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AIDS fight differs in Africa – Basic care wanted, not experiments

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Bristol Meyers has committed $100 million to fight AIDS in southern Africa, but is finding that American rules for nonprofits don’t work well in an African setting, the Wall Street Journal reported July 7.

Wary of government corruption, the pharmaceutical company has chosen to deal directly with individuals, universities, and nongovernmental organizations. This approach has caused problems, however, particularly in South Africa, where government officials felt slighted and became suspicious of the company’s motives.

Another problem was the poor quality of the grant requests Bristol Meyers received when it sent out a call for proposals. Such calls are routine in America, but foreign to Africans.

“People with great ideas had no experience writing a persuasive grant proposal, and, of course, why should they?” public health advocate Audrey Kgosidinsti asked the Journal.

In the end, the company funded only two programs in its first round of funding and had to seek a second round of proposals in its first year.

The company was also surprised to find that Africans are more interested in basic health-care services, such as education and pre-natal care for infected mothers, than in experimental studies. Debbie Matthew, head of the AIDS Foundation of South Africa, told Bristol-Meyers staffers they were making a mistake in putting their money into scientific projects and physician exchanges.

“Very little of the money is going into community programs, where real change must take hold,” Matthews said.

Mark Ahn, the manager of the company’ s donation program, says the company is learning to listen.

The greatest lesson, he says, has been giving up “some control, being humbled by the magnitude of the problems and learning to let people tell us what they want and how things should be done.”

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