News

    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.
    Comments
         
    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.
    Chinese-Americans Heart Trump, Bucking National Trendi
    X
    May 27, 2016 5:57 AM
    A new study conducted by three Asian-American organizations shows there are three times as many Democrats as there are Republicans among Asian-American voters, and they favor Hillary Clinton over Donald Trump. But one group, called Chinese-Americans For Trump, is going against the tide and strongly supports the business tycoon. VOA’s Elizabeth Lee caught up with them at a Trump rally and reports from Anaheim, California.
    Video

    Video Chinese-Americans Heart Trump, Bucking National Trend

    A new study conducted by three Asian-American organizations shows there are three times as many Democrats as there are Republicans among Asian-American voters, and they favor Hillary Clinton over Donald Trump. But one group, called Chinese-Americans For Trump, is going against the tide and strongly supports the business tycoon. VOA’s Elizabeth Lee caught up with them at a Trump rally and reports from Anaheim, California.
    Video

    Video Reactions to Trump's Success Polarized Abroad

    What seemed impossible less than a year ago is now almost a certainty. New York real estate mogul Donald Trump has won the number of delegates needed to secure the Republican presidential nomination. The prospect has sparked as much controversy abroad as it has in the United States. Zlatica Hoke has more.
    Video

    Video Drawings by Children in Hiroshima Show Hope and Peace

    On Friday, President Barack Obama will visit Hiroshima, Japan, the first American president to do so while in office. In August 1945, the United States dropped an atomic bomb on the city to force Japan's surrender in World War II. Although their city lay in ruins, some Hiroshima schoolchildren drew pictures of hope and peace. The former students and their drawings are now part of a documentary called “Pictures from a Hiroshima Schoolyard.” VOA's Deborah Block has the story.
    Video

    Video Vietnamese Rapper Performs for Obama

    A prominent young Vietnamese artist told President Obama said she faced roadblocks as a woman rapper, and asked the president about government support for the arts. He asked her to rap, and he even offered to provide a base beat for her. Watch what happened.
    Video

    Video Roots Run Deep for Tunisia's Dwindling Jewish Community

    This week, hundreds of Jewish pilgrims are defying terrorist threats to celebrate an ancient religious festival on the Tunisian island of Djerba. The festivities cast a spotlight on North Africa's once-vibrant Jewish population that has all but died out in recent decades. Despite rising threats of militant Islam and the country's battered economy, one of the Arab world's last Jewish communities is staying put and nurturing a new generation. VOA’s Lisa Bryant reports.
    Video

    Video Meet Your New Co-Worker: The Robot

    Increasing numbers of robots are joining the workforce, as companies scale back and more processes become automated. The latest robots are flexible and collaborative, built to work alongside humans as opposed to replacing them. VOA’s Tina Trinh looks at the next generation of automated employees helping out their human colleagues.
    Video

    Video Wheelchair Technology in Tune With Times

    Technologies for the disabled, including wheelchair technology, are advancing just as quickly as everything else in the digital age. Two new advances in wheelchairs offer improved control and a more comfortable fit. VOA's George Putic reports.
    Video

    Video Baby Boxes Offer Safe Haven for Unwanted Children

    No one knows exactly how many babies are abandoned worldwide each year. The statistic is a difficult one to determine because it is illegal in most places. Therefore unwanted babies are often hidden and left to die. But as Erika Celeste reports from Woodburn, Indiana, a new program hopes to make surrendering infants safer for everyone.
    Video

    Video California Celebration Showcases Local Wines, Balloons

    Communities in the U.S. often hold festivals to show what makes them special. In California, for example, farmers near Fresno celebrate their figs and those around Gilmore showcase their garlic. Mike O'Sullivan reports that the wine-producing region of Temecula offers local vintages in an annual festival where rides on hot-air balloons add to the excitement.
    Video

    Video US Elementary School Offers Living Science Lessons

    Zero is not a good score on a test at school. But Discovery Elementary is proud of its “net zero” rating. Net zero describes a building in which the amount of energy provided by on-site renewable sources equals the amount of energy the building uses. As Faiza Elmasry tells us, the innovative features in the building turn the school into a teaching tool, where kids can't help but learn about science and sustainability. Faith Lapidus narrates.

    Special Report

    Adrift The Invisible African Diaspora