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20th International AIDS Conference (AIDS 2014)

News

AIDS Crisis, or Funding Crisis: Call for Resources Comes From All Corners of AIDS 2014

July 21, 2014

The newly-released report Financing the Response to AIDS in Low- and Middle-Income Countries: International Assistance From Donor Governments in 2013, from UNAIDS and Kaiser Family Foundation, reveals that donor governments in 2013 committed US$8.1 billion in new funding to support the AIDS response in low- and middle-income countries, down 3% from 2012.

From words scrawled on a sign, to stark statistics on slides, to succinct tweets linked to graphic information, as well as postings from afar, excitement about breakthroughs in HIV/AIDS prevention, treatment and care is often tempered by the assertion that there are not enough resources to get the job done.

"Does anybody remember AIDS?"

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It seems a strange question to ask in the lead-up to a week where the spotlight shines more brightly on global efforts against the pandemic. But this headline from the no-punches-pulled essay by Mark Heywood, member of the board of directors of South Africa's Treatment Action Campaign (TAC) and director of SECTION27, comes at a time when funding cuts have forced TAC to shrink in size even as drastic problems remain in the South African health system.

Heywood writes,"Today AIDS makes a mockery of government leaders in South Africa who have made a virtue of their disassociation with the old AIDS denialism but have now embraced a new form of denialism. The new AIDS denialism denies that parts of our health systems are in cardiac arrest, that medicine stock-outs are epidemic; it denies condoms to schools, or TB control in prisons. It protects corrupt politicians and imprisons low-paid health workers."

He urges conference-goers to "question the duplicity of international aid, the donors who rode on AIDS whilst it was a badge that they could use for self-gratification, but whose short-sightedness and lack of enduring commitment to poor people's health is once more plain to see."

In a post on the conference-focused blog Crowd360, Rajiv Malik, the president of the pharmaceutical company Mylan Inc., which produces generic antiretroviral (ARV) therapies, cites the great strides that have already been taken in lowering drug costs. And with hope mounting for antiretroviral therapy that could be taken as infrequently as once a month, it's not unrealistic to think that the cost equation for treatment could shift significantly in coming years.

But Malik notes that low drug costs alone won't bridge the treatment gap:

Treatment programs need more than affordable drugs to expand access and provide sustainable services to all 28 million treatment-eligible patients. We need to scale up, which requires investment in physical and human-resource infrastructure and systems to improve patient linkage, retention in care and adherence support. It also requires a joint effort among all manufacturers to add ARV production capacity to ensure adequate supply of safe, high-quality medicine. To that end, it is important that we balance the historic focus on ever lower ARV prices with the investments needed for continued innovation, capacity and quality.

In addition to scaling up, we believe to reach the end of AIDS, HIV program policies need to be adjusted to reflect the latest scientific evidence. For instance, we know that early treatment benefits HIV patients and largely prevents transmission. Yet guidelines in many countries reflect older policies that recommend later treatment initiation. Similarly, studies have shown that certain lower-dose regimens reduce side effects without compromising efficacy. Yet the timeline for global adoption of these newer and more cost-effective treatments is unclear. If the world aims to treat three times as many people without a tripling in treatment funds, the HIV community cannot afford to delay introduction of dose-reduced regimens.

On Facebook, Gregg Gonsalves asks, "With a 3% drop last year in AIDS funding according to the Kaiser Family Foundation, is it serious to say: let's build a more comprehensive model of care across the board, when programs are struggling to make ends meet?"

"Everyone loves a happy ending. After 33 years of a terrible epidemic, looking forward into the distance and glimpsing the end of the disease, an AIDS-free future is like seeing water on the horizon after a long, hard walk through the sands of a desert. We want it so desperately, so acutely, we can taste it," says the longtime activist living with HIV who is now a research scholar in law and a lecturer in law at Yale Law School and the co-director of the school's Global Health Justice Partnership.

"It's not only NGOs who are facing budget cuts. Many countries are seeing less foreign assistance for HIV/AIDS, either because they've 'graduated' to middle income status or soon will be doing so, are one of the countries where bilateral donors are pulling away from. Even in countries that are still a priority for donors, many are dealing with flat funding but rising needs, which means less money to go around, even if the sums are the same," he notes. "While Occupy Wall Street has receded from the public imagination and public sphere, the real trade off here is the 1% vs. the rest of us. If we're going to see an end to AIDS it's going to have to come in the context of a fairer world and we have to be part of that fight."

In the world of harm reduction and drug use policies, advocates say that the funding situation is worsening. In "The Funding Crisis for Harm Reduction," a report released at the conference by three international harm reduction groups, they note that:

Funding for HIV-related harm reduction programs globally is in crisis. There can be no "AIDS free generation" without targeted efforts with and for people who inject drugs, yet, as this report shows, funding for harm reduction falls dangerously short of estimated need. As a result, coverage of essential HIV and harm reduction programs targeting people who inject drugs is very low and wholly inadequate to respond effectively to HIV among this community. While this has been the case for some time, the data and policy analysis conducted for this report shows that rather than action being taken to address this problem, the situation looks set to deteriorate.

Julie "JD" Davids is the managing editor for TheBody.com and TheBodyPRO.com.

Follow JD on Twitter: @JDAtTheBody.


Copyright © 2014 Remedy Health Media, LLC. All rights reserved.



This article was provided by TheBodyPRO.com. It is a part of the publication The 20th International AIDS Conference.
 


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Please note: Knowledge about HIV changes rapidly. Note the date of this summary's publication, and before treating patients or employing any therapies described in these materials, verify all information independently. If you are a patient, please consult a doctor or other medical professional before acting on any of the information presented in this summary. For a complete listing of our most recent conference coverage, click here.

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