Academic journal article Africa

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

Academic journal article Africa

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

Article excerpt


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.


Cet article examine le financement de la lutte contre le VIH/SIDA en Afrique du Sud, et la relation entre les bailleurs de fonds etrangers et le gouvemement sud-africain. La reconnaissance de la pandemie du SIDA en tant que crise epoquale a conduit a une proliferation d'organisations internationales et bailleurs de fonds aujourd'hui directement impliques dans la gouvernance, le suivi et la gestion de la pandemie dans de nombreux pays africains. A plusieurs egards, le poids des bailleurs de fonds qui definit de plus en plus la pandemie et la reponse globale qui lui est donnee s'inscrit dans une nouvelle logique imperialiste qui subordonne les programmes panafricains, masque des questions plus larges d'acces qui sont au centre de la lutte contre la pandemie, et renforce les relations traditionnelles de dependance entre les nations occidentales riches et les nations africaines pauvres. Cependant, la relation qu'entretient le gouvernement sud-africain avec les bailleurs de fonds etrangers a ete faconnee par ses efforts d'elaborer une reponse africaine la pandemie qui ne soit pas determinee ni essentiellement financee par l'aide etrangere. Cet article met en lumiere les implications positives et negatives de la relation parfois difficile entre le gouvernement sud-africain et les bailleurs de fonds etrangers, ainsi que les objectifs d'entraide axes sur l'Afrique qu'il poursuit, en soulignant les opportunites et les defis qui se posent aux gouvemements africains pour definir la reponse globale a la pandemie.


At a time when the AIDS pandemic has finally drawn the attention of--and is increasingly being defined by-the international community, the South African government has sought to develop a uniquely African response. Indeed, the persistence of patterns of African dependence on the West has been a key issue that has shaped the government's response to AIDS. While many of its neighbours have seen their health budgets dwarfed by foreign aid and their health policies in large measure determined by donor organizations, South Africa has sought to negotiate the tricky interface between self-help and dependence, partnership and paternalism. This has led to a series of policy positions and statements that sparked a furore of criticism and debate, exacerbating the AIDS crisis. While the country's response to the AIDS epidemic has been marred by controversy, confusion and policy inaction, it is also true that South Africa now boasts the world's largest public sector anti-retroviral treatment programme, one that is 90 per cent funded by government resources, not donor funding (Tshabalala-Msimang 2006). …

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