On a Saturday afternoon outside the Tanzanian capital, dozens of HIV positive men, women and children trek miles toward an HIV clinic that used to provide them with meds but now offers only support groups and testing. The clinic is run by WAMATA, the oldest HIV organization in the AIDS-ravaged East African nation.

The thatched roof under which the travelers finally gather for their weekly meeting seems worlds away from the sleek Swiss offices of the Global Fund to Fight AIDS, Malaria and Tuberculosis. But it is at clinics like this one throughout the world that the paltry Fund commitment from wealthy countries—so far just $200 million of the $1.1 billion budgeted for 2007—is most acutely felt.

In the late 80s, when Theresa Kaijage founded WAMATA—the Swahili acronym for People in the Struggle Against AIDS in Tanzania—“There was a policy of silence” in Tanzania about HIV, she recalls. “I knew I needed to start a support group where people could talk about their diagnosis.” The organization quickly grew, and in 1990 Kaijage set up WAMATA’s Dar es Salaam clinic to provide Tanzanians with medical care and treatment along with support. The center currently has about 1,000 positive clients who visit regularly.

There are now WAMATA clinics all over the country, but they stopped offering meds in late 2005 when AIDSETI, the U.S.-based nongovernmental organization that WAMATA relied on, lost funding. Neither the Tanzanian government nor any other international organization has stepped in since.

“People already walk over ten kilometers just to get here,” says the clinic’s executive director, Barabona Thomas Mubondo, when asked about the wisdom of perhaps sending people elsewhere in search of scant meds.  

Government official Amani Karume acknowledges that Tanzania needs to treat its own people but says the government cannot provide HIV meds unless it can rely on consistent outside funding from the Global Fund or other sources. “There should be much more commitment from the developed world, and America should lead the way,” he says. “They have the resources, the people and the technical know-how.”

Adds Global Fund spokesperson Jon Liden, “Our goal is to provide recipients with predictable, long-term financing. Hopefully, this will happen within a few years.”