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  • Christine Chumbler
    Dec 1, 2004
      Malawi: Aids Drug Rollout Hampered By Lack of Funds

      UN Integrated Regional Information Networks

      November 30, 2004
      Posted to the web November 30, 2004


      Malawi needs an estimated US $28 million to provide free anti-AIDS treatment to some 36,000 people by next year, Health Minister Heatherwick Ntaba, has announced.

      According to the Pan African News Agency, Ntaba said a lack of adequate funding was the main obstacle blocking the country's delivery of treatment.

      Although the government programme plans to operate from 54 accredited sites, a consignment of drugs expected this week will only cover 20 of the sites.

      Malawi's initial target was to place up to 20,000 people on treatment by the end of 2004, but only 8,000 people currently have access to antiretroviral medication.


      Statement By IMF Staff Mission to Malawi

      International Monetary Fund (Washington, DC)

      November 29, 2004
      Posted to the web November 30, 2004

      Washington, DC

      The following statement was issued on November 25, 2004 in Lilongwe at the conclusion of an International Monetary Fund (IMF) staff mission:

      "An IMF mission visited Lilongwe during November 9-23, 2004 to review performance under the Staff Monitored Program (SMP) with the IMF.1 The mission met with a broad range of senior government officials, including the Minister of Finance and the Governor of the Reserve Bank of Malawi, and private sector representatives. The mission also discussed with the authorities economic policies for the remainder of the current budget year and some medium-term issues.

      "In July 2004, the Government of Malawi requested an SMP to support the government's efforts to reestablish its track record of economic policy implementation. The program aims to address macroeconomic imbalances by containing government borrowing and holding down inflationary pressures.

      The SMP, which is closely aligned to the 2004/05 budget approved by Parliament, supports key government initiatives, including the targeted input program (TIP), the purchase of maize to alleviate the expected shortage, and the recent increases in civil service pay. While these initiatives are costly, the mission agrees that food security and a more efficient civil service pay structure are important government priorities. The success of the SMP will, therefore, depend on adherence to the approved budget provisions for these and all other spending items.

      "In general, the mission was encouraged by recent signs that Malawi's economy is strengthening. Preliminary information indicates that economic growth picked up in 2003-04; it is now estimated to be around 4¼ percent in 2004, in part because of a very large increase in tobacco production that is also contributing to a rise in foreign exchange earnings. Average inflation has remained in the 10-12 percent range, but it is projected to rise temporarily to14½ percent around the end of the year because of the impact of higher fuel and maize prices.

      "The mission welcomed the progress observed under the SMP through end-September. In particular, discretionary spending and net domestic financing to the government were significantly below their ceilings due to the new government's effort to rein in spending by rejecting requests for extra budgetary spending and the postponement of maize purchases into the October-December period. Targets on net foreign and net domestic assets of the Reserve Bank of Malawi (RBM) were comfortably met, pointing toward strong performance by the RBM in mopping up the monetary overhang and in building the necessary level of reserves during the tobacco marketing season. The authorities have also implemented measures to improve financial management, particularly in the areas of budget monitoring and expenditure control.

      "Going forward, the mission encouraged the authorities to continue the implementation of reforms in order to improve Malawi's growth prospects and social conditions. The success of the SMP, however, depends critically on adherence to the approved budget provisions, and the government will need to counter quickly any pressures that develop. The government is already addressing higher-than-expected costs stemming from the civil service wage reform. It is equally important that the RBM continue to mop up the monetary overhang and take the needed steps to contain inflation.

      "The IMF remains committed to helping Malawi achieve macroeconomic stabilization, sustainable growth, and poverty reduction. The mission team plans to return to Malawi in February to monitor the country's financial performance through December and to continue the policy dialog. Strong performance under the SMP would provide a basis for a new financial arrangement under the Poverty Reduction and Growth Facility (PRGF)."


      Some ballots sent out in canoes for Mozambique poll


      01 December 2004 12:44

      Mozambican President Joaquim Chissano voted on Wednesday in a landmark election which will see him step down after 18 years in power, saying he was proud of his role in cementing peace after helping end a brutal civil war that killed about one million people.

      "We managed to consolidate the peace process. Things seem to be very well organised ... I feel proud that I can finish my mandate in these circumstances," the 65-year-old Chissano said after casting his ballot at a school near the presidential residence.

      Chissano admitted that there had been some problems in transporting ballot material in certain areas of this impoverished southern African nation, which gained independence from Portugal in 1975, only to be wracked by a 16-year civil war which started a year later.

