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AIDS Treatment Gap Widening in Africa

  • Joe DeCapua

The medical aid group – Doctors Without Borders – is warning of “dire consequences” due to a flatlining of international AIDS funding.

The group – also known as MSF – has released a new report called No Time to Quit: AIDS treatment gap widening in Africa. It’s based on an analysis of HIV/AIDS related programs in seven countries: Malawi, Mozambique, Zimbabwe, South Africa, Lesotho, Kenya, Uganda and DRC.

The report says donor countries are “backing away” from their commitments to HIV/AIDS.

Emi MacLean, U.S. director of the Essential Medicines Campaign for Doctors Without Borders, says there are four million people alive today thanks to donor funding for AIDS drugs, known as anti-retrovirals (ARVs). But she says progress could be reversed by a shortage of funds.

“For the past year, we at MSF have become increasingly alarmed by how the HIV/AIDS treatment landscape is shifting. The global Fund (for AIDS, Tuberculosis and Malaria) and the countries that fund it…are all beginning to retreat from their commitments to the global HIV response,” she says.

She says the trend may indicate “going back to a time of more rationed care and treatment.”

Shortfalls

“The Global Fund is facing a severe shortfall in funds to meet the demand, with various countries, including the U.S., announcing a reduction of contributions to the fund. The funding limitations threaten a core principle of the Global Fund – that demand by countries and quality of proposals will drive funding choices,” says MacLean.

The Doctors Without Borders report bases its findings on anecdotal evidence from its teams in Africa.

“Patients are being shuffled around from one clinic to another because of limited treatment slots. There are now new waiting lists; and doctors and nurses facing the agonizing choice of which patients they should treat – a patient who arrives very sick with late stage AIDS or the patient not yet sick, but who needs treatment and will get sick quickly without it,” she says.

MSF teams in Zimbabwe, South Africa and Uganda report HIV infected people are not getting into treatment programs as soon as they should.

“A letter from the U.S. Centers for Disease Control in Uganda to PEPFAR implementing partners suggests that rationing to be ‘the sickest patients, eligible pregnant women, children, pedi (pediatric) HIV patients and family members of persons on ART (anti-retroviral therapy),’” she says.

MacLean says such rationing “moves programs backwards…even though the science and the medical advice is unanimous that treatment should start earlier.”

VOA has requested a response from PEPFAR (President’s Emergency Plan for AIDS Relief) officials to the MSF report.

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