AIDS 2010 opens: Leaders weigh in on global HIV/AIDS funding; Clinton, Gates on efficiency

Jul 20 2010

The six-day International AIDS Conference-AIDS 2010 kicked off Sunday in Vienna, Austria "amid resurgent fears that advances in the 29-year war against the disease were threatened by a slump in funding," Agence France-Presse reports.

Though the conference is expected to highlight some of the most recent advances in improving HIV prevention and treatment, "[d]windling donations from rich countries imperils the 2006 U.N. and G8 goal of providing universal access to HIV drugs by 2010, AIDS campaigners warned," according to the news service (Ingham, 7/18).

According to a joint report on support for HIV/AIDS by donor nations released by the Kaiser Family Foundation (KFF) and UNAIDS on Sunday, "in 2009, the Group of Eight (G8) nations, European Commission and other donor governments provided US$7.6 billion for AIDS efforts in developing nations, compared with US$7.7 billion in 2008," IRIN/PlusNews reports (7/19).

The report came one day after "[t]he International HIV/AIDS Alliance warned … that the annual cost of tackling the HIV epidemic could balloon to $35 billion (22.9 billion pounds) by [2031] if governments fail to invest in efficient, targeted and cost-effective prevention measures," Reuters reports (Kelland, 7/17).

"The 2009 totals ended a run of annual double-digit percentage point increases in donor support for international AIDS assistance since at least 2002, when donor governments provided a total of US$1.2 billion. The results are consistent with preliminary data about overall trends in official developmental assistance during last year's global recession and economic instability," according to a joint KFF-UNAIDS press release.

"Donor nations essentially were treading water last year on AIDS relief, but did not cut back overall as they dealt with the economic tsunami that sparked a global recession," KFF President and CEO Drew Altman said. "Time will tell whether support will resume its rapid growth once the global recovery takes hold," he added.  

"Reductions in investment on AIDS programs are hurting the AIDS response. At a time when we are seeing results in HIV prevention and treatment, we must scale up, not scale down," said Michel Sidibe, UNAIDS Executive Director.   

"Like most countries, the U.S., the world's largest global health donor, accounting for more than half of governmental support, has slowed its giving. It is also devoting its global health dollars to a wider number of diseases as part of a strategy to reduce maternal and child mortality," the Wall Street Journal writes. "But funding from the U.S. still increased in 2009 to $4.4 billion from $3.95 billion, helping to make up for reduced donations from Canada, France, Germany, Ireland, Italy, and the Netherlands, the report found," the newspaper writes (Winslow, 7/18).

"The U.S. alone accounted for 58 percent of disbursements in 2009, followed by Britain (10.2 percent), Germany (5.2 percent), the Netherlands (5.0 percent), and France (4.4 percent)," AFP/France24 reports.

"UNAIDS estimates that US$23.6 billion was needed to address the epidemic in low- and middle-income countries in 2009," the press release adds. "That suggests a growing gap of US$7.7 billion between available resources and need, according to UNAIDS estimates."

In addition, the report looked at how the money was distributed: "In 2009, donor governments disbursed US$5.9 billion bilaterally and earmarked funds for HIV through multilateral organizations, as well as an additional US$1.6 billion to combat HIV through the Global Fund to Fight AIDS, Tuberculosis and Malaria and US$123 million to UNITAID" (7/18).

International HIV/AIDS Leaders Speak Out On HIV/AIDS Funds

At the opening of the conference Sunday, International AIDS Society President and AIDS 2010 co-chair Julio Montaner warned of the consequences of G8 nations falling short on their previous commitment to provide universal access to HIV treatments for patients worldwide by 2010, the Associated Press/Washington Post reports.

"This is a very serious deficit," Montaner said. "Let's rejoice in the fact that today we have treatments that work ... what we need is the political will to go the extra mile to deliver universal access."

The article details the commitments made by G8 leaders in 2005 to develop and implement "an Africa-focused package for HIV prevention, treatment and care with the aim of getting 'as close as possible to universal access to treatment for all those who need it by 2010.'" The article also notes that the most recent G8 accountability report "acknowledged that the 'universal access targets with respect to HIV/AIDS will not be met by 2010'" (Oleksyn, 7/18).

While praising recent progress in the global fight against HIV/AIDS, U.N. Secretary-General Ban Ki-Moon addressed his concerns over global funding cuts to fight HIV/AIDS, Reuters reports. The article also includes comments by Michel Kazatchkine, head of the Global Fund to Fight AIDS, Tuberculosis and Malaria.

According to the news service, the Global Fund has "said it needed up to $20 billion in the next three years to sustain progress. … Kazatchkine said its funding for AIDS, which accounts for around half the fund's spending, was split into three areas - treatment, prevention and health infrastructure for delivery."

The article notes that "hundreds of protesters marched through the conference centre demanding that rich nations deliver on their promise that all those in needs of AIDS drugs should get them" during the first day of AIDS 2010 (Kelland, 7/18).

South African Deputy President Kgalema Motlanthe, also on Sunday addressed AIDS 2010 delegates, noting the recent progress of the country's efforts to control HIV/AIDS and calling for sustained funding for the global fight against HIV/AIDS, Times LIVE reports. "We cannot allow the recession to take precedence over the right to health and the principles enshrined in the Universal Declaration of Human Rights," he said, according to the newspaper (Evans, 7/18).

