HIV response leaders: Restore PEPFAR funding to reap gains that treatment, research offer now

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A physician researcher just returned from a major scientific conference where once unhoped for advances against HIV were unveiled led a call today by global health experts asking Congress to increase funding for a global AIDS response over the flat funding proposed for the coming fiscal year by President Obama.

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Dr, Rochelle Walensky

Research presented at the Conference on Retroviruses and Opportunistic Infections last week underscored not only the promise of treatment to reverse the trajectory of HIV around the world, said Dr. Rochelle Walensky, of Harvard Medical School, but also bolstered hopes that a cure for the virus is possible, to the point, she said, “We can really taste it.”

Walensky was joined at a news briefing this morning by economist Jeffrey Sachs of Earth Institute and Columbia University, Shepherd Smith of the Institute for Youth Development, and Matthew Kavanagh of Health GAP and the Center for Public Health Initiatives at the University of Pennsylvania, all of whom stressed that progress against the global HIV pandemic made in the last decade could be squandered without sufficient investment now.

“We finally and definitively know,” the value of treatment to prevent transmission of HIV while preventing illnesses as well, said Walensky, who called antiretroviral medicine a “triple winner,” that saves lives, protects uninfected people and saves money. She compared the roughly $100 a year cost in medicine to treat HIV, to the money spent to “treat their opportunistic infections, care for their orphans, and to bury them.”

“The disease will win if we don’t care for these patients,” said Walensky, who also stressed research presented at CROI showing that children living with HIV continued to suffer from shortfalls in HIV responses that see just 34 percent of children who need antiretroviral treatment receiving it, and just 40 percent of children being tested for the virus that leads to AIDS. Walensky emphasized as well that without continued investment in research, advances that include the breakthrough HPTN 052 study which proved that treatment for HIV prevents transmission of the virus won’t occur.

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Jeffrey Sachs

“Treatment as prevention is perhaps the single most powerful tool that we have,” Sachs concurred. “We should be celebrating in the streets,” he said. He called the President’s FY budget proposal “a little bit surprising and more than a little disappointing.”

Smith, who called himself a “compassionate conservative,” recalled the pre-PEPFAR era, and the bipartisan support garnered by the plan launched by President George W. Bush in 2004, and weighed in with his belief that Obama would have found support in Congress for a stronger proposal to support global health response and research efforts.

As it is, Kavanagh, who with amfAR’s Chris Collins recently penned a Health Affairs blog post delineating the impact of flat funding on HIV treatment provision, the pace that has brought success will be impossible to maintain without adequate funding. To meet continuing needs for treatment, he said, Congress needs to exceed Obama’s proposal by $400 million, but should up the proposal by $600 million to recoup losses to the program through funding cuts since 2010.

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