At last week’s HIV/AIDS Implementers’ Meeting in Namibia, participants expressed deep concern about the commitment among donor nations to maintaining the momentum in the global fight against HIV/AIDS.
This week, attention will turn to the House of Representatives, where a key spending panel will divvy up the foreign aid spending pie—and the global health community will get the first real indication of how much Congress is willing to spend in FY 2010 on global AIDS as well as tuberculosis.
On Wednesday, June 17, a House Appropriations subcommittee chaired by Rep. Nita Lowey, D-N.Y., will take up the foreign operations spending bill. That legislation includes almost all global TB and HIV money, including funding for the President’s Emergency Plan for AIDS Relief (PEPFAR), so it’s no wonder that global AIDS & TB experts are on pins and needles awaiting the panel’s action.
The Senate will mark up its version of the foreign operations spending bill sometime in July; then the two chambers will have to reconcile their competing versions before sending a final compromise to the White House.
President Barack Obama has called for a modest $100 million increase for global AIDS, which will effectively stall the program at a critical juncture in the fight against the deadly pandemic. (For bilateral tuberculosis programs, Obama has only called for a $10 million increase, an inadequate amount especially given the growing threat of drug-resistant TB.)
The concerns over Obama’s proposed spending for global AIDS, and what funding levels Congress might set, were compounded by a new study released last week showing the immense benefits of starting HIV therapy earlier for HIV-infected patients, a result that, if acted upon, could dramatically increase demand for antiretroviral drugs.
The implications of that study and of the potential funding crisis was front and center at last week’s Implementers’ conference, where physicians and scientists spoke in unusually stark terms about the consequences of a pull-back.
Fareed Abdullah, director of the Africa Unit for the Global Fund to Fight AIDS, Tuberculosis and Malaria, warned of a coming AIDS treatment shortage, while Kevin DeCock, head of the World Health Organization’s HIV/AIDS program, cautioned against moving toward a “two-tiered system of global AIDS treatment,” in which lower standards of care and medications are used for patients in the developing world.