Making The Aids Money Work

Making the AIDS money work: the product of corruption in HIV&AIDS response in Nigeria By Onyemelukwe Akaoma. Background of the problem In the last decade, the HIV&AIDS epidemic has assumed an alarming dimension with exponential increase in the rates of new infections across the globe including Nigeria. About 33 million people are living with HIV&AIDS with 2.1 million new infections in 2007 The HIV&AIDS epidemic in Nigeria has a sero-prevalence of 4.4% with an estimated population of about 140 million people. Nigeria is rated second after South African in the number of people living with HIV&AIDS. This evidences the level of the epidemic burden of new infections, care and support and mitigation of the impact in the country. With about 22 years from the first reported case of HIV&AIDS in Nigeria, the national response has continued to stimulate activities with the multiplied funding stream/ budget scale up for interventions; the people are yet to feel the impact of the AIDS money especially at the rural and community levels. The major limiting factor to the efforts to control the spread of HIV and the increase treatment for people living with HIV&AIDS in Nigeria is Corruption. The response with increased budgets have not paid attention regarding to the anti-corruption mechanisms needed to ensure their proper use providing further opportunity for corruption. Corruption experienced in HIV&AIDS prevention, treatment and care and support are not different from the corruption in the health sector. However, the problem is magnified because of the impact of the pandemic, the HIV related stigma and the high cost of treatment resulting to deaths. Issues and effect Corruption in Nigeria especially within the HIV&AIDS National response is bedeviled with lots of alarming practices and principles which have limited the effectiveness of the intervention in prevention, care and treatment. The sources of corruption in HIV&AIDS in many ways are similar to the health sector. The issues of corruption in the AIDS response are more in the weak structures and systems of government agencies and the way government does it business. This weakness is more in its organizational and institutional establishment for internal control and systematic processes in areas such as procurement which are known to be opaque and some misappropriation of funds earmarked for the response. The corruption is seen in the weak coordinating capacity of the national and state agencies to coordinate the response using the identified priority areas to guide interventions among the players and stakeholders ensuring reach and coverage of the people most affected, vulnerable and powerless. The coordinating agencies are majorly donor fund driven and stand alone has implication in increasing corruption The performance based disbursement has some potential for increasing accountability but this is a wicked kind of incentive for falsified accounting and reporting. The weak programming and coordinating capacity can as a result of required speed in disbursement make for careless and fictitious allocation of funds and claims for activities not executed. Cutting corners by attempting to implement programmes, influencing decision of disbursement of funds to less competent organisations such as NGOS The national response is characterized by corruption in the urbanization of treatment centers. Larger African Conference on Institution, culture and corruption 2008- Akaoma

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percentages of that need treatment live in the rural areas but many of them who are on treatment have to travel long distances. Large number of people who need the drugs cannot access it either because of the coverage The ARV drugs are free in many parts of Nigeria but there are hidden charges and are yet to be comprehensive. The money for AIDS cannot work for its people because the donor community in their processes fuel corruption in Nigeria. In the last few years, they have increased their funding for interventions but have not increased the capacity of staff to monitor accurate expenditure of the funds and compliance. They are only interested in the evidence of the capacity to spend funds (Burn Rate) The HIV&AIDS pandemic has continued to spread in Nigeria. Women and girls are about 4 times more likely to get infected. Several factors drive the epidemic such as poverty, powerlessness, gender based violence, stigma and discrimination, cultural and religious tents and norms, inadequate social support systems etc. The issue of corruption has deepened the impact of the pandemic ensuring that efforts do not yield commensurate results. It has resulted in more deaths and production of more numbers of children orphaned by Aids. This has increased the fact that many CSO and NGO working in the national response see HIV&AIDS funds as free money and money for their personal gain and enrichment. The ethnic inclination has made for the concept “fraternitization” in these lines deepening patron-client relationship. This has made for more words that are not matched by action. Lessons learnt The HIV&AIDS response in Nigeria need to develop systematic processes and accurate anti corruption mechanism for monitoring budgets and expenditure; the coordinating agencies capacity should be strengthening in this area. There is a need to make the coordinating agencies multi sectoral and increase government funding. The technical capacity of the both civil society organisations and the coordinating agencies to be strengthened to understand the rights based perspective to HIV&AIDS response and development. International development partners are to increase staffing capacity for monitoring of funds. The need to involvement people in the response from the community level will build voice for greater impact of AIDS money Recommendation Change in the way government does it business and the value system on Nigeria eradicate corruption, poverty and make HIV&AIDS money work for the poor and excluded.

African Conference on Institution, culture and corruption 2008- Akaoma

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