      "They had to utilise canoes because we don't have our own means in this country for transportation. We don't have helicopters, we don't have planes. We have still a lot of roads to be constructed.

      "In spite of that we are doing our best," he said.

      About eight million people are eligible to vote in the two-day presidential and legislative polls, the third since independence as well as a 1992 peace accord signed in Rome that ended the civil war.

      There are about 3 000 polling stations scattered over 11 provinces and the polls are being monitored by about 400 foreign observers, including former United States president Jimmy Carter, and 1 600 domestic monitors.

      Voters queued up in polling stations ahead of the opening time of 7am (5am GMT) and some were wistful about Chissano's departure.

      Twenty-three-year-old Sonia Mate said Chissano's successor "should continue what Chissano has done in terms of poverty, education, Aids and peace".

      Jamisso Taimo, a former head of the country's National Elections Commission who was among one of the earliest voters, said Mozambican elections were always special given the country's bloody history.

      "All our elections are historical in the sense that in other countries elections are an exercise in democracy but here it's an exercise in democracy and reconciliation."

      And Paulo Mabunda (71) who came to vote in a wheelchair added: "We want to continue to live in peace."

      Chissano became president after the shadowy death of founding president Samora Machel in a 1986 plane crash over apartheid South Africa and unlike some other African leaders, he has not tried to tamper with the Constitution to allow himself a third term.

      The governing Mozambique Liberation Front (Frelimo), a former armed group that fought Portuguese colonial rule and became the ruling party after, has picked rich businessman Armando Guebuza as its presidential candidate.

      Guebuza (61) is locked in a tight race with the main opposition leader Afonso Dhlakama (51) whose former rebel Mozambican National Resistance (Renamo) party was backed by apartheid South Africa and fought Frelimo during the civil war.

      Guebuza on Wednesday promised to fight corruption and red tape and speed up foreign investment to accelerate the economic revival of Mozambique, which heavily depends on foreign aid.

      He also pledged to fight HIV/Aids -- which affects about 1,1-million of the country's 17-million people.

      "If I am elected, my government will accelerate the fight against Aids," he said.

      "People need to have more information about how they can defend themselves from the disease. We also need to make sure that infected people get proper treatment. We also need to look at orphans and widows."

      Although Guebuza is expected to win the presidential race, there is the possibility of a run-off vote with Dhlakama, whose Renamo remains popular in the north and centre despite being blamed for committing some of the worst atrocities during the war.

      Dhlakama -- who lost to Chissano in the last two elections and claimed that victory had been snatched from him through fraud -- has cried foul ahead of the current polls, saying the ruling party was planning widespread rigging.

      But he said on the eve of the elections that he would accept defeat if the polls were conducted in a freely and fairly. - Sapa-AFP


      Long queues in Mozambique polls
      By Dan Isaacs
      BBC News, Maputo

      The people of Mozambique have begun voting in presidential and parliamentary elections.
      After 18 years in power, President Joachim Chissano is stepping down and five candidates are vying for his post.

      In scorching heat long queues formed at polling stations around the country on the first of two days of voting.

      The leading candidates are from two parties which fought a destructive civil war which ended in 1992.

      The winner will inherit a country that has shown remarkable economic progress since the end of the conflict, but remains one of the world's poorest.

      The former rebel movement, Renamo, with its strongest support in central Mozambique, is hoping that leader Afonso Dhlakama can improve on the result of the previous poll, in which the party came very close to winning.

      The candidate for the governing Frelimo party, Armando Guebuza, is banking on the electorate supporting the party that has governed the country without interruption since independence 30 years ago.

      Maintaining peace

      Mr Guebuza has been a government minister in charge of senior posts and is also reputed to be a wealthy businessman.

      His supporters see in him a leader who can be trusted to maintain policies that have brought stability and progress.

      "If we want to maintain peace in this country, to see improvements of the country we should vote Guebuza because for now he's the best we have," said one supporter at a rally in Maputo.

      But despite its impressive overall economic growth over the past decade, the vast majority of Mozambique's population lives in deprived urban areas or in rural isolation.

      Opponents of the government argue that it has failed to address these issues and that it has favoured the southern provinces where the ruling party's support has traditionally been the strongest.

      And despite a largely peaceful election campaign, Renamo leader Afonso Dhlakama has complained of widespread procedural irregularities.

      He has also highlighted the failure of the electoral commission to get ballot papers on time to all 13,000 polling stations around the country.

