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AIDS: Will Funding Levels Limit Treatment?

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Joe DeCapua

Next week, donor nations will announce how much money they’ll pledge to the Global Fund to Fight AIDS, Tuberculosis and Malaria.  Activists and NGOs say $20 billion is needed to replenish the fund and expand its grant programs.  But many believe it’s unlikely donors will pledge that amount.

What’s at stake

“We’re kind of at a crucial moment in terms of the fight against HIV,” says Jen Cohn, HIV policy adviser for the medical aid group Doctors Without Borders.

“There’s been a lot of new research that has shown that treatment for HIV can not only vastly improve the lives and decrease morbidity and mortality for those with HIV, but it can actually also have population effects in that it prevents transmission of HIV from one person to another.”

About a year ago, the World Health Organization issued new guidelines saying it would be better to treat HIV-infected patients much earlier.  In other words, put them on anti-retroviral drugs long before their immune systems collapse due to a lack of CD-4 cells.  Studies show earlier treatment does a better job of extending lives, as well as improving the quality of life.

The WHO guidelines also recommend the use of less toxic but very effective drugs to keep the virus in check.

“However, doing this means that more people will be on treatment.  And the newer treatments, while they’re much better tolerated…are somewhat more expensive,” she says.

$20 billion – how likely?

As for next week’s donations, Cohn says, “We continue to be hopeful that the donor nations will realize the importance of this current round of grants and the future rounds of grants that the global fund will be giving in order to reach goals like universal access and use treatment as prevention.”

But being hopeful is far from being certain.

“I am very concerned that donations from wealthy countries to the Global Fund will not even reach a level of $13 billion that the Global Fund says it needs to basically just keep its doors open and continue existing grants, without significantly scaling up or being able to fund new, more ambitious grants,” says Cohn.

G8 nations

The Doctors Without Borders HIV policy adviser says, “Countries such as France and Japan have actually announced their donations.  Their donations are a modest increase from previous years.”

Tuesday was the Global Day of Action for activists, NGOs and others to call attention to the funding issue.  In South Africa, for example, demonstrations were held at the German and Italian embassies.  Germany and Italy have not officially announced their latest global fund donations.

“But we suspect they’re going to be drastically decreasing their donations from previous years.  And in fact there has been a preliminary announcement that Germany may give just $200 million in FY11 (fiscal year 2011) but then not actually contribute anything in fiscal years ’12 and ’13,” she says.

Germany is the third largest donor to the Global Fund after the U.S. and France.

“Italy has not yet paid its promise from last year,” says Cohn.  “And we don’t expect them to put in a significant or any contribution for this current replenishment.”

She calls funding from the United States “crucial,” adding, “The U.S. really needs to set the tone and lead the way with a bold contribution.”

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