“Cash-strapped Swaziland is struggling to fund its HIV programs, and experts are warning of long-term damage to treatment and prevention schemes if steps are not taken to ring-fence funding and supplies,” the Mail & Guardian reports. About 200,000 people are living with HIV in Swaziland, nearly one quarter of the population, the newspaper notes, adding, “Until now the government has done well in terms of providing antiretroviral (ARV) treatment — achieving 78 percent coverage, just under the World Health Organization’s ‘universal coverage’ rate of 80 percent. But there are fears that uncertainty about funding streams and weak supply-chain management could result in a reversal of this progress.” The article discusses funding from the government, PEPFAR, and the Global Fund to Fight AIDS, Tuberculosis and Malaria; antiretroviral drug and testing supply problems; and the epidemic’s effect on children and life expectancy in the country (Redvers, 2/27).
“President Barack Obama [on Monday] proposed a $3.8 trillion budget for fiscal 2013 that aims to slash the deficit by $4 trillion over 10 years,” the Associated Press reports, and provides an agency-by-agency breakdown of the proposed budget (2/13). “Making up just one percent of the U.S. Government’s overall budget, the Department of State/USAID budget totals $51.6 billion,” a U.S. Department of State fact sheet notes (2/13). “Overall, funding for the Global Health Initiative (GHI) is down in the FY 2013 request, with most of the reduction coming from HIV/AIDS bilateral amounts,” according to the Kaiser Family Foundation’s Policy Tracker. “Most other areas saw decreases as well, except for family planning and funding for the Global Fund to Fight AIDS, Tuberculosis and Malaria and the GAVI Alliance, which increased,” the resource adds. The budget plan proposes a total of approximately $8.5 billion for GHI, down more than $300 million from FY 2012, the resource notes, adding that $6.4 billion of that funding would go to PEPFAR, including about $4.5 billion for HIV and $224 million for tuberculosis. The Global Fund receives $1.65 billion in the request, according to the resource (2/13).
“For the past two weeks, the buzz in Washington, D.C., and at the White House is all about women and girls,” Roxana Rogers, director of the USAID Office of HIV/AIDS, writes in this “IMPACTblog” post. She highlights a recently announced initiative, funded through PEPFAR, “to help local communities and grassroots organizations fight HIV/AIDS and gender-based violence [GBV].” Rogers continues, “Partnerships between U.S. agencies, civil society, private corporations, and international institutions are key to tackling these issues,” and describes several USAID-supported programs working to address HIV/AIDS and GBV (3/15).
In the Huffington Post’s “Politics” blog, Serra Sippel, president of the Center for Health and Gender Equity, notes that Secretary of State Hillary Rodham Clinton said at the XIX International AIDS Conference in July that all women should be able to decide “when and whether to have children” and that PEPFAR, in a guidance [.pdf] released last week, said, “Voluntary family planning should be part of comprehensive quality care for persons living with HIV,” and referred to family planning as a human right. “Then, in bold type, they punctuated it with, ‘PEPFAR funds may not be used to purchase family planning commodities,’” she writes. “They take it a step further with a caveat that before anyone decides they’d like their program to have anything to do with family planning, they had best consult relevant U.S. legal counsel first,” she adds. “To be fair, they do say that PEPFAR programs can just refer women to a different program that offers family planning,” but those programs are not always available, Sippel writes, adding, “So the suggestion is flawed from the start.”
GlobalPost’s “Global Pulse” blog examines the issue of HIV/AIDS in the presidential election, writing, “This campaign season, the fight against HIV/AIDS has been absent from the press materials released by both President [Barack] Obama and [Republican presidential nominee Gov. Mitt] Romney — as well as from the conversation.” The blog provides examples of Obama’s actions addressing HIV domestically and abroad and summarizes remarks on the epidemic made by Romney during the campaign. The blog includes quotes from several experts and officials (Judem, 10/8).
“On Wednesday, October 10, U.S. and Bahamian officials attended the official launch of ‘The Caribbean Grant Solicitation and Management Program,’ a new PEPFAR initiative that will be executed locally by the U.S.-based nonprofit World Learning through USAID,” a press release from the U.S. Embassy in Nassau, Bahamas, reports. “The main goals of these grants include: educating people, especially youth, about HIV/AIDS and thereby preventing its spread; reducing stigma and encouraging safe practices for those living with the disease; and supporting communities to cooperate in fighting the epidemic,” the press release notes, adding, “Project proposals are being accepted through November 16, 2012” (10/10).
“Construction has begun on Ethiopia’s National Public Health Training Center, the first of its kind to be established in the country at a cost of $4 million,” Malaysian News Agency Bernama reports, noting, “The U.S. President’s Emergency Fund for AIDS Relief (PEPFAR) committed to the cost of the project, while the Atlanta-based Centers for Disease Control (CDC) will manage the construction of the ground and three facilities which are expected to be completed by April 2014” (10/23). “It will be the first national training center for health, according to the press statement from the United States Embassy in Ethiopia,” according to New Business Ethiopia, which adds, “The new national public health training center will be a state-of-the-art facility that will act as a training and support hub for Ethiopia’s national public health monitoring, research, and laboratory network” (10/23).
“The United States should be more selective about where and how it spends foreign assistance,” according to a new report (.pdf), titled “Engagement Amid Austerity: A Bipartisan Approach to Reorienting the International Affairs Budget,” co-authored by John Norris of the Center for American Progress and Connie Veillette of the Center for Global Development (CGD), the CGD website notes. The report “identifies four flagship reforms that would help U.S. foreign affairs institutions to better reflect national interests and reduce ineffective spending,” including “[a]ccelerat[ing] cost-sharing arrangements with upper middle income recipients of” PEPFAR and “[o]verhaul[ing] U.S. food aid laws and regulations,” according to the website (5/8).
The Lancet examines the history of the Obama administration’s attempt to “reform the way the country delivers development assistance for health abroad” by establishing the Global Health Initiative (GHI). “Despite unusual bipartisan support in Congress and broad consensus among development practitioners about the goals of reform, it proved surprisingly difficult for the multiple entities involved in U.S. global health assistance to agree on a way forward,” the journal states, noting that GHI leadership and the three core entities of GHI — USAID, the Centers for Disease Control and Prevention (CDC) and PEPFAR — announced the closure of the GHI office and an end to the initiative’s current phase on July 3. The Lancet outlines several challenges the initiative faced, including collaboration among the three agencies, leadership, and external factors, such as “the austere budgetary climate.”
“Zimbabwe is set to attain ‘universal’ coverage for AIDS treatment thanks in part to an $84 million disbursement [on Tuesday] by the United Nations-backed Global Fund to Fight AIDS, Tuberculosis and Malaria,” the U.N. News Centre reports (10/2). “The new disbursement will cover the cost of life-saving antiretroviral drugs (ARVs) for an additional 10,000 new patients, bringing the total number of people on treatment with Global Fund support to 203,440 by the end of the year,” the Global Fund announced in a press release. The funding also will support a six-month ARV buffer stock to prevent treatment interruptions for the 480,000 patients on therapy in Zimbabwe, the press release notes (10/2). The Global Fund’s announcement to support additional patients comes together with an announcement from PEPFAR to increase the number of patients supported by its program from 80,000 to 140,000, with a goal of having 160,000 patients on therapy by the end of next year, Zimbabwe’s Herald notes.