In 2005 the international community made an historic commitment to achieve universal access to HIV prevention, treatment and care by 2010 at the Group of Eight (G8) summit in Gleneagles, Scotland. Despite important progress, the world is not yet on track to achieve this commitment, and there are troubling signs that donors and implementing countries are capping or shrinking funding for the HIV response.
"Walking away from this commitment would be extremely short sighted," said Julio Montaner, President of the International AIDS Society, "It will not only undermine any gains that have been made, but will undoubtedly lead to an increase in infection rates, illness and death."
The 2010 G8 Summit, in Muskoka, Canada on the 25-26 June, will emphasize the need for increased focus on Millennium Development Goal (MDG) 4 (reducing child mortality) and MDG 5 (improving maternal health). Evidence shows that combating HIV/AIDS, malaria and other diseases is essential to meeting these important goals. "Improving the health of women demands a sustained commitment to addressing HIV which is the leading killer of women of reproductive age worldwide and one of the leading causes of adult and child deaths in low- and middle-income countries." added Professor Montaner "We absolutely recognize the importance of emphasizing maternal and child health, but the interrelatedness of the health MDGs and the centrality of an effective AIDS response to maternal and child health cannot be denied. It is striking that countries that have made the least progress with regards to reducing maternal deaths are the countries in which the AIDS crisis has been most severe".
Evidence has also demonstrated that effective responses to AIDS have multiple benefits for other health issues, reducing not only HIV transmission, but also tuberculosis (TB) transmission and deaths from TB. The expansion of AIDS services has led to an improvement in maternal and child health and significantly strengthened health systems in low and middle income countries.
Discussions on the resources needed to achieve universal access may also have overestimated the long term financial implications for governments as they have failed to fully account for the prevention effect of treatment roll-out and the impact that this could have on HIV incidence. 'We are concerned that discussions about the 'treatment mortgage' have failed to take fully into account the potential longer term savings arising from a reduction in infections as a consequence of wider treatment uptake', said Mats Ahnlund, Acting Executive Director of the IAS 'A continued and robust response to AIDS could ultimately reduce health spending in many areas, including TB and maternal and child health'.
As G8 leaders gather, they must not ignore the fact that 2010 is the deadline established by the G8 itself to achieve universal access to HIV prevention, treatment and care for all those in need. While there has been substantial progress towards this goal, it is still far from being met.
The G8 needs to hold itself accountable to previous commitments made; progress towards these commitments needs to be measured and more importantly the G8 must ensure that these commitments continue being taken forward. Failure in this regard will not only undermine the credibility of the G8, but will result in more lives being lost
At a minimum the G8 needs to make the following commitments in Muskoka:
- A recommitment to the achievement of universal access to HIV/AIDS prevention, treatment, care and support by 2015 at the latest;
- A political commitment for the continued work of the Global Fund and a financial commitment of at least $20 billion for the Global Fund 2011-2013 replenishment.
'The credibility of the G8 will be determined by accountability' said Professor Montaner 'Sidelining the commitment to AIDS threatens this credibility, and also undermines the validity of new commitments on global health made at this year's summit. Universal access is a collective commitment, a shared responsibility, and a realistic, achievable goal.''