A coming AIDS treatment shortage?

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So warns Fareed Abdullah, director of the Africa Unit for the Global Fund to Fight AIDS, Tuberculosis and Malaria, at a press conference here kicking off the HIV/AIDS Implementers’ Meeting.

In unusually forceful language, Abdullah diverted from his prepared talking points to say that not only is there not enough money for AIDS treatment in the developing world, and that a new study showing the benefits of starting treatment much earlier will greatly increase the demand.

“Next year funding for AIDS treatment globally might even be lower than this year,” Abdullah said. “The single biggest issue facing the global AIDS movement now is there is not enough money on the table for ARV (antiretroviral) treatment in countries where the need is greatest.”

He added, “In a world where cash is short, we need to ask for more money for ARV treatment now. I know it’s a big ask, but we must ask.”

The Global Fund contributes 23 percent of all international HIV/AIDS spending. PEPFAR, the US government program, is the biggest funder at 55 percent.

Michelle Maloney-Kitts, the assistant US global AIDS coordinator, said at the press conference that the new study showing the benefits of initiating AIDS treatment when a patient has a 350 CD4 count or lower adds a major new issue for PEPFAR and other donors in the coming months and next few years.

“We are not naive,” she said. “We know this creates a huge new cohort of people eligible for ARV treatment. This will create a very substantial financing challenge.”

She said, though, that she and other leaders at PEPFAR would wait to make any recommendations on financing until the expected confirmation of Dr. Eric Goosby as the next US global AIDS coordinator.

“But this study does underscore the absolute importance for us to find cost savings in our programs,” she said. “We cannot allow any duplication of efforts with our partners.”

0 thoughts on “A coming AIDS treatment shortage?

  1. Alvaro Bermejo

    The new evidence showing the benefits of early treatment must, as Dr Abdullah says, focus peoples´minds on the increased resources needed for ARV treatment as well as on the need to invest much more on preventing new infections.

    These are our two biggest issues and both can and must be addressed by mobilising aditional resources through innovative funding mechanisms.

    A Currency Transaction Levy that would bring USD 30 to 50 Bn a year got a lukewarm reception from the Taskforce on International Innovative Financing for Health co-chaired by Gordon Brown, UK Prime Minister and Robert Zoellick, President of the World Bank.

    Let´s make sure that they hear the plight coming from this implementers meeting!

  2. Richard Stern

    My understanding is that there is still a very large number of people who do not have treatment access, no matter what their CD4 count is. I hope that that issue remains at the forefront at this meeting, and I assume that
    it will. It would be good to know what the current estimates are of the
    number of people who continue to die without any access, per country– often in slums, rural areas, refugee camps, etc. Which Agency is responsible in which region for tracking AIDS deaths?

    This has become an issue we don’t hear much about in Latin America. Also the issue of those who die because of lack of 2nd and 3rd line drugs when resistance becomes a problem, and of those who still die from opportunistic infections seem to receive relatively little emphasis.

    In reference to Latin America, it is my impression that it has somehow become ‘politically acceptable’ if ‘only’ 10 to 15 percent of the population of PLWA doesn’t get treatment. Governments are doing so much better than several years ago, that no one really wants to confront them about those people who are still dying without ever even having had the chance to receive ARVs. This seems to be the stance of UNAIDS and PAHO in this region, as well, as the stance of (some of) the mega NGO’s and Networks that are most often present at these activities and conferences. It would appear that in Latin America, that providing 85% of people with full blown AIDS with treatment is as good as it’s going to get. The 5% or 10% or 15% of PLWA who never get treatment are not part of the NGO scene, and tend to be less educated, and also live in extreme poverty.

    Accurate mortality figures for regions, countries and sub-regions within countries would be important in order to confirm this hypothesis. Most National AIDS program Directors are in denial about those who continue to die without treatment, or because of IO’s, etc, and continue to boast about
    ‘universal access.’ The evolution of “AIDS politics” in the past few years
    has created a new alliance of Civil Society, the Global Fund, and the International Agencies, which has seemingly led to some of these less pleasant issues being swept under the carpet, although there are obviously benefits to this alliance as well. As long as the Global Fund continues to finance treatment, we can apparently do without the kind of activism that existed 5-10 years ago, although there are some casualties caused this
    approach in terms of the issues I refer to above. In any event, it will
    be interesting to see how this issue is treated at the implementers meeting.

    Richard Stern
    San Jose, Costa Rica

    —–Original Message—–
    From: healthgap-bounces@critpath.org [mailto:healthgap-bounces@critpath.org]
    On Behalf Of Asia Russell
    Sent: miércoles, 10 de junio de 2009 10:04 a.m.
    To: HealthGap and discussions
    Subject: [HEALTHGAP] Donnelly’s blog: funding impact of ART initiation at 350 at implementers meeting

    Below is a blog entry from John Donnelly (who is covering the Implementers Meeting in Windhoek).

    An opening press conference focused on the urgent need to fund the increased demand that will be created by implementing the findings from the new Haiti clinical trial data that call for initiation of treatment at a CD4 cell count of 350 in developing countries.



  3. Pingback: Key Decision on HIV/AIDS Funding Looms in the U.S. House « Science Speaks: HIV & TB News

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