The NYTimes has an article about problems with the Global fund to fight AIDS.

It seems that they checked the books and found some of the money was stolen or diverted, and as a result, a lot of European donors are not giving any more money until the problem is cleared up.

You want honesty at all levels of government so your money will only go to those in need?

Good luck on that, fellahs.

From the NYTimes article:

The Global Fund to Fight AIDS, Tuberculosis and Malaria said on Wednesday that it would stop making new grants until at least 2014 and would bring in a new manager to help administer the fund…

What’s up? Seems like some of that funding got sidetracked.

Several countries, including Djibouti, Mali, Mauritania and Zambia, lost their grants or had new safeguards put in place after officials were accused of stealing. The Global Fund’s own inspector general exposed the fraud and earlier this month was trying to recover about $20 million that had been stolen; that amount is less than 1 percent of the $13 billion that has been disbursed.

Only 1 percent stolen? I doubt it.

Here in the Philippines, the joke is that the bribes are given “over the table, under the table, and with the table”. Some politicians are honest, but gifts to thank someone for their help is part of the system and not considered wrong. The going bribe rate here is 20 percent, but the rule is don’t be greedy (the Broadband scandal resulted in a whistle blower because the bribes/diversion came to 40 percent, and the whistleblower thought it was excessive).

Indeed the terrible Maguindanao massacre here was not religious but political: Which clan would stay in charge of that area and have access to all that lovely development aid money pouring in?

When we worked in Africa, the churches who ran most of the rural hospitals and hospitals tried to keep people honest, but you had to watch that your drugs and supplies didn’t get diverted by the staff.

But not all folks are that honest. A Huffpost article about the problems with the Global Fund has more details. LINK

Much of the money is accounted for with forged documents or improper bookkeeping, indicating it was pocketed, investigators for the Global Fund to Fight AIDS, Tuberculosis and Malaria say. Donated prescription drugs wind up being sold on the black market….

A full 67 percent of money spent on an anti-AIDS program in Mauritania was misspent, the investigators told the fund’s board of directors. So did 36 percent of the money spent on a program in Mali to fight tuberculosis and malaria, and 30 percent of grants to Djibouti.

In Zambia, where $3.5 million in spending was undocumented and one accountant pilfered $104,130, the fund decided the nation’s health ministry simply couldn’t manage the grants and put the United Nations in charge of them. The fund is trying to recover $7 million in “unsupported and ineligible costs” from the ministry.

Yeah, that sounds more like it.

Every once in a while, the press picks up the story of corruption and bribery in religious or health related organizations, and the lay reader might start thinking that every charity is a scam. But fear of bad press coverage over a minor incident leading to the loss of donations is one reason that folks keep quiet. They figure that if  even half of the aid money  manages to get to those who need it, it’s better than no aid at all.

The western idea that more rules and regulations would stop this is not necessarily true: Too much “regulation” leads to no aid in areas where there are not enough people to fill out the forms correctly, and of course, doesn’t stop thieves from faking documents to steal money.

You need a head with “street smarts” to keep the kleptomaniacs under control.

In today’s NYTimes article, you see this sentence:

That panel recommended the appointment of a general manager, who would also report directly to the board, and better assessments of which nations could be trusted not to steal.

No general manager has been named. One person mentioned as a possible American candidate for a leadership job at the fund is Dr. Mark R. Dybul, the Bush administration’s last director of the President’s Emergency Plan for AIDS Relief, who was ousted from that job by Secretary of State Hillary Rodham Clinton when she took office. He seems to have repaired his relationship with her, since he was in the front row at her recent speech on AIDS at the National Institutes of Health.

This is interesting. You see, Dybul’s departure from the US program was pure politics. For the new Obama administration, the head of the President’s Emergency Plan fund had to leave because he dared to point out that condoms and western sex ed to the general population doesn’t work everywhere…

Now, Dybul was a gay activist, not a member of the religious right, but he was street smart enough to recognize that you have to work with the culture to stop the disease. and often this meant not imposing your morality on others.

It is called targeting your message. You can give out condoms to sex workers, but don’t promote western sexual ideas to the daughters of middle class Africans whose morality is a bit different.  For the general population, promoting marriage fidelity (or polygamy/mistresses) and circumcision worked because these practices were culturally traditional.

Condoms are not traditional, especially cheap counterfeit condoms that don’t stretch anc which deteriorate and break in the heat, do not work as well for the general population.

Destigmatizing HIV also helped, as was stressing that HIV is treatable.  (Some tribes had beliefs that sickness, especially a wasting sickness, is often punishment for sin. And unlike the west, the biggest sins are greed or theft and not caring for family members, not necessarily promiscuity, which is not a big sin in most tribes).

However, many people, especially those who attended Churches, opposed the western “safe sex” ideas because these ideas implied that Africans could not control the sexual impulse. Many Africans are horrified at this, since they saw a racist element behind the idea.

Let me give you some background here.

With the imposition of colonialism and modern culture, many of the tribal customs were destroyed.

Often church schools resulted in the educated no longer believing in old rules, but they didn’t believe in the new rules either, especially when they saw the corruption of the colonial powers who claimed to be Christian or Muslim, and the “get rich quick” ideas of  modern capitalism.. Much of the corruption and chaos in these countries come from this loss of a moral sense.

Yet the average person sees the church or mosque as promoting a new and more dignified way of life, and that is one reason for the spread of Christianity and Islam in the post colonial era.

So, although the western ideologues were horrified at what they saw as the influence of the religious right in the Bush program against HIV, they weren’t seeing how cooperating with churches and mosques were actually part of the solution.

Churches and mosques do not only teach “abstinence” or run HIV clinics. They also preach marital fidelity, the dignity of all people, the need for men to respect and protect their family, the dignity of women, honesty in one’s job, non violence, and a lot of other rules that need to be reinforced to reform societies destroyed by colonialism.

Which brings us back to the problem of corruption.

The press loves to point fingers at corruption in charities, whether these be NGO’s or churches and Muslim charities. Yet they are missing the big picture: That without the presence of religion, the corruption and violence would be a lot worse.

So yes, be aware that there is corruption in this program, and seek for ways to stop it or at least limit it. (you can’t jail everyone, and many of the most skilled at doing these things are corrupt. Quick: do you want results with a kickback, or an honest incompetent? ).

In other words, without putting corruption into perspective, the danger is that a flashy overblown headline will cause donations to stop, and more people will die in the long run.


Nancy Reyes is a physician living in the rural Philippines. She has worked in Africa and the US.

A longer version of this was posted at her Xanga Blog.

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