as high.

Cameroon, Ethiopia, Senegal, South Africa and Swaziland are the only countries considered “well positioned” by the IMF to meet the income poverty goal. Ghana and Mozambique also have a shot at attaining it “if their recent growth performance is sustained”, the IMF said.

However, these countries account for less than a third of the population of the sub-Saharan region. At least 40 percent of sub-Saharan African countries are either “off-track” or “seriously off-track” on each millennium development goal.

Progress toward the goals in up to a third of sub-Saharan countries “cannot be measured at all” due to weaknesses in their statistical systems, the IMF said.
Author: IRIN
Source: IRIN

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