Bill Gates says in these tough economic times, more efficiency is needed in HIV/AIDS treatment and prevention programs. At the same time, he says more people need to be on anti-retroviral drugs. The billionaire philanthropist spoke Monday at the 18th International AIDS Conference in Vienna.
As global economies faltered, many donor nations scaled back the size of their increases in AIDS spending. Critics say the flatlining in funding comes at a time when great progress is being made in the epidemic. Gates says he’s disappointed in the funding levels.
“The turbulence has driven up government deficits and many countries responded by freezing or even reducing their investments in global health. We have to do everything we can to change that,” he says.
The Microsoft founder and co-founder of the Bill and Melinda Gates Foundation says when it comes to HIV/AIDS, he’s still very much an optimist.
“This decade saw remarkable progress,” he says. “We all celebrate the five million people receiving antiretroviral treatment, up from just half-million just 6 years ago. We all celebrate that since 2001 the rate of infection has fallen 17 percent. It’s not enough, but it’s certainly a move in the right direction.”
Defying the odds
He says over the years, scientists, activists and those living with HIV/AIDS have defied what skeptics said could be achieved. Now he says the skeptics doubt much progress can be made with current funding limitations.
“If we push for a new focus on efficiency, in both treatment and prevention, and we continue to innovate, to create new tools, we can drive down the number of infections dramatically and start writing the story of the end of AIDS,” he said.
Gates says, for example, that circumcision and prevention of mother to child transmission of HIV are both cheap and effective. He says both bring an immediate cost benefit to countries’ health systems. But Gates says he was once a doubter himself.
“I have to admit when it comes to circumcision I used to be a skeptic. I said, yes, the studies showed that it reduces transmission by nearly 60 percent, but I was doubtful a large number of men would sign up for it. I’m glad to say I was wrong. Wherever there are clinics available men are volunteering to be circumcised in huge numbers - far more than I expected,” he says.
However, he says millions of men in sub-Saharan Africa are yet to benefit from the practice.
“In Russia, the epidemic is largely spread by injecting drug users. And areas where they receive clean needles, testing and other services, the infection rate rose 15 percent over five years. Where they didn’t, it skyrocketed 105 percent. Clearly these services make a difference. Yet Russia has cut the budget for them to zero and shifted the money into programs for the general population,” he said.
The right tools
Gates warns that even if everything is done with the current tools to fight HIV/AIDS, new infections would only be cut by half.
“Millions of people would continue to transmit the virus and we would not have enough money to treat everyone who needs it. Fortunately, we don’t have to assume that in the future we’ll be limited to fighting HIV with the tools we have today,” he said.
Gates says he expects new tools to include better anti-retrovirals, microbicides and eventually a vaccine.