There is need to ensure that the home fund to the HIV pandemic grows. An analyst said there was need to ensure that mechanisms are put in place to create jobs as soon as possible in order to grow the National Aids Trust Fund (NATF) so as to up the Aids Levy.
The Aids Levy ought to be augmented by permanent mechanisms that will see a continuation of treatment in case donor funds decrease. President Emmerson Mnangagwa hit the ground running at the end of November 2017 during his inauguration where he promised job creation to resuscitate the economy.
“Jobs, jobs, jobs . . .,” he called for job creation. When production levels improve tax collections will improve. All employees locally contribute 3 percent to the NATF through corporate tax collected by the Zimbabwe Revenue Authority (ZIMRA).
ZIMRA through Pay As You Earn (PAYE) collects the deduction of 3 percent of taxable income and forwards it to the National Aids Council (NAC). The fund was created through an Act of Parliament in 1999 when the pandemic was declared a national disaster.
In 2016 NAC collected $36 million, a drop from the $38 million collected in 2014. Due to job losses the fund is expected to collect less in the year ending December 2017.
More ways are needed to collect more revenue to the fund. Small-scale miners are expected to formalise operations through registering to the parent ministry. We expect a boost to the NATF coffers from this.
Companies owing ZIMRA must also pay. ZIMRA reported that 15 State enterprises owed it more than $170 million and if these enterprises owned up it will help the fund grow.
The Global Fund, USAID, EGPAF and partners continue to contribute the bulk of ART funding in Zimbabwe. With a total 1,3 million Zimbabweans living with HIV, a total of 850 000 are on antiretroviral therapy (ART) with the balance waiting to be initiated on ART. The domestic fund supports a tenth of the total on ART. Comparing with our neighbours Botswana their reliance on donor fund is minimal.
The Botswana National Aids Co-ordinating Agency (NACA), which falls under the President’s Office, co-ordinates the multi-sectoral response and administers the fund just as our local NAC. The Botswana fund started in 1999 through a directive by the president supports 80 percent of the ART needs. Donors support 20 percent of the needs.
The country has a public private partnership programme where patients on ART and are stable get to be transferred from State hospitals to private doctors. The doctors are given a negotiated fee easing the strain on state institutions.
Laboratories are also paid at the negotiated rate. Viral loads which determine the amount of HIV virus in one’s body are expensive with a test running at $100 locally and out of the reach for many. Less than a quarter of people on public health have undergone a viral load.
A viral load is the gold standard of checking efficacy of medication in one taking ART. Prevention remains the cornerstone to halting new infections.