Circumcision targets not being met
Review of donor finance programmes in KZN mooted as some NGOs failing communities
CIVIL rights group the Treatment Action Campaign (TAC) has called for an urgent review of how donor funding is being spent on circumcision programmes in KwaZulu-Natal amid concern the province has failed to meet its targets.
“Most of our NGOs are working hard to assist in achieving healthy outcomes with little or no funding. Many have suffered funding cuts because of the economic crisis.
“Yet we also have other NGOs that consistently receive millions of rand in foreign funding to scale up medical male circumcisions (MMC) but fail to achieve their targets.
“Despite this, they hold on to the funding instead of pouring money into community-based programmes or organisations that can speed up circumcisions quickly and effectively. Why do donors continue to fund the same organisations who fail to deliver?
“There must be a change. We need more funding, but donors must make it a criteria that the big firms they fund must sub-grant to smaller community based organisations who can achieve the targets set out, especially in rural areas.
“The organisations that receive funding all the time don’t even account to the people of South Africa and many of them don’t want to tell us how much they receive or open their books to transparency.
“That tells us they are enriching themselves at the expense of health programmes that funders pay for,” says the TAC’s national deputy chairperson, Patrick Mdletshe.
His call comes amid an announcement by the US President’s Emergency Plan for Aids Relief that it would fund medical male circumcisions in South Africa to the tune of more than R330 million over the next five years.
While Mdletshe did not want to name the organisations he was referring to, investigations by the Sunday Tribune found that while many NGOs in the province were transparent about their work and funding, a few were not.
Investigations found one such organisation received funding from more than 10 foreign donors over five years, yet consistently failed to meet circumcision targets.
Its directors drove luxury cars, owned several properties and made frequent trips abroad and failed to provide any response to questions sent to them on their funding or failure to achieve circumcision targets.
South Africa has the highest number of people living with HIV in the world with low rates of male circumcision seen as one of the contributing factors to the epidemic. MMC is seen as a cost effective way of reducing the risk of contracting and spreading HIV by up to 60 percent.
The KZN department of health has set an ambitious target of 2.5 million circumcisions by 2016, but has carried out just over 700 000 medical male circumcisions so far, fail- ing to meet its target.
“The government has done a lot to improve its take up of medical male circumcisions, including mobilisation of youth to embrace medical male circumcisions.
“This has been a positive step in the right direction, but it has not been enough. There is a real danger in the reality that nationally, we are failing to meet our circumcision numbers and this could have serious consequences for our AIDS targets. One of the reasons for this, apart from the issue of donor funding concerns, is current policies.
“As an organisation we are calling on government to urgently review their MMC policy, as we feel it discriminates against those who are HIV-positive.
“Currently, a person must take an HIV test before he is offered a medical circumcision. If he is HIV-positive, he does not qualify immediately as he needs to wait for his CD4 count (the most important laboratory indicator of how well the immune system is working and the strongest predictor of HIV progression) to reach a certain level.
“The problem is that when groups of friends go to the circumcision camps, those who are turned away because they are HIV-positive are stigmatised as their status becomes known to their friends.
“The government needs to change this because circumcision not only reduces the risk of HIV but also of other sexually transmitted infections. So, regardless of status, males should be allowed to circumcise without the fear of their status being exposed or being turned away because they are HIV positive,” said Mdletshe.
The department of health did not respond to queries, nor answer questions on its use and costs of the controversial Tara Klamp device as a circumcision tool.