A new study says developing countries will need between $400 million and $700 million over the next 20 years to battle HIV/AIDS.  The findings appear in The Lancet medical journal.  The estimates are being released at a time when overall funding for HIV/AIDS has flatlined in a troubled world economy.

At this month?s replenishment round for the Global Fund to Fight AIDS, TB and Malaria, donor nations pledged $11.7 billion over three years - an amount several billion dollars below what many had called a bare minimum.

Dr. Robert Hecht says the situation underscores the need for long-term financial planning.

?This epidemic is not a short-term phenomenon.  We?ve been battling with the virus and with the epidemic now for almost three decades.  And we still have a long way to go.  It?s important now that we move out of the short-term emergency mode and mentality and look long term.  Even while we act in the short-term, we need to see where this epidemic is going<? he says

Hecht is managing director of the Results for Development Institute in Washington and lead author of The Lancet article.

Take action now

Five million people are currently receiving anti-retroviral therapy.  But it?s estimated at least 10 million people should be receiving the life-saving drugs.

?Actions we take today to prevent new infections ? and this is where we need to do a great deal more than we are right now ? will have huge consequences for what happens 5 to 15, 20 years ahead of us,? he says

Dr. Robert Hecht
Dr. Robert Hecht

The Lancet article estimates the cost for developing countries to fight HIV/AIDS will range from $397 billion to $722 billion.  Hecht says it all depends on the choices developing countries make now.

?Countries do have distinct choices. They can do much better to target and use their dollars for prevention.  They can avoid people becoming infected at a higher rate if they do the right things.  And this has big savings down the road when it comes to treatment and caring for orphans,? he says.

Take heed

He warns if funding and treatment efforts level off in the coming years, the number of new HIV infections could rise to more than 3-million annually by 2015.  That?s up from 2.3 million in 2009.  If an aggressive prevention approach is taken, he says, the number of new infections each year could fall to one million.  Hecht calls that ?progress,? but says without a cure or an effective vaccine the epidemic will continue.

?Even if we expand the prevention services that we have today, the things that are in our prevention toolkit, we will still be seeing more than a million people becoming infected 20 years from now.  We still will not have completely stopped AIDS in its tracks,? he says.

He describes that as very sobering news for donor countries, who will need to target countries most in need.  These include countries with very high HIV rates and weak economies.

?Using whatever money is available in the most targeted and efficient way I think is only underscored by the situation that?s occurring right now with the challenges of the global fund and the leveling off of U.S. bilateral assistance for HIV,? he says.

The Lancet article also calls for greater investment in research and development to ?generate game-changing technologies? and to ?intensify targeted cost-effective prevention.?