How Much Would it Cost to End AIDS?

via Bloomberg, by Simeon Bennet

Michel Kazatchkine and Eric Goosby may be able to halt the spread of HIV. They just need the money.

The two men control the funds that buy drugs for most of the world’s AIDS patients. Studies in July provided the strongest evidence yet that medicines used since 1994 to treat HIV can almost eliminate the chance an infected person will pass the virus to a sex partner. Given to healthy people, the treatments can also protect against infection, offering the potential to end a pandemic that has killed 30 million people in 30 years.

Governments are now planning projects to assess whether those findings can be replicated in the real world, and what that might cost. Getting the drugs just to those patients who should be treated under existing guidelines would cost another $6 billion a year, according to the United Nations. Treating all those infected, in some of the world’s poorest countries, would cost tens of billions more.

Finding more money will be difficult with economic growth stalling and nations including the U.S., the biggest donor to the AIDS fight worldwide, trying to curtail overall spending to rein in debt. Funding for AIDS in poorer nations fell 10 percent to $6.9 billion in 2010 from 2009 levels, according to the UN.

“We may well be able to overcome AIDS,” Kazatchkine, the director of the Geneva-based Global Fund to Fight AIDS, Tuberculosis and Malaria, said in an interview. Still, “the gap between what the science is telling us we can achieve and what we would be able to achieve is at risk of increasing.”

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[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

30 Years: Epidemic to Pandemic

by Aldona Martinka

This Sunday was the thirtieth anniversary of the CDC report that would become the first mention of HIV/AIDS. IRMA is commemorating this with a short series on AIDS history. It will explore where we began, where we are now, and where we are going as we continue to battle this disease with hope and determination. This is part three of five.

Today everyone realizes that AIDS is a global issue, from the First World to the Third World. In 1999, AIDS became the fourth most common cause of death in the world. To the average American, however, AIDS as a global issue did not seem so important until the turn of the century. The United Nations began to hold increasingly frequent meetings to discuss HIV/AIDS-related issues, and American politicians and activists began to turn their gaze outward.

The Joint United Nations Programme on HIV/AIDS (UNAIDS) was launched in 1996, and by 2000 the UN was a vital player in the global fight against the disease. In that year alone the UN, the WHO, and UNAIDS worked to negotiate pharmaceutical prices for HIV/AIDS drugs in the developing world, the UN Security Council met regarding AIDS and its effects on peace/security in Africa, and the UN announced its Millennium Development Goals. The same year the G8 met and announced a need for more resources to battle the pandemic. The UN would, in the next few years, hold its first Special Session on AIDS (reviewed in 2005), launch the Global Coalition on Women and AIDS, and continue to reinforce its commitment to providing prevention and treatment options for HIV/AIDS worldwide.

The United States also began fighting AIDS on a global scale during this time. In 200 President Clinton announced his administration’s Millennium Vaccine Initiative, declared HIV a national security threat, and issued an executive order to aid developing countries in producing and importing generic treatments for HIV/AIDS. He and his legacy would continue to work to provide these drugs at a low cost to developing countries worldwide for years to come. In 2001, the Bush administration vowed to continue a commitment to fighting AIDS both nationally and globally. The CDC created a plan to halve US infections within five years. Early in 2003, President Bush announced the creation of the President’s Emergency Plan For AIDS Relief (PEPFAR), a five year plan devoting $15 billion dollars to fight AIDS internationally. This was, and continues to be, the largest commitment by any country to combat HIV/AIDS. The first $350 million was authorized the next year.

The US, the UN, the G8, international projects such as the Global Fund to Fight AIDS, Tuberculosis, and Malaria, countless other organizations, have continued to fight for HIV/AIDS prevention and treatment, and as the 31st year of AIDS begins there is a renewed energy to this battle.

