South African health minister Manto Tshabalala-Msimang this week highlighted the need for improved management of existing state resources when she attributed the rollover of about US $10 million in HIV/AIDS money to poor governance at provincial and local level.
According to news reports, the National Treasury found that the department of health had failed to spend about R67 million (US $10 million) of the R1.1 billion (US $165.3 million) HIV/AIDS budget in the 2004/05 financial year.
Nevertheless, finance minister Trevor Manuel announced last week that he would increase the Comprehensive HIV/AIDS grant to R1.5 billion ($225 million) in the next financial year and to R1.7 billion (US $255 million) in 2008/09.
Nhlanhla Ndlovu, manager of the HIV/AIDS budget unit at the Institute for Democracy in South Africa (IDASA), told PlusNews that the under-expenditure was related to implementation of the national treatment programme.
"Most of the systems were not in place before [the money was] allocated, so the department of health was struggling to use this money without these systems," he said.
In a report analysing HIV/AIDS expenditure in the mid-term budget, Ndlovu noted that the bulk of the money had not been spent because of the slow rollout of the treatment plan.
Inadequate infrastructure and insufficient human resources at provincial level, as well as a slow national drug procurement process, had hampered the free distribution of antiretroviral (ARV) medication in the public healthcare sector.
Ndlovu called for "bottlenecks" affecting the delivery of the ARV plan to be given "urgent attention" to ensure that funds were spent efficiently.
He stressed the need for the establishment of financial tracking systems to monitor provincial health expenditure. "The national government should take a step to assess the provinces that are underspending and to provide them with necessary support," the report said.
The department of health issued a statement saying the unspent millions were earmarked for setting up a centre for multidrug resistant tuberculosis (TB); a tracking system to monitor the distribution of ARVs; and an outstanding payment for a one-month supply of condoms delivered in March.