Rich nations taking health away from poor Living with AIDS # 434

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Eight countries in sub-Saharan Africa are grappling with the consequences of reduced funding for AIDS treatment. Five are already in urgent need of emergency antiretroviral supplies. Malawi, Zimbabwe and the Democratic Republic of Congo in southern Africa and Kenya and Uganda in east Africa are experiencing drug stock-outs and, consequently, patient treatment interruptions. This is because major donor nations and organisations are either capping, reducing or withdrawing their support for AIDS treatment programmes.

‘The Global Fund, a multi-lateral fund that was initially foreseen to have about $ 10 billion annual budget to fund HIV, TB and Malaria now has an annual pledge of about $3 – $3.5 billion. Nevertheless, there are 117 countries that get HIV grants from the Global Fund and they support about 2.5 million people on treatment. The Global Fund faces a serious short-fall and the donors to the Global Fund who are supposed to keep up the levels of funding for the Global Fund to provide grants to the countries are not stepping up their contributions. The US Emergency Programme for HIV and AIDS have kept their budget at the 2009 level around $6 billion, including their contribution for the Global Fund. And it is proposing to include other activities like the training of health workers (and) more capacity building. But the problem is that it is with the same amount of money over a longer period of time. PEPFAR is very important for treatment. There are about 2.4 million people that are supported by them’, says Dr Mit Phillips, health policy analyst for the MSF.

The Global Fund to fight AIDS, TB and Malaria and Pepfar are just a few in a list of funders who are either reducing or withdrawing their support for AIDS treatment programmes. Details of this are contained in a new report by humanitarian medical aid agency Medecins Sans Frontieres (MSF) titled ‘No Time to Quit: HIV/AIDS Treatment Gap Widening in Africa’.

Chairperson of the Treatment Action Campaign, Nonkosi Khumalo, fears that the trend will reverse what Africa has been able to achieve in its response to AIDS over the last decade.

‘The hope that was there before is diminishing again. We look like fools once again. There would be a complete collapse of health care systems, which the donors are saying ‘we’re not going to fund HIV, TB and Malaria, we want to fund health systems’. I don’t know how you define health systems if you’re going to build all these beautiful hospitals that would accommodate people that are dying. Many people will die of AIDS. Failure of treatment programmes will have negative impacts on prevention. What we know already is there are three million more infections every year in the sub-Saharan region. So, for every person we put on treatment there are new infections, but there will be more infections when people are not on treatment. What we are basically doing is rubbishing the gains of the past’, she said.

MSF Clinical Director Dr Eric Goemaere, said the waning support by donors was a ‘moral betrayal’. Goemere reminded donors that they had made a commitment to support AIDS programmes in poor countries.

‘In 2005 you had the G8 meeting in Gleneagles and they committed for universal access to treatment. What they said there’¦ If countries can provide the service, we’ll provide the funding. It was clearly said. It was written. Some years ago the message to governments in the region was unambiguous. They were told: ‘We want to see ambitious targets and we want to see an impact. We’ll follow you with the money’. Today the message has changed. If this trend is confirmed, I would call it a moral betrayal’, he said.

Advocacy groups including the Treatment Action Campaign and Section 27, formerly known as the AIDS Law Project, are planning to stage a march to the US Embassy in Johannesburg to protest against the moral betrayal. They maintain that rich nations have made a long-term political commitment to support people living with a life-long condition, which requires life-long treatment.