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Africa And The Gates Foundation: Slipping Through The Cracks

By KJ Mullins     Dec 15, 2007 in Health
The Gates Foundation has been making strides in the lives of those who suffer from malaria, HIV and AIDS in Africa. There is a flip side to that coin though. For all the help there are many in need of basic health care. Where are those doctors?
With all the money that has been filtered in to help sufferers of those diseases there has been much less money used in maintaining basic medical needs and equipment in Africa. The staff shortage is at an all time high.
Medicine is getting to those who need it in the fight with HIV/AIDS. The Bill and Melinda Gates Foundation has given $8.5 billion dollars to global health causes. AIDS, Tuberculosis and Malaria have all benefited through the foundation that underwrites, inspires or directs major efforts both to the prevention and the treatment of these ailments. The foundation is also helping in finding cures for these killers of millions of people. Patients who are diagnosed with these horrible illnesses are getting the best in medicine which is a great thing.
For all of this good works though there is a flip side. Newborns are packed into cribs that are filled with sick infants when they are born. A single valve of oxygen is shared among all of them. Each tube costs $35. There is no money for more than one. The money is going to AIDS treatment.
There are now staff shortages in hospitals. The need for specially trained, higher paid clinicians have diverted the already short staffed clinics and hospitals. The shortages have left the children at higher risk for birth sepsis, diarrhea and asphyxia than before the foundation started.
While there is much in the way of treatment and free medicines there are other costs that have been neglected. The cost of transportation and nutrition has been overlooked. Without transport those who could be saved aren't. Without better nutrition some of those getting the free pills vomit them up because there is nothing else in their stomachs.
There are more vaccination programs. The flip side is that caregivers do not discuss the ailments that are not helped by these vaccines. In some areas the only contact with medical personnel for years is the shot clinic.
There are two groups in Africa that get the lion's share of foundation monies. Global Fund and Geneva-based GAVI have received $1.5 billion dollars for their vaccination programs. The Gates Foundation has a seat on each group's board of directors and helps on decision making directly.
Without the money from Bill Gates AIDS would not be leveling off according to Dr. Mphu K. Ramatlapeng. There are more children than ever vaccinated against malaria and measles that remain killers.
Within Africa there are many factors to deal with. Not only is AIDS wiping out many but war and poor governships can stall health care. The use of global medical groups is not always the best route.
With the extra help with the donors some things do improve. Sadly other health care directives suffer because of the focus of so few diseases when so much work needs to be done on the full health care range.
"They can also do dangerous things," Dr. Peter Poore, a pediatrician who has worked in Africa for three decades, is a former Global Fund board member and consultant to GAVI said. "They can be very disruptive to health systems -- the very things they claim they are trying to improve."
The Global Fund, GAVI and the Gates Foundation do acknowledge the gaps within health care in Africa. They are certain that within time those gaps will cease and the overall health care will improve.
The Global Fund is very young," having started in 2002, said its director, Dr. Michel Kazatchkine, a French physician who formerly led France's National Agency for AIDS Research. To see decades of neglect reversed, "wait for two or three more years," he said.
These problems are not new by no means. There has always been a shortage of medical care in the poorest African countries. Even pouring billions of dollars into health care will not overnight change decades of problems. The governments themselves have to change their budgets for more health care related issues instead of money for weapons.
The shortages that are being seen are considered normal. On a recent night at "Queen II" hospital there were three midwives to handle 110 mothers and other infants in addition to the 15 that were born that night. The weakest die. That is normal. There were no doctors on the premises. That is normal.
In Sub-Saharan African nations AIDS has not just claimed the common man. The virus doesn't look at what career path a potential victim has chosen. There have been health care workers whose lives have been lost to the virus adding to the shortage burden. Many other health care workers leave for areas that pay them a decent wage for their work. With the narrow scope of some of the groups it further cuts into the field of workers leaving some areas without anyone to tend to the sick.
The donors don't give money to pay for basic health care workers salaries. They pay for the medicines, the programs, the specialized clinicians. With higher pay for those who go into the AIDS arena the basic caregiver makes less. It makes finical sense to go into AIDS care instead of treating the multiple of other illnesses. In Rwanda a nurse makes $50 to $100 a month for taking care of patients. If they diverse and go into AIDS care they can make upwards of $200 a month. It doesn't take rocket science to know where the majority of nurses veer off to.
"All over the country, people are furious about incentives for ART staff," said Rachel M. Cohen, mission chief in Lesotho for Doctors Without Borders, which operates health facilities in partnership with the government.
Botswana is one country that shows how devastating it can be when only one illness is targeted. In 2000 the Gates Foundation poured in $100 million to combat AIDS. While there are less deaths from the killer now the spread of HIV has continued to spread like wildfire. For all the money that was spent only one in ten know the ways to avoid contracting the disease.
the care for those who did not have HIV/AIDS though suffered. There are more newborn deaths than prior to 2000.
"They have an opportunity to double or triple their salaries by working on AIDS," "They have an opportunity to double or triple their salaries by working on AIDS," Dean James said. "Maybe the health ministry replaces them, maybe not.
"But if so, it is usually with less competent people." said. "Maybe the health ministry replaces them, maybe not.
"
The war on HIV/AIDS may be having an impact but when you have poor nations struggling to have enough food for their population the problems can not be solved.
In some cases the nations AIDS rate is low and yet the funding for that virus is very high. Rwanda is a case in point. The infection rate is at 3% but the groups working with the Gates Foundation are only focusing on three diseases.
"Health delivery systems in Africa are now weaker and more fragmented than they were 10 years ago," said a 2006 report commissioned by the Global Fund and the World Bank. The weakening has been "exacerbated as the Global Fund and other programs now promote universal access to [AIDS] treatment."
The only way a foundation as vast as the Gates Foundation can win is by working on the human support that is needed along with the support for those infected by TB, malaria and HIV/AIDS.
If there is no food the problems will not go away. If there are no doctors for basic needs only those who have a clinic and are infected will be taken care of properly.
"Who chose the human right of universal treatment of AIDS over other human rights?" asked economist William Easterly, co-director of the New York University Development Research Institute, in his book "The White Man's Burden." He added: "A nonutopian approach would make the tough choices to spend foreign aid resources in a way that reached the most people with their most urgent needs."
With the many improvements with the help of the Foundation it is hard to make criticisms. Still there is work to be done to help right the health care situation in Africa. Without help on all health care fronts the good will only be undone in the long run.
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This article received an award from Digital Journal's Editorial Board for outstanding citizen journalism. Every Friday, Digital Journal profiles the top news stories from around the world.
For more details on this award and to find other top-rated articles, check out DigitalJournal.com's TopFinds report.
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