South African AIDS U-turn & my job

There's just been a stunning announcement by the South African Cabinet that they will start providing antiretroviral drugs to AIDS patients. This is a amazing news, and a good time to explain a little about my weird job, since I've been researching AIDS in South Africa as part of my job at New Philanthropy Capital.

NPC is a charity which looks and sounds a lot like an investment bank. In fact most of the people working here have come from the world of finance (I was previously an equity analyst at Schroders, working on socially responsible investment). About 2 years ago a group of wealthy individuals from the City, were thinking about how to improve their philanthropic giving. They concluded that they should really be putting as much research into give away their money effectively as they did in making it in the first place. Unfortunately no organisation existed which analysed charities with the rigour that investors analyse companies, and hence NPC was founded to fill this gap.

One way we go about this is by producing sectoral reports on particular areas of social need - such as domestic violence, cancer, community regeneration, conflict resolution etc. - which provide the context for effective philanthropic giving. We look at the extent of the need, methods of intervention and their outcomes (which we try to quantify as far as possible), existing provision and specific charities which could make good use of additional funding. We present this in reports and presentations which are designed to appeal to wealthy individuals to enable them to give in the most effective way (and thereby inspire them to give generously).

I joined NPC in mid-March and have been working largely on AIDS in South Africa along with a colleague with a wonderful name, Iona Joy. She made two trips to South Africa to visit about 20 projects, whilst I've been doing the contextual research - on the extent of HIV/AIDS, it's impact on society, the government response, the outcomes of interventions to prevent the spread of HIV and to treat and care for AIDS patients and their children.

What has been shocking is the appalling way the SA government, particularly President Mbeki and Health Minister Tshabalala-Msimang, have refused to even discuss providing antiretroviral drug treatment. AIDS cannot be cured, but drugs can control the damage HIV does to a persons immune system, which can extend their lives by many years. The cost of drugs has come down greatly in the last few years thanks to campaigns against pharmaceutical companies by Oxfam, MSF and others. They will never be cheap, but it would be affordable for South Africa to provide treatment for around a million patients at an advanced stages of AIDS for under a billion pounds. South Africa is fiscally quite strong and could afford this within the existing budget, however AIDS campaigners such as the inspirational Treatment Action Campaign have had to fight long and hard even to get basic provision such as drugs to reduce the risk of transmission of HIV from mothers to children.

Last week there was talk of the South African Medicine Control Council removing it's approval for Nevirapine, the drug used to reduce mother-to-child transmission and a clause was removed from the Sexual Offences Bill which would have provided antiretroviral treatment to rape victims to minimise their risk of contracting AIDS. These were the latest of many backwards steps by the government. So the announcement by the cabinet yesterday, was completely unexpected. The statement was very measured, but did say "Antiretroviral drugs do help improve the quality of life of those at a certain stage of the development of AIDS, if administered properly... The Cabinet decided that the Department of Health should, as matter of urgency, develop a detailed operational plan on an antiretroviral treatment programme... by the end of September."

The SA government has broken it's word on AIDS in the past, so we'll have to wait and see what happens but, on the face of it, this is incredibly good news! Universal treatment programs in Europe, US and Brazil have transformed the lives of many people with AIDS, contributed to reducing the spread of HIV and actually reduced health costs incurred from the hospitalisation of people dying of AIDS.

The bad news for me is that we'll have to seriously rethink our report. We've just about produced the final version of the report are receiving feedback on the draft from experts in South Africa and were planning to go to print next week... Our report is entitled "From Rhetoric to action: a guidebook on AIDS in South Africa for grantmakers and donors", and the extra work this U-turn will cause for me is a very small price to pay if the government's latest rhetoric really dues turn into action which may begin to turn the tide on AIDS.