Global AIDS Fight Hits Hurdle Over Funding

Betsy Mckay & Mark Schoofs. Wall Street Journal. May 27, 2011

In advance of a major United Nations meeting on the global AIDS epidemic, public-health leaders face a paradox: New evidence suggests the epidemic can finally be controlled, but that would demand increased spending at a time of severe global budget restraints.

Preliminary estimates show that funding from donor nations to fight AIDS in developing nations actually fell in 2010, the first decline ever in the battle against HIV, which currently afflicts 33 million people world-wide.

The U.N. High Level Meeting on HIV/AIDS, to be held June 8-10 in New York, is designed to chart how to fight the disease through 2015. A key point of contention: Whether to set specific targets for how many people to put on AIDS treatment.

Any such targets will not be met unless new money is found to buy medicine for more people after the 2010 funding drop. Last year was “a real decrease,” said Jennifer Kates, director of Global Health and HIV Policy at the Kaiser Family Foundation, which tracks global HIV spending with the Joint U.N. Programme on HIV/AIDS, or UNAIDS.

Ms. Kates declined to provide specific figures, saying they were still under analysis. But she said “a major factor” in the decrease appeared to be the global economic crisis.

Earlier this month, a landmark study proved that AIDS drugs, known as antiretrovirals, not only restore health to people with HIV but also make them strikingly less infectious. Compared with people not yet taking drugs, those on treatment were found to be more than 96% less likely to transmit the virus to their sexual partners.

The study was funded by the U.S. National Institutes of Health and led by Myron Cohen, director of the Institute for Global Health and Infectious Diseases at the University of North Carolina at Chapel Hill.

The Netherlands reduced its 2010 pledge by about $41 million, citing the economic slowdown, according to spokesmen for the Global Fund and the Dutch Minister of Development Cooperation.

U.S. funding for global AIDS efforts stayed flat, with $6.6 billion appropriated in 2010, according to a Kaiser analysis, and the 2011 budget keeps roughly the same amount of money. The Obama administration has requested $6.9 billion in its 2012 proposed budget, according to Kaiser, an increase of about 4.5%,

The new science has prompted the administration to undertake a “rigorous” internal dialogue to determine what targets and commitments would be needed to get enough people on treatment to reverse the epidemic, and what the U.S. contribution should be, said Eric Goosby, the U.S. Global AIDS Coordinator.

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