[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

HIV/AIDS: Straight Talk with Stephen Lewis

Via PlusNews

A former politician, diplomat and aid worker, few people have witnessed the fight against HIV from as many international vantage points as former UN Special Envoy for AIDS in Africa, Stephen Lewis.

Now co-director of the international advocacy organization, AIDS-Free World, Lewis spoke to IRIN/PlusNews about the direction of the international response to HIV.

Excerpt:

The fight against HIV is at a very difficult moment, there's no question and for two reasons. First, the decline in funding could be truly catastrophic by or before the end of this year. Western governments, which are reducing their contributions to the Global Fund to Fight AIDS, Tuberculosis and Malaria, and the United States, which is flat-lining the US President's Emergency Plan for AIDS Relief, do it all on the ostensible rationale of the financial crisis but that's just utter nonsense. There's never a financial crisis when you have to bail out the banks or provide a stimulus package... there's only a financial crisis when you’re dealing with global public health and putting people at risk.

We have 10 million people who require HIV treatment urgently and there is no guarantee we'll be able to roll out the drugs fast enough to keep people alive. There are already many projects in Africa that cannot enrol new patients. This is preposterous. It's happening in Malawi, it's happening in Uganda, it's happening in Zambia, and there are drug stock-outs. It's becoming increasingly clear that the hazard of cutbacks financially is putting more and more lives at risk.

The other factor: there is a determination to expand the portfolio of health interventions in a way that is prejudicial to the work on HIV and AIDS. HIV is possibly the worst pandemic in human history - 30 million people dead, 33 million people infected... 15 million orphans – how in God's name is [this] not exceptional?

That doesn't mean that other things should be prejudiced by AIDS... no one who works on HIV and AIDS would deny funding for maternal and child health or for non-communicable diseases... You have a moral obligation to enlarge the pie to encompass all the requirements of health and what [funders] are doing in a kind of Pavlovian, unthinking way is to fail to analyze the overall needs. 

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[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

Financing the Fight Against HIV/AIDS

On the heels of a report that pledges to the Global Fund fell far short of a $20 billion dollar goal, a Lancet article examines the financial needs of global HIV/AIDS treatment and prevention programs.

From the New York Times, by Donald G. McNeil

In another signal that the global battle agains AIDS is falling apart for lack of money, the Global Fund to Fight AIDS, Tuberculosis and Malaria failed on Tuesday to reach even its lowest "austerity level" fund-raising target of $13 billion - the amount it had said it needed just to keep putting patients on treatment at current rates.
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From The Lancet, by Hecht et al.

As the global HIV/AIDS pandemic nears the end of its third decade, the challenges of efficient mobilisation of funds and management of resources are increasingly prominent. The aids2031 project modelled long-term funding needs for HIV/AIDS in developing countries with a range of scenarios and substantial variation in costs: ranging from US$397 to $722 billion globally between 2009 and 2031, depending on policy choices adopted by governments and donors.
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Fully Finance the Global Fund to Fight AIDS, Tuberculosis and Malaria

Sign on to the letter, and help achieve 500,000 signatures by September 30.

Excerpt from letter:

Contributing to the success of the Global Fund is its commitment to the core principles of demand-driven, country-owned responses.  Some international donors have pre-empted the outcome of the Third Voluntary Replenishment, and have begun calling for caps on the amount of funding to be made available for each round.  This would be a disastrous consequence, going against the very basic foundation of which the Global Fund was established upon, and would leave countries and communities without the resources identified as necessary to effectively respond to HIV, TB and Malaria.

Sign!

Activists Lobby for "Robin Hood" Levy

Via The Body

Now is the time to push for a micro-tax on all financial transactions to fund HIV prevention and care throughout the world, activists said this week at the 18th International AIDS Conference in Vienna.

The so-called "Robin Hood" tax of 0.005 percent would generate $33 billion annually worldwide, said Khalil Elouardighi of Coalition PLUS, an assembly of HIV advocacy groups.

