MSF Alarmed Over Plans to Cut US AIDS Program

    Blood is tested at the AIDS Care Training and Support Initiative (ACTS) at White River Junction, South Africa. The center is partly funded by the President's Emergency Plan for AIDS Relief (PEPFAR), December 2008 photo
    Blood is tested at the AIDS Care Training and Support Initiative (ACTS) at White River Junction, South Africa. The center is partly funded by the President's Emergency Plan for AIDS Relief (PEPFAR), December 2008 photo

    Medical aid organization Doctors Without Borders is concerned that proposed budget cuts to a U.S. program for HIV treatment around the world threatens the progress being made against the pandemic in Africa.  

    On World AIDS Day in December, U.S. President Barack Obama announced that the United States would aim to treat six million people infected with HIV around the world by the end of 2013 - two million more than the previous target.

    The organization responsible for the outreach will be the President's Emergency Plan for AIDS Relief, better known by its acronym PEPFAR.

    But while Mr. Obama has pledged to expand PEPFAR to include more people, his budget proposal for the fiscal year 2013 cuts more than a half-billion dollars from the program, about 13 percent of its current funding.

    Doctors Without Borders, known by its French acronym MSF, has raised the alarm over the proposed cut, saying it will undermine the president's own goals.

    Jennifer Cohn, the East Africa policy advisor for the MSF Access Campaign, said she is concerned that countries that receive PEPFAR support may begin scaling back their own treatment programs in anticipation of the cuts.

    “In terms of the budget shortfall, I think many problematic things might occur as a result of that, including decreases in treatment, decreases in other sorts of support, and then, sort of a chilling effect on country guidelines themselves,” said Cohn.

    Budget figures outlined by MSF show some major reductions in Africa, including a nearly 50 percent cut in funding for Kenya and 82 percent for Ethiopia.

    In a post on the official State Department blog in February, U.S. Global AIDS Coordinator Eric Goosby wrote that the administration is “freeing up resources by reducing programs in countries with a lower HIV prevalence,” specifically mentioning Ethiopia.  He also said the program in Kenya had “matured” and that it was adjusting the country's funding to reflect a new focus on local implementation.

    Proposed cuts not final

    PEPFAR senior advisor Tom Walsh said all the budget figures being discussed are preliminary and that some of the country figures are certain to change.

    Still, he emphasized that PEPFAR has made dramatic gains in efficiency, and that the budget requested for 2013 is the amount needed.

    “Over the years, we've gotten the cost of treating an individual person per year with antiretroviral therapy down from about $1,100 in 2004 to $335 in 2011," said Walsh.. "That kind of dramatic gain in efficiency, in reaching more people with the resources available, is what Congress likes to see and we think we're going to make continued progress on that front.”

    The president's budget proposal needs the approval of the U.S. Congress. Walsh said PEPFAR has always received strong bipartisan support.

    MSF is not only concerned about the budget numbers, but also with some of the program's accounting methods.

    Cohn said the way PEPFAR counts the number of people receiving treatment can be misleading.

    “What we're finding is actually that whereas PEPFAR is not necessarily directly supporting people on treatment in certain countries, they're actually counting those people toward the 6 million people they promise to put on treatment by 2013, so we find that concerning and somewhat disingenuous,” said Cohn.

    Cohn's concerns are highlighted in a U.S. report from earlier this year on PEPFAR's programming in Malawi.

    In the document, PEPFAR outlines the support it provides in the country, such as funding staff for visits to treatment sites, training service partners and developing an electronic data system. Nowhere does it say the U.S. provides antiretroviral medication (ARVs) for patients.

    But, in the “Recommendations” section of the document, the authors suggest that all HIV-infected adults receiving treatment in Malawi's national program should be reported as “directly supported” by the U.S. government.

    Tom Walsh for PEPFAR could not confirm that this accounting practice is common, and said the methods vary based on the arrangements in each individual country.

    He said the U.S. supports a variety of services, and treating HIV is about more than just providing drugs.

    “ARVs are an important part of treatment, but also important is the infrastructure to deliver the drugs, support for the clinics, training for the health providers who do the work," said Walsh. "In every country there's a different combination of resources that it takes to deliver treatment.”

    Partnering against HIV/AIDS

    The United States is increasing its reliance on partners in treatment programs, one of the biggest being the Global Fund to Fight AIDS, Tuberculosis and Malaria.

    Walsh points out that responsibilities for HIV programs around the world are divided up between partner organizations.  So, PEPFAR may pay for training and infrastructure, while the Global Fund or the host government buys the medication.

    Despite scaling back PEPFAR, President Obama's 2013 budget request includes an increase of $350 million for the Global Fund.

    But that increase does not make up for PEPFAR's cuts.  If the budget is approved as is, the net decrease for AIDS funding would be about $213 million.

