Lagging Funding From U.S., Other Countries Threatens HIV/AIDS Progress, Doctors Without Borders Says

Main Category: HIV / AIDS
Also Included In: Aid / Disasters;  Tuberculosis;  Tropical Diseases
Article Date: 10 Nov 2009 - 2:00 PDT

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Global economic problems and other factors have slowed public health funding from the U.S. and other international donors, threatening recent gains in providing antiretroviral drugs to people with HIV/AIDS in developing countries, according to a new report by Doctors Without Borders, the Washington Post reports.

The President's Emergency Plan for AIDS Relief, launched by President George W. Bush, now pays for antiretrovirals for more than two million people. Because the drugs must be taken for life, some experts feel the launch of PEPFAR essentially committed the U.S. to indefinite funding. According to the DWB report, after years of expansion, PEPFAR has leveled off, and less money is now dedicated to treatment. Although President Obama pledged to increase the plan's funding during his 2008 campaign, it has remained about level since he took office. The report found that strained financial support is undermining progress made against HIV/AIDS in countries such as Uganda, where clinics are now refusing new patients or accepting them only after others have died.

Funding cuts also are affecting the Global Fund To Fight AIDS, Tuberculosis and Malaria, which distributes almost 25% of all HIV/AIDS donor money, the report found. The fund's main contributors -- the U.S. and European countries -- have cut approved grants by 10% and are considering canceling a 2010 funding round, according to the report.

U.S. officials have said that they remain committed to programs such as PEPFAR but that the current economic situation means they must concentrate on sustaining initiatives rather than expanding them. Eric Goosby, the U.S. global AIDS coordinator, wrote in an August letter to U.S. ambassadors, "The landscape around us is changing, with the need to balance a broad portfolio of global challenges at a time of financial crisis," adding, "As a result, we need to plan for the next stage of PEPFAR's development in this context and cannot assume the dramatic funding growth of PEPFAR's early years will be repeated."

The report authors' indicated that continued expansion is critical to fulfilling a pledge by the world's wealthiest nations of providing universal access -- defined as 80% of the population -- to antiretroviral medication. Tido von Schoen-Angerer, director of DWB's Campaign for Access to Essential Medicines, said, "The donors, I think, are getting cold feet about committing to a long-term, chronic disease." Although DWB officials acknowledged the difficult economic climate, they said that "political" motivations are also causing funding withdrawals. They criticized intensifying claims by public health researchers that a disproportionate amount of global health funding goes toward HIV/AIDS treatment at the expense of lower-cost treatments for more deadly illnesses. "Some policymakers say AIDS is expensive, we should focus on cheap and easy things," von Schoen-Angerer said. However, he added, "This cannot be an either-or game. ... It's not that HIV is overfunded. Global health is underfunded" (Brulliard, Washington Post, 11/6).

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