      The head of the commission, Reverend Arao Litsuri, said any claims put to the commission would be thoroughly examined.

      All the indications are that this is a very close race for the presidency.

      Five years ago, President Chissano won the poll by a margin of just four percentage points over Mr Dhlakama.

      Although recent splits within the Renamo movement may have weakened the former rebel leader's chances, he remains very much in the running.

      The theory is that if he loses, judging by his hostile campaign rhetoric, he is unlikely to concede gracefully.


      Mozambique faces HIV cash dilemma
      By Orla Ryan
      BBC News business reporter in Mozambique

      It is hard to imagine now, but at the peak of her illness Ana Maria Muhai was a skeletal 29 kilos.

      Her husband left her and her neighbours shunned her when they realised she was HIV positive, leaving her struggling to support her six children.

      Now she is full of fighting talk and enthusiasm, fuelled by the knowledge that if she had not found treatment, she would be dead.

      Italian non-governmental organisation Sant Egidio in Maputo treats Ms Muhai with generic antiretroviral drugs (ARVs).

      Sant Egidio was a pioneer of this treatment in Mozambique, where it launched a pilot project in 2001.

      The trickle of money - and interest - in treatment with ARVs has become a flood.

      The Mozambican government is now one of the recipients of US President George W Bush's $15bn Emergency Plan for Aids Relief (Pepfar).

      Pepfar represents a healthy injection of cash into the fight against HIV/Aids. Just as importantly, it is the result of US recognition that action is urgently needed.

      Spending rules

      But Pepfar cash, however welcome, has attracted controversy.

      It comes with restrictions that prevent the purchase of generics - cheaper, copies of brand name drugs.

      Beneficiaries of Pepfar cash are only allowed to buy drugs approved by the US Food and Drug Administration (FDA). This effectively rules out the vastly cheaper generic treatments that Ms Muhai benefited from.

      Avertino Barreto, a director in Mozambique's Ministry of Health and one of the coordinators of the HIV/Aids effort, welcomes the cash, but says the restrictions are unfair.

      With less than $2 per head to spend on drugs, the Ministry's policy has always been to buy generics approved by the World Health Organisation (WHO).

      The health ministry plans to treat 8,000 people with ARVs by the end of this year, using money from its own coffers and from other donors who do not have a problem with the generics. By the end of 2008, it hopes to treat 128,000 people.

      Safe, cheap drugs?

      Mozambique and other recipient countries have their hands tied by Pepfar's conditions.

      Within two years, Pepfar money will account for about 20% of the country's HIV/Aids budget, Mr Barreto says.

      Unless the generics have been approved by the US regulator, Mozambique will still not be able to use the Pepfar cash to buy ARVs.

      Emotions run high when you talk of treatments for Aids, which is estimated to kill about 6,000 people each day in Africa.

      Leading pharmaceutical companies argue that they need to charge higher prices to justify the billions of dollars they spend on research and development, costs which generic drug makers like India's Cipla and Ranbaxy do not have to bear.

      There is also a view that generic drugs are unsafe.

      Pepfar, which falls under the auspices of Randall Tobias, a former Eli Lilly chief executive, questions the safety of some generic treatments and the WHO has withdrawn its approval for some generic treatments.

      Generic drug-maker Cipla, which views the Pepfar ruling as unfair, is currently applying for FDA approval.

      Better use of the cash

      Mr Barreto is among the first to say that money spent on drugs is just one part of the Pepfar story.

      "We are using most of the money available for training," he says.

      "Training doctors, training nurses, people for planning, people for management. ARVs is not a question only of drugs, you need to guarantee the system is functioning well," Mr Barreto says.

      US diplomatic sources in Maputo agree.

      "Drugs are an easy way to spend a lot of money," one official said. "The difficult part is to put the programme in place, training and using the healthcare system."

      He points to the fact that there are only 650 doctors in Mozambique, many hospitals lack regular water and electricity supplies and there are only three labs where your CD4 count (a blood test which indicates whether you need to start taking ARVs) can be tested.

      Mozambique is at a far earlier stage of the HIV epidemic than neighbouring countries. Just 14% of its population has the disease, compared with 40% in neighbouring Botswana.

      This could justify spending more of the Pepfar money on prevention and improved healthcare than on buying ARVs, brand names or generics.

      There is, however, no escaping the importance of treatment.

      "Treatment is a component of prevention," a Maputo-based NGO worker says.

