Cuts Hamper Bid to Tackle AIDS

At the recently concluded 19th Conference on Retroviruses and Opportunistic Infections in Seattle, scientists and advocates expressed concern that austerity budgets are eroding the funding needed to prevent HIV globally.

Last month, Obama's 2013 budget proposal requested a 10.8 percent cut to direct international HIV program aid under the President's Emergency Plan for AIDS Relief. Combined with previous cuts, that would represent a PEPFAR funding decline of more than $1 billion from the 2010 level. And in November, the Global Fund to Fight AIDS, TB and Malaria announced that a shortfall in donations would leave it unable to support new programs until 2014.

At the conference, data continued to bolster evidence that early antiretroviral treatment is a powerful HIV prevention tool. Last May, the HIV Prevention Trials Network's HPTN 052 study found early treatment greatly helped to cut HIV transmission among serodiscordant couples. Final data on the Partners PrEP (pre-exposure prophylaxis) trial found that HIV infection risk could be reduced by as much as 90 percent if the regimen is taken as prescribed.

However, developing countries may be unable to reap such benefits, given cuts to support existing treatment programs. Myanmar scaled back a plan to expand treatment access by 46,500 more patients after the Global Fund cancelled the funding round. The Democratic Republic of Congo is lowering its 2014 treatment target from 82,000 people to 54,000, and it has told some non-governmental organizations to stop HIV testing.

PEPFAR's budget for next year is months from a decision. However, Doctors Without Borders is calling for an emergency Global Fund meeting to lobby for donations that would enable HIV grants to be issued before 2014. Gabriel Jaramillo, the fund's general manager, supports the proposal.

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