"It acts like an invisible micro-withdrawal. Knowing that 97 percent of transactions are of a speculative nature, there will be no consequence on the real economy," noted Philippe Douste-Blazy, UN undersecretary-general for innovative financing for development.

One challenge is to ensure that receipts from such a tax are funneled to HIV/AIDS and not diverted to other needs, said Douste-Blazy, a former French foreign minister.

Douste-Blazy also serves as chair of UNITAID, a World Health Organization enterprise dedicated to expanding treatment for HIV, tuberculosis, and malaria. France and 11 other countries have implemented a UNITAID funding mechanism in which a small tax on airline tickets helps to pay for treatment of HIV-positive pregnant women.

Countries adopting a micro-tax assessment would not be immune from existing donor obligations, said Christoph Benn of the Global Fund to fight AIDS, TB and Malaria.

"We are not taking away any pressure from governments to provide additional resources from their development budgets: that is a given, that is our first request, that they increase their contributions," Benn said.

Activists feel this is the right time to advocate for the tax, given the upcoming Millennium Development Goals meeting in September and a G-20 gathering in November.

Please click here for more.

'The business of public health': new research on financing of HIV programmes

Via AIDSMap, by Rebecca Hodes

At the International AIDS Conference in Vienna, a session on the financing of HIV programmes yielded important results about the long-term costs and health impacts of continued Global Fund financing of ART. John Stover, from the Futures Group, presented the findings of a model on the future financing required for Global Fund-supported cohorts of ART patients.

Stover explained: “The Global Fund provides grant funding to 140 countries, costing a total of about $11 billion so far. A large proportion of this money is spent on ART. By the end of 2009, the Global Fund was supporting 2.5 million people on ART. This is going to increase to 3.5 million by the end of 2011.”

The key objective of Stover’s study was to answer the question: “How much funding is required to maintain support for these 2.5 million ART patients for as long as they need treatment? And what is the impact of providing this support?”

For more click here.

AIDS advocates inaugurate Obama as the President who will finally change the way the US fights AIDS

(Check out the full press release.)

On November 20, one thousand people living with HIV and allies from across the United States rallied in front of the White House to hold an "inauguration ceremony" for Barack Obama as the president who, during his first one hundred days, will prioritize policies to end the AIDS epidemic in the U.S. and worldwide...

President-elect Obama has made historically bold commitments to reform and expand U.S. AIDS policies. His campaign promised to develop a National AIDS Strategy that includes guaranteed treatment and care for all people with HIV in the US. The campaign pledge goes on to detail a commitment to housing as an integral part of HIV services, an end to the federal ban on funding for syringe exchange, and a call to redirect abstinence-only-until-marriage sex education funding into honest and accurate programs like comprehensive HIV prevention programs.

Internationally, Obama has promised to build on President Bush's global AIDS plan by removing the ideological strings the Bush administration attached to prevention funding. Specifically, Obama has committed to end the Prostitution Loyalty Oath and to support an evidence-based approach to HIV prevention that doesn't overly emphasize abstinence and fidelity at the expense of condoms. He has also pledged to increase funding for the Global Fund to Fight AIDS, TB and Malaria, a multilateral program which fights the three killer diseases in over 170 countries and which is facing a major funding shortfall...

Gerald LeMelle, Executive Director, Africa Action: "Over the past five years, the U.S. has made great strides in fighting AIDS around the world, yet 33 million people remain infected with the virus, and HIV/AIDS is still the leading cause of death in sub-Saharan Africa. Barack Obama has made bold pledges to build on President Bush's global AIDS plan by removing ideological restrictions on comprehensive prevention programs and increasing support for the multilateral Global Fund to Fight AIDS, Tuberculosis and Malaria. Starting to implement these promises during his first 100 days would go a long way toward reasserting U.S. moral leadership in the world. Amid international economic turmoil, evidence-driven programs to combat AIDS abroad remain a smart and strategic investment in human security."

For more information, check the 100 Days to Fight AIDS web site.