      "When you propose testing and you don't have availability of treatment, you are giving someone a death sentence."


      Mugabe moves against party rivals

      Deep splits have emerged in Zimbabwe's ruling party as delegates gather for the opening of the Zanu-PF congress.
      Seven provincial party leaders were suspended for opposing President Robert Mugabe's choice of a new vice-president, state media reports.

      Controversial Information Minister Jonathan Moyo was also severely reprimanded for campaigning against the nomination of Joyce Mujuru.

      Correspondents say the splits result from a campaign to succeed Mr Mugabe.

      Teenage fighter

      Parliamentary speaker Emmerson Mnangagwa, who had been seen as Mr Mugabe's choice to replace him when he eventually steps down, had coveted the post of vice-president.

      The Zanu-PF provincial chairmen and Mr Moyo had reportedly attended a meeting held to discuss how to block Mrs Mujuru's nomination in favour of Mr Mnangagwa.

      Mr Mugabe reportedly now favours Water Resources Minister Joyce Mujuru, whose husband, retired General Solomon Mujuru, is seen as a kingmaker within Zanu-PF.

      Mr Mugabe, 81, is not thought likely to stand for re-election when his current term of office expires in 2008.

      Mrs Mujuru, 49, a former teenage guerrilla fighter with little formal education, is not seen as a likely presidential candidate.

      She is set to become the first female vice-president of both Zanu-PF and the country.

      Meanwhile, in a BBC interview, Zanu-PF spokesman Nathan Shamuyarira has called for improved relations between Zimbabwe and Britain.


      Zim security police budget to surge


      01 December 2004 07:10

      Spending on Zimbabwe's feared security police is set to surge to Z$395,8-billion ($70,6-million) in 2005, according to expenditure estimates released on Tuesday.

      President Robert Mugabe's government refuses to discuss the operations of the Central Intelligence Organisation. Funding for the shadowy force appears under a "special services" category in the budget for his own office.

      According to figures released Tuesday, spending on special services ballooned in 2004 from an approved Z$62-billion ($11,1-million) to Z$101,6-billion ($16,3-million) without consulting Parliament. No explanation was given.

      Next year, Z$334,5-billion ($59,7-million) is budgeted for special services.

      A separate equipment procurement account for special services is also increasing from Z$10-billion ($1,8-million) -- of which just Z$1,5-billion ($270 000) was spent in 2004 -- to Z$61,3-billion ($10,9-million) in 2005.

      The funds are being used to build training facilities, housing and regional officials, as well as to purchase unspecified equipment.

      Mugabe, who has lead Zimbabwe since independence in 1980, has stepped up a crackdown on descent in this troubled southern African country since losing a constitutional referendum in 2000.

      The surge in spending on the security police comes as Zimbabwe prepares to hold key parliamentary elections next year.

      Human Rights groups accuse Mugabe of using the Central Intelligence Organisation to spy on suspected opponents at home and abroad, intimidate voters and other abuses.

      Parliament is barred from discussing the special services allocations in the annual budget, which regularly increase at a rate in excess of the country's soaring inflation. - Sapa-AP


      WFP to feed 1,6 in Zimbabwe


      01 December 2004 09:41

      The World Food Programme (WFP) confirmed on Tuesday that it plans to expand its support to 1,6-million Zimbabweans during December via its targeted feeding programme.

      WFP spokesperson in Zimbabwe, Makena Walker, said that about 25 000-million tonnes of food aid, left over from its assistance programme last year, would be distributed next month to vulnerable groups, including the chronically ill, child-headed households and the disabled.

      "At the request of the government we will go ahead and increase the number of people under WFP's targeted assistance programme. It is a necessary move because it coincides with the upcoming lean period, when vulnerability increases among the population," Walker said.

      Up to 600 000 beneficiaries received WFP aid between October and November.

      Earlier this year the government decided not to renew an appeal for international food aid and, controversially, cancelled a crop assessment mission by the Food and Agriculture Organisation and WFP, claiming the country would have a bumper harvest.

      Walker said: "So far there has been no indication from the government that they would like us to continue with general distributions."

      A report released by the parliamentary portfolio committee on lands and agriculture last month said the government had seriously miscalculated the size of its grain stocks, and noted that despite a predicted maize production of 2,4-million tonnes, as of 15 October the state-owned commodity buyer, the Grain Marketing Board, had received only 388 558 million tonnes.

      The GMB told the committee that farmers preferred to hold onto their grain stocks rather than sell them to the board. * I-Net Bridge
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