Analysis looks at fiscal savings, human toll

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Unless Congress finds ways to lower the federal deficit by $1.2 trillion in the next five months,  the law passed last year mandating across-the-board cuts to nearly all budget items will reduce current global health spending by about 10 percent of its current level, an analysis by the Foundation for AIDS Research (amfAR) estimates.

The savings? A fraction of one percent of the total deficit. The cost? The analysis estimates about 62,000 more people will die from AIDS-related illnesses, 122,500 more children will be orphaned, 111,000 more pregnant women living with HIV will go without the treatment that helps to prevent transmission of the virus to their children, about 21,000 more children will be infected with the virus that leads to AIDS — next year alone. And that’s just the impact on people served through HIV and AIDS treatment programs. The analysis also looks at projected impacts on food and education for children, on tuberculosis treatment, and on disease prevention.

The analysis, called The Effect of Budget Sequestration on Global Health: Projecting the Human Impact in Fiscal Year 2013, based its estimates on current budget allocation approvals, and on agency reports including data on costs, services provided, and impacts of those services.

“We believe it’s as realistic as it could possibly be,” amfAR vice president and director of public policy Chris Collins told Science Speaks.

Money within programs could be allocated differently than it is now, he says, but smaller cuts made in one area would lead to larger cuts in another.

What if all spending within the President’s Emergency Plan For AIDS Relief was directed to solely to evidence-based approaches?

“Even with reallocations in PEPFAR’s portfolio, sequestration means major cuts to treatment, prevention of mother to child transmission, programs for orphans and vulnerable children,” Collins said. That will happen, he added, unless Congress reverses the sequestration law, or comes up with ways to reduce the deficit by $1.2 trillion over the next nine years.

In addition to the direct impact on health and life expectancy projected in the analysis, the law would take away about $258 million in funding for AIDS research, immediately, Collins continued, “making it virtually impossible to follow through on the incredible scientific gains that we have today in AIDS.”

The analysis looks at the effects of sequestration on U.S. funding for multilateral efforts, including the Global Fund to Fight AIDS, Tuberculosis and Malaria as well as direct aid.

“Global health is such a small piece of the budget that if you apply sequestration, you get negligible savings,” Collins said. “But you really undermine the life-saving programs the U.S. is doing overseas.”

Finally, the effect of sequestration on global health spending would be something of a surrender, he said. “Sequestration would undercut our ability to achieve the ‘AIDS-free generation’ goal Secretary of State Clinton announced in November.”

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