Integrated Regional Information Networks - November 5, 2009

On 14 October dozens of people living with HIV organized a sit-in in front of the World Bank building in the capital Nouakchott to draw the Bank's and the international community's attention to their situation.

"By suspending their programmes without consulting us, donors have not taken our distress into account," Fatimata Ball told IRIN/PlusNews. Ball represents people living with HIV at the SENLS (the national AIDS committee) Executive Secretariat, the government body implementing Global Fund and World Bank programmes.

"We, people living with HIV, did not bring about these problems, so should we suffer the consequences?" she added. "The reason donors give millions to Mauritania is that we are a poor country. They gave us hope of a second life when we had given up on that hope; they should not drop us."

US$21 million of World Bank funding through 2009 was suspended in August 2008 following the military coup against President Sidi Mohamed Ould Cheikh Abdallahi.

Shortly afterwards the Global Fund suspended HIV/AIDS funding, $15 million over five years which was granted in 2006, following suspected irregularities in grant management. An audit in September 2009 confirmed "embezzlement" had occurred, which led the World Bank also to carry out an audit.

In accordance with the Global Fund's terms for reinstating funding the new government, named in September following June presidential elections, began proceedings against four SENLS members suspected of being involved in the embezzlement. The State has also promised to return $1.7 million to the Global Fund and to provide supporting documents on the use of a further $2 million. Finally, the government has also committed to re-structuring the CCM (Country Coordinating Mechanism), the country's Global Fund funding management body; weakness of the CCM is seen as contributing to the problems.

Commitments

While SENLS members recognize the problems that have occurred over the last few months, they are convinced that the new government is keen to resolve the situation as quickly as possible. "The State has made a strong commitment to clearing up the situation. We asked the state general inspectorate to carry out audits and they are now underway," Ahmed Aida, the recently appointed interim SENLS national executive secretary, told IRIN/PlusNews.

"Corrective measures have been taken to ensure things go smoothly in the future. We need [partners] to join us," he urged.

In the meantime SENLS wants to ensure that medical care and support issues are addressed. "The government is willing to take responsibility for treatment," Aida said. In theory, access to treatment is safeguarded under a law introduced in 2007.

The Global Fund have said they are aware of the government's commitment and will do all they can to limit the impact the suspension has on people living with HIV. "We are 100 percent committed not to break up treatments and we will do whatever we can ... to continue the grant," Jon Liden, Head of Communications at the Global Fund in Geneva, told IRIN/PlusNews.

"There is a difficult situation [because of] corruption... but the Global Fund is very committed to continue working in the long term to re-establish a way to deliver services in a safe and predictable way, and to expand them as planned," he added.

The World Bank reaffirmed it is keen to clear up the situation as quickly as possible, but also that they are available to help people living with HIV overcome this crisis.

"We are aware of the urgent nature of the situation and we continue to look after the sick," Francois Rantrua, World Bank representative in Mauritania, told IRIN/PlusNews. In terms of care and support for new patients, "we are well on our way to finding a very short-term funding solution," he added.

While Global Fund-financed HIV/AIDS programmes have been suspended this has not affected patients who were already on ARVs before the irregularities were discovered - just over 1,000 people have continued to receive their medication; but it has not been possible to add any new patients (totalling around 40 people a month) to the treatment programme.

And other activities in the fight against AIDS funded as part of these programmes have also come to a standstill, such as prevention activities and support (psychological, socio-economic) for people living with HIV.

"We are not against [donors] checking [the accounts] because this will make our lives more secure", said Ball. "But what is affecting us is that things stopped so suddenly. If we had had some warning we would have been able to mobilize to find other solutions. We are already suffering due to AIDS; we don't want to be victims of procedures too."

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