Lack of political will threatens AIDS funding Living with AIDS # 412
Universal access to antiretrovirals in poor countries is under threat as donors reduce funding for AIDS programmes, warns Medecins Sans Frontieres (MSF).
According to the MSF’s recent report, titled ‘Punishing Success? Early Signs of a Retreat from Commitment to HIV/AIDS Care and Treatment’, funders’ commitment to supporting AIDS treatment for people in poor countries is waning. The report largely focuses on two of the world’s foremost programmes that support AIDS treatment. They are the Global Fund to Fight AIDS, TB and Malaria and the US President’s Emergency Plan for AIDS Relief (PEPFAR).
‘Last year, in 2008, the Global Fund approved Round 8 Proposals. Unfortunately, because of lack of funding the Global Fund had to cut already approved proposals by $1.5 billion’, said Sharonann Lynch, policy adviser for MSF’s Campaign for Access to Essential Medicines.
‘Another case in point (is) PEPFAR. In Uganda, currently, PEPFAR-supported facilities have been told that they must suspend treatment for new patients in need. Some are doing what they can and, at least, putting pregnant women on treatment or the very sick on treatment or people who have TB-HIV co-infection. Others have been told that they can only put new people on treatment if someone dies that is currently on ARVs, thus freeing up a space, a slot if you will, or if someone is lost to follow-up. None of that is good news’, Lynch continued.
‘In South Africa, PEPFAR-supported facilities are ‘ from what we understand ‘ referring patients in need of treatment that have yet to be started on ARVs to other facilities’, she said, speaking of the devastation already being caused by the reduction of funding.
The Global Fund relies heavily on individual governments and business for its funding. At its board meeting this week, it has to decide whether it has sufficient money to support proposals for Round 9 of applications. Already there is talk that funding for this round will be reduced by $1 billion. The board may not call for new rounds of applications next year. If it decides not to due to lack of funding, it will be a historic event. It will be the first time that it has not provided financial support in a given year. PEPFAR, on the other hand, is a programme funded by the United States’s government.
According to the United Nations’ AIDS agency, UNAIDS, the Global Fund and PEPFAR have put a combined total of 2. 95 million people around the world on ARVs by the end of last year. But they are not the only ones going back on their commitments.
‘The UK had led the charge for there to be unanimous support for universal access to treatment within the Group of 8 wealthy countries, which was then endorsed by the UN General Assembly in 2005 and 2006. Now the UK is switching gears, shifting its funds elsewhere and their political spotlight elsewhere. The Netherlands, which has been one of the strongest supporters for funding HIV/AIDS treatment, are considering a 30% reduction next year in their funds. France as well is considering a reduction in HIV funding’, said Lynch.
This reduction of funding will negatively affect the more than five million people in developing countries estimated to need ARV treatment, but who cannot afford it and whose governments do not have the capacity to provide it to them.
In 2005, the international community committed itself to universal access to treatment by the year 2010. This commitment was preceded by the formation of the Global Fund in 2002 and PEPFAR in 2003. It’s immoral that these commitments are now not being stuck to, said Dr Tido von Schoen- Angerer, Director of the MSF’s Campaign for Access to Essential Medicines.
‘There’s a dirty secret here, I think. It is that the donors are getting cold feet about commitment for a long term’¦ a chronic disease. As a medical humanitarian organisation, we see that there is today a betrayal of commitments that were only made a few years ago. Slowing down what is finally starting to work would be really punishing success. We need the sustained increased funding for HIV/AIDS and it’s possible to plan it. We know we will be faced with the AIDS epidemic, at least, for another 30 years’, von Schoen-Angerer said.
While the world is facing tough economic times, he argues that money is not the real issue why AIDS funding is being reduced.
‘Many economists actually think it will be possible to fund global health at adequate levels. It’s of course at a time of a financial crisis that the poorest countries are hit the most ‘ and not only at country level, but also individuals. Actually, more support is needed for the poorest at times of crisis. It has to be put in perspective: In the European Union, $1 billion is spent a day on agricultural subsidies, and you’re telling us there is no money to fund global health where people are dying? This is an excuse. I think the funding is possible. It’s an issue of political will’, von Schoen-Angerer said.