Thursday, June 24, 2010

Revolving Drug Funds

A revolving drug fund works like this: AIDSfreeAFRICA donors donate the initial amount of money needed that enables AIDSfreeAFRICA to buy a substantial amount of medicine, supplies and laboratory reagents and diagnostic tests. This is given to a small rural clinic that so far operated with few drugs and often no doctor. The clinic now treats patience who pay for the service and treatment. Every week small amounts of money is deposited in a bank account controlled by AIDSfreeAFRICA. When the money in the bank reaches an agreed level and AIDSfreeAFRICA founder Dr. Rolande is visiting, she takes the money and buys more drugs and supplies. The fund generates more money that what is required to keep the fund liquid, thus salaries can be paid more reliably, small improvements can be undertaken and most important the patience come to a clinic that can do more than just talk to them.

Imagine, a child five years or younger contracting Malaria - a very common occurrence - will die within 3 days if the proper treatment is not initiated. Imagine to visit a clinic without malaria drugs in the pharmacy. Imagine mother and child now need to hire transport and travel to the next hospital which may be hours away and if it has medicine you can bet that the waiting time to see a health care provider is long.... 

Our first established revolving drug fund with the Cameroonian Christian Welfare clinic in Limbe is showing success. Leading the clinic is Polycarp Nji, left in the picture with his daughter and relatives taken in his native village Esu. Back in Limbe before the revolving drug fund I saw hardly any patient at all. Now six month later at any given time I showed up there where patients on drips occupying the 12 beds and being treated. About half of the drug we had supplied had been used and paid for by patients.

We thank Alfred Schwendtner and his wife Carole, both members of Servas a international peace organization for helping us to establish the fund with a generous donation. You can not imagine how many peoples lives have been saved and will be saved.

But the before and after picture shows the difference, first a few packages in the hospital pharmacies shelves monitired by John Laluh and the next picture four boxes (one shown) with drugs and supplies arrive.



AIDSfreeAFRICA's projects are all designed to be income generating and perpetual. For this design we reached the semifinals in the 2009 Buckminster Fuller Design Challenge Every year the finalist of this challenge receives a $100,000 US$ award. However, we also have to keep an eye and strict control over these projects. Persistent poverty and living permanently on the edge of an emergency together with access to money, especially cash creates situations where money is easily misappropriated. Of course often we are dealing with outright theft, but where theft is not a problem it is our responsibility to avoid to create temptations. I recommend everyone dealing with African humanitarian projects not to wire money and not to give cash - the temptation is too big, the pressure from begging and deserving friends in need too large to resist. Believe me we speak from experience.

It is also not enough to reward projects well done. We have implemented a double strategy: reward good behavior, severely punish wrong doing. The key is that the punishment has to be figured to really impact the people who run the projects. It has to have teeth. In a society where suffering and uncertainty is a fact of life the definition and type of punishment has to be closely examined and adjusted to the situation.

Non-profits have poured too much money into the hands of people who abuse our generosity. it is time to ask for accountability and to set strict rules. Zambian native and Columbia University professor Dambisa Moyo put is all into her book: "Dead AID, why AID is not working and how there is a better way for Africa." AIDSfreeAFRICA agrees fully with her assessments and recommendations.




 

No comments: