Speakers at Tuesday’s plenary session at the XIX International AIDS Conference in Washington, D.C. highlighted the challenges that lie ahead in the response to HIV/AIDS and discussed potential solutions, ABC News reports (Duwell, 7/25). Bernhard Schwartlander, director for evidence, strategy and results at UNAIDS, “highlighted the many new possibilities for collaboration, activism, and financing for the AIDS response as economic growth is rapidly changing the global order,” UNAIDS reports in a feature story (7/24). “A lot of very clever and dedicated people are working very hard in making sure that services are delivered more efficiently, and … more people receive HIV services with the same amount of money,” he said at the session, PlusNews writes (7/25). According to UNAIDS, Schwartlander “outlined a number of innovative financing methods … such as the financial transaction tax; front-loading investments for health through bonds; or utilizing fines paid by pharmaceutical companies for anti-competitive practices for health assistance” (7/24).
Programs, Funding & Financing
In this post on the Center for Global Development’s (CGD) “Global Health Policy” blog, Mead Over, economist and senior fellow at CGD, previews his participation in a panel that took place Monday evening at the XIX International AIDS Conference. Participants discussed whether AIDS spending is a sound investment in a resource-constrained environment (7/23). Additional information regarding the debate, which was held at World Bank headquarters and included several high-level speakers, is available on the World Bank website (7/23).
In a round-up of events from the XIX International AIDS Conference on the Bill & Melinda Gates Foundation’s “Impatient Optimists” blog, Trevor DeWitt, new media communications officer for the foundation, notes that the Global Fund to Fight AIDS, Tuberculosis and Malaria on Monday released results “showing broad gains in the number of people receiving HIV treatment” (7/23). According to a Global Fund press release, “The results show that 3.6 million people living with HIV are now receiving antiretroviral treatment under programs backed by the Global Fund, an increase of 600,000 since the end of 2010.” In addition, “Overall, 8.7 million lives have been saved by programs supported by the Global Fund since the organization was formed in 2002. The results include data through June 2012,” the press release states (7/23).
In an opinion piece in The Hill’s “Congress Blog,” international health consultant Taufiqur Rahman argues that funding for the HIV/AIDS response is sufficient. He says countries should pay for their own first-line antiretroviral treatment, integrate programs to include HIV prevention activities and apply pressure to bring down the cost of second-line drugs. “We are not using technology and best practices sufficiently to accelerate and sustain our gains to save more lives quickly and build country systems,” Rahman states, adding, “We do not need more funds. We need to be smarter about investing existing resources of $8 billion with careful planning, economic analysis, proper prioritization, and lots of coordinated as well as collaborative efforts.” He continues, “We now need to focus on a ‘Transition Strategy’ with countries and this requires serious rethinking and refocusing. Let us have one global strategy of transition, critical investment, and country capacity building. Focus on collaboration, integration, revised national strategy and national financing to win this battle” (7/23).
Jonathan Klein, board chair of Friends of the Global Fight Against AIDS, Tuberculosis and Malaria and co-founder and CEO of Getty Images, writes in a guest post on Forbes, “The U.S. government has long been the world’s most stalwart Global Fund supporter, and U.S. leadership continues to be the most effective tool in leveraging additional resources for the fight against AIDS, tuberculosis and malaria, particularly at a time when budgets are universally tight.” He notes that “[f]or every $1 invested by U.S. taxpayers, the Global Fund leverages at least $2 more from international donors. And that money translates directly into lifesaving prevention and treatment.” Klein says, “Continued U.S. leadership is essential to maintain these gains and reach our health goals. … With sustained strong support, policymakers in Washington can continue to be responsible … for the uptick in people living healthy, productive lives.” Noting that U.S. foreign aid accounts for less than one percent of the federal budget, he concludes, “But it reaps enormous rewards in generating global good will, boosting national security, saving lives and creating a safer, more stable world for all of us” (7/23).
In a feature analysis, Devex examines the history of PEPFAR, the program’s sustainability, its use of public-private partnerships, and the potential impact of the closure earlier this month of the Global Health Initiative (GHI) office. Noting that next year marks the 10-year anniversary of PEPFAR, Devex concludes, “The Obama administration’s apparent about-face on components of GHI is but one reminder that in Washington — especially as administrations come and go — ideas, initiatives, and funding often fade away all too quickly. The U.S. foreign aid industry is no exception. If PEPFAR can continue its commitment to innovation and partnership, however, visitors to the U.S. capital this week [for the International AIDS Conference] can still be hopeful over America’s leadership role in the fight against HIV/AIDS” (Troilo/Piccio, 7/23).
Bill Gates Stresses Importance Of Investment In Both HIV Treatment And Research For Vaccines, Microbicides
In a symposium session on Monday at the XIX International AIDS Conference in Washington, D.C., politicians and public health experts joined Bill & Melinda Gates Foundation Co-Chair Bill Gates for a discussion about improving effectiveness and efficiency in the HIV/AIDS response, the Washington Post reports (Brown/Botelho, 7/23). “Gates … reiterated the importance for nations and donors to support research, but also expressed support for ongoing treatment initiatives in the meantime,” according to Agence France-Presse. “No one should think that we have got the tools yet. We will get the tools but only if we stay the course in terms of the scientific investments,” Gates said, AFP notes (Sheridan, 7/23). The Washington Post adds that “[t]he main one lacking is a vaccine, but also important and missing are woman-controlled means to prevent infection, such as a vaginal microbicide” (7/23).
Secretary Clinton Reaffirms U.S. Commitment To 'AIDS-Free Generation,' Pledges More Than $150M For Global Efforts
In a speech delivered at the XIX International AIDS Conference in Washington, D.C. on Monday, U.S. Secretary of State Hillary Clinton “underscored the United States’ commitment to achieving an ‘AIDS-free generation’ and announced more than $150 million in additional funding,” Politico reports (Norman, 7/23). “‘Iâ€™ve heard a few voices from people raising questions about America’s commitment,’ she said, adding, ‘We will not back off. We will not back down,'” according to The Hill’s “Healthwatch” (Viebeck, 7/23). Of the $150 million pledged, “$80 million will be dedicated towards preventing mother-to-child transmission abroad, with the goal of eliminating it by the year 2015”; “[a]nother $40 million is allotted for voluntary male circumcision in Africa to decrease risk of transmission of the virus”; “an additional $15 million [will] fund research on interventions”; “$20 million [is] to bolster country-led efforts to expand HIV-related services”; and “$2 million [will go] towards civil society groups to reach key populations affected by HIV,” ABC News writes (Duwell, 7/23). “Clinton said she had commissioned [U.S. Global AIDS Coordinator Ambassador Eric Goosby] to produce a blueprint for the way ahead,” the Guardian notes (Boseley, 7/23). “Goosbyâ€™s deadline is the upcoming World AIDS Day, Dec. 1,” Inter Press Service adds (Biron, 7/23).
Noting that former British Prime Minister Margaret Thatcher’s special cabinet committee on AIDS in 1986 “decided there should be clean needle exchanges for injecting drug users (IDUs) to prevent the spread of HIV,” Norman Fowler, a member of the British House of Lords and former British health secretary, writes in The Hill’s “Congress Blog,” There is no question that needle exchanges and drug substitution have reduced HIV: only two percent of new infections in Britain now come through that route.” In addition, “The policy has neither encouraged drug taking nor crime. Similar reports come from other nations that have adopted this approach,” he says, continuing, “Tragically, not all nations have followed such a lead,” including the U.S. and the Ukraine. Fowler adds, “If the U.S. was to reconsider [its recently reinstated] ban [on funding domestic and international needle exchanges] and recognize that without needle-exchange programs it is impossible to provide full protection from the spread of HIV and the death and suffering that goes with it, it would send a message around the world” (7/20).
Michael Merson, director of the Duke Global Health Institute, writes in The Hill’s “Congress Blog” that much of the progress in the fight against HIV/AIDS “has been made — and the lives of millions of people saved — because of PEPFAR, … [t]he largest ever global investment in health by the United States government.” With PEPFAR’s “aggressive new goals” — to provide antiretroviral drugs to six million people in low- and middle-income countries, “fund 4.7 million male circumcisions and provide antiretroviral therapy to 1.5 million HIV-infected pregnant women by 2013” — “[w]e need to ask: Are we setting ambitious goals that we’re not prepared to fund or meet? Are we setting up one of our country’s greatest successes for failure?” Merson asks. He notes that “PEPFAR funding has flatlined despite these new targets and is not nearly enough to maintain progress and continue reducing new HIV/AIDS cases and deaths” and that “uncertainty” surrounds the “commitment by Congress” and the outcome of the presidential election. Saying that “PEPFAR itself also needs to continue to adjust its priorities,” Merson states that “treatment, prevention, care, health system capacity and scientific research to develop an HIV vaccine require financial commitment, strong political will and investment in resources from all stakeholders. Let us not fall behind now and bring back the suffering of the past” (7/20).