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Funding squeeze threatens HIV progress, AIDS leaders warn

by Megan Rowling | @meganrowling | Thomson Reuters Foundation
Tuesday, 9 March 2010 17:23 GMT

LONDON (AlertNet) - Progress on tackling HIV and AIDS could go into reverse as the global economic downturn pinches poor countries' budgets and donors show signs of backing away from their promise to provide universal access to AIDS treatment, the British government and an aid group warned on Tuesday.

At an "emergency meeting" in London to reinvigorate international efforts to fight the pandemic, the British government urged countries in the G8 group of industrialised nations to live up to their financial pledges to the Global Fund to Fight AIDS, Tuberculosis and Malaria and called on other G20 countries, including emerging economies, to put money into the fund.

The Global Fund, created in 2002, has become a major source of finance for programmes to fight the three infectious diseases with approved funding of $19.3 billion for more than 572 programmes in 144 countries. It provides a quarter of all international financing for AIDS.

"As the economic downturn squeezes the health budgets of the world's poorest countries, efforts to tackle HIV and AIDS Â? particularly amongst those who are marginalised and discriminated against - are being hit hardest," said Britain's International Development Minister Gareth Thomas in a statement. "As a consequence we face the very real prospect that progress on tackling HIV will go into reverse."

In 2005, the G8 agreed to work with international bodies to develop and implement a package for HIV prevention, treatment and care in Africa "with the aim of as close as possible to universal access to treatment for all those who need it by 2010".

According to WHO, access to antiretroviral therapy (ART) has expanded at a rapid rate - of the estimated 9.5 million people in need of treatment in 2008 in low- and middle-income countries, 42 percent had access, up from 33 percent in 2007. An estimated 2.9 million people in sub-Saharan Africa received ART in 2008, with coverage in the region at 44 percent.

But there are still at least 5 million people worldwide who don't have access to the life-prolonging treatment, WHO says.

The medical aid group Medecins Sans Frontieres warned on Tuesday that those working to combat HIV and AIDS face the challenge of implementing WHO recommendations for earlier treatment with better AIDS drug cocktails just as donors seem to be rowing back from their promises on universal access.

MSF said it was striving to put WHO's higher standards of care into practice. "However, we see ministries of health hesitating to make these changes because of a withdrawal of donor commitments," Ariane Bauernfeind, programme manager at MSF in Brussels, said in a statement.

'FRAGILE' ACHIEVEMENTS

Beverly Collin, health policy advisor at MSF UK, told AlertNet the success of international efforts to tackle HIV and AIDS must be reinforced by providing adequate funding for future work.

Donors will discuss financial contributions to the Global Fund for 2011-2013 at a conference in New York in October, with an initial replenishment review in The Hague on March 24, where the organisation will lay out what can be achieved for a further $13-20 billion.

"The hope is that (rich nations) will continue to pledge the amount of money that is needed to slow the epidemic and ultimately end it. The concern is that they're not going to pledge enough, that they're not going to put the amount of money against the actual need," said Collin.

In a document looking at three scenarios for replenishment funding of $13 billion, $17 billion and $20 billion, the fund says that, if programmes are to be scaled up in an attempt to accelerate progress towards the health-related Millennium Development Goals (MDGs), the resources needed would be more than $17 billion.

The MDGs on HIV and AIDS are to halt and begin to reverse its spread by 2015, and to achieve universal access to treatment for those who need it by 2010.

Christoph Benn, the fund's director of external relations, who has been discussing the replenishment with donors, told AlertNet the results of international programmes to tackle HIV and AIDS since the millennium have exceeded expectations, and investments in the fund have met their targets.

On Monday, for example, the fund said it was possible transmission of the HIV virus from mothers to babies could be eliminated by 2015.

But Benn emphasised those achievements are fragile and there is a need to redouble efforts.

"We have to continue to help these countries otherwise we will move backwards," he said. "In the end, without additional money, we will not achieve (our) goals as an international community and that is what we are proposing to donors when they come together at the end of this month."

He conceded that the general economic climate was difficult, but added donors recognise the progress that has been made in tackling diseases like AIDS as well as the fund's effectiveness as an instrument for spending aid money.

"It's not that they are saying we don't believe you can really use the money well or it's wasted. It's more that they are saying...we might have budgetary problems, that's why we can't tell you yet how much we will commit, but many would say we hope to increase (our contributions)," Benn said.

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