AFP, also reports on HIV/AIDS funding and includes comments from global HIV/AIDS funding by Bill Gates, co-chair of the Bill & Melinda Gates Foundation, Anthony Fauci, head of the National Institute for Allergy and Infectious Diseases (NIAID), and Paul Zeitz, founder and executive director of the Global AIDS Alliance (Santini, 7/17).

Former President Bill Clinton, Bill Gates Call On HIV/AIDS Community To Promote Efficiency In Prevention, Treatment Programs 

During a speech to AIDS 2010 delegates on Monday former President Bill Clinton "called for more efficient use of funding in the fight against AIDS to ensure that people who need it actually get it," the AP/NPR reports.

"He said that in many countries, foreign assistance, including money for AIDS, is misspent and that funding should go directly to local organizations and national plans in developing countries that can effectively deliver services at a lower cost and less overhead than established organizations," the news service writes (7/19).

"In too many countries, too much money pays for too many people to go to too many meetings and get on too many airplanes to do too much technical assistance," Clinton said during his address, the Guardian reports. "Too much money is spent on reports that sit on shelves. Every dollar we waste a day puts a life at risk" (Boseley, 7/19). 

Clinton "waded into a mounting controversy about funding at the … conference [by] defending Barack Obama from activists' claims that he reneged on a campaign pledge," AFP/IOL reports in a piece that examines AIDS advocates concerns with the U.S. commitments to the global fight against HIV/AIDS.

"Clinton laid the blame for financial belt-tightening at the door of the U.S. Congress, lauded Obama for honouring his promises and urged campaigners to be smarter and more efficient in how they spent their own money," the news service writes (7/19).

"The world is awash in troubles. It is easy to rail at a government and say ... give us more money. But we also have to change the way we do what we do," Clinton told the conference, Reuters reports. "If we're going to make this case, they (donor governments) have to believe that we are doing our job faster, better and cheaper. Then we have the moral standing to go ask people to give us more money."

Bill Gates also addressed the need for increased efficiency in spending during a speech at the conference Monday, the news service adds (Kelland, 7/19).

"Even if we advocate for more funding, we can do more to get the most benefit from each dollar," Gates said, the AP reports. "If we push for a new focus on efficiency in both treatment and prevention and we continue ... to create new tools, we can drive down the number of infections dramatically and start writing the story of the end of AIDS."

"Some countries - such as Russia - are not using data to make funding decisions that target the right populations because those groups make politicians uncomfortable, Gates added."

"If you're afraid to match your prevention efforts to the right populations, then you're wasting money and that costs lives," Gates said (Oleksyn, 7/19).

During his speech, "Gates [also] called for rapid scale-up of 'cheap, effective, and easy to apply' HIV/AIDS prevention measures - such as male circumcision and prevention of mother-to-child transmission of HIV - which he said were so cost-effective 'that in endemic countries it is more expensive not to pursue them,'" Reuters writes (Kelland, 7/19).

Webcasts of Clinton's speech, Gates's speech, and Gates's press conference are available now.

Wall Street Journal Examines Prevention, Treatment

The Wall Street Journal examines how the "high cost of treating millions of people is forcing governments and donors to focus more aggressively on the difficult challenge of prevention" - a topic the newspaper writes "will be the crux of discussions" in Vienna. The article details the challenges historically associated with efforts to prevent HIV and highlights several recent studies that have demonstrated the potential of several prevention methods, such as male circumcision.

"The focus on costs and prevention is rooted in pressures the tough economy has put on major economies and other large donors to global health. Also at work is an emerging shift in how the U.S. - the largest funder of AIDS programs - is approaching the disease," the newspaper writes.

The piece explores the dilemma the Obama administration is facing as it attempts to slow increased funding for HIV/AIDS "while devoting more dollars and attention to improving maternal and child health, attacking neglected tropical diseases and implementing other initiatives," as part of the administration's Global Health Initiative.

The article includes comments by Ezekiel Emanuel, senior adviser for health policy to the director of the Office of Management and Budget, U.S. Global AIDS Coordinator Eric Goosby, Gates and Princeton Lyman, a former U.S. ambassador to Nigeria and South Africa (McKay/Guth, 7/17).

Human Rights Watch Calls For Governments To Repeal Laws Discriminating Against Groups At High-Risk For HIV/AIDS

Ahead of AIDS 2010, Human Rights Watch Director Joseph Amon on Saturday "called on governments of more than 160 countries to repeal laws criminalising sex workers, drug addicts and homosexuals," arguing that such laws "fuel stigma and discrimination, increase the risk of HIV, and prevent HIV/AIDS services from reaching the most vulnerable populations," Agence France-Presse reports. 

"Only by protecting the human rights of marginalized and vulnerable populations can we succeed in ending HIV transmission and ensuring universal access to care," Amon said in a statement (7/17).

"Over the past 30 years, our medical knowledge has increased dramatically but our commitment to human rights has not," Yves Souteyrand of WHO said during an opening session at AIDS 2010.

"He said while there is much talk of universal treatment, meaning everyone with HIV/AIDS who could benefit from antiretrovirals would get them, 'universal treatment cannot be achieved without human rights,'" the Globe and Mail reports.

The article includes comments by Sidibe, Brigitte Schmied, president of the Austrian AIDS Society, and Rachel Arinii Judhistari of the Independent Youth Alliance in Bali, Indonesia (Picard, 7/19).