    This forum has been closed.
    There are no comments in this forum. Be first and add one

    Featured Videos

    Your JavaScript is turned off or you have an old version of Adobe's Flash Player. Get the latest Flash player.
    Tensions Rising Ahead of South China Sea Rulingi
    May 03, 2016 5:16 PM
    As the Philippines awaits an international arbitration ruling on a challenge to China's claims to nearly all of the South China Sea, it is already becoming clear that regardless of which way the decision goes, the dispute is intensifying. VOA’s Bill Ide has more from Beijing.

    Video Tensions Rising Ahead of South China Sea Ruling

    As the Philippines awaits an international arbitration ruling on a challenge to China's claims to nearly all of the South China Sea, it is already becoming clear that regardless of which way the decision goes, the dispute is intensifying. VOA’s Bill Ide has more from Beijing.

    Video Painting Captures President Lincoln Assassination Aftermath

    A newly restored painting captures the moments following President Abraham Lincoln’s assassination in 1865. It was recently unveiled at Ford’s Theatre in Washington, where America’s 16th president was shot. It is the only known painting by an eyewitness that captures the horror of that fateful night. VOA’s Julie Taboh tells us more about the painting and what it took to restore it to its original condition.

    Video Elephant Summit Results in $5M in Pledges, Presidential Support

    Attended and supported by three African presidents, a three-day anti-poaching summit has concluded in Kenya, resulting in $5 million in pledges and a united message to the world that elephants are worth more alive than dead. The summit culminated at the Nairobi National Park with the largest ivory burn in history. VOA’s Jill Craig attended the summit and has this report about the outcomes.

    Video Displaced By War, Syrian Artist Finds Inspiration Abroad

    Saudi-born Syrian painter Mohammad Zaza is among the millions who fled their home for an uncertain future after Syria's civil war broke out. Since fleeing Syria, Zaza has lived in Lebanon, Egypt, Jordan and now Turkey where his latest exhibition, “Earth is Blue like an Orange,” opened in Istanbul. He spoke with VOA about how being displaced by the Syrian civil war has affected the country's artists.

    Video Ethiopia’s Drought Takes Toll on Children

    Ethiopia is dealing with its worst drought in decades, thanks to El Nino weather patterns. An estimated 10 million people urgently need food aid. Six million of them are children, whose development may be compromised without sufficient help, Marthe van der Wolf reports for VOA from the Metahara district.

    Video Little Havana - a Slice of Cuban Culture in Florida

    Hispanic culture permeates everything in Miami’s Little Havana area: elderly men playing dominoes as they discuss politics, cigar rollers deep at work, or Cuban exiles talking with presidential candidates at a Cuban coffee window. With the recent rapprochement between Cuba and United States, one can only expect stronger ties between South Florida and Cuba.

    Video California Republicans Weigh Presidential Choices Amid Protests

    Republican presidential candidates have been wooing local party leaders in California, a state that could be decisive in selecting the party's nominee for U.S. president. VOA's Mike O’Sullivan reports delegates to the California party convention have been evaluating choices, while front-runner Donald Trump drew hundreds of raucous protesters Friday.

    Video Kurdish Football Team Helps War-Torn City Cope

    With the conflict still raging across much of Turkey’s predominantly Kurdish southeast, between the rebel PKK and the Turkish state, many Kurds are trying to escape the turmoil by focusing on the success of their football team Amedspor in Diyarbakir. The club is increasingly becoming a symbol for Kurds, not only in Diyarbakir but beyond. Dorian Jones reports from southeast Turkey.

    Video ‘The Lights of Africa’ - Through the Eyes of 54 Artists

    An exhibition bringing together the work of 54 African artists, one from each country, is touring the continent after debuting at COP21 in Paris. Called "Lumières d'Afrique," the show centers on access to electricity and, more figuratively, ideas that enlighten. Emilie Iob reports from Abidjan, the exhibition's first stop.

    Video Florida’s Weeki Wachee ‘Mermaids’ Make a Splash

    Since 1947, ‘mermaids’ have fascinated tourists at central Florida’s Weeki Wachee Springs State Park with their fluid movements and synchronized ballet. Performing underwater has its challenges, including cold temperatures and a steady current, as VOA’s Lin Yang and Joseph Mok report.

    Video Somali, African Union Forces Face Resurgent Al-Shabab

    The Islamic State terror group claimed its first attack in Somalia earlier this week, though the claim has not been verified by forces on the ground. Meanwhile, al-Shabab militants have stepped up their attacks as Somalia prepares for elections later this year. Henry Ridgwell reports there are growing frustrations among Somalia’s Western backers over the country’s slow progress in forming its own armed forces to establish security after 25 years of chaos.

    Video Nigerians Feel Bite of Buhari Economic Policy

    Despite the global drop in the price of oil, Nigerian President Muhammadu Buhari has refused to allow the country's currency to devalue, leading to a shortage of foreign exchange. Chris Stein reports from Lagos businessmen and consumers are feeling the impact as the country deals with a severe fuel shortage.

    Special Report

    Adrift The Invisible African Diaspora