“Urban America continues to suffer high rates of HIV despite successes of antiretroviral treatment that can suppress the virus, decrease transmission, prevent progression to AIDS, and lower death rates,” Gregory Pappas, senior deputy director of the Washington, D.C., Department of Health’s HIV/AIDS, Hepatitis, STD and TB Administration (HAHSTA), writes in a Washington Blade opinion piece. “The global U.S. response known as the President’s Emergency Program for AIDS Relief (PEPFAR) succeeded by enhancing funding, coordinating government efforts and working across jurisdictions,” he states, adding, “A domestic PEPFAR would emphasize enhanced spending, promote regional data, and plan and coordinate services regionally.”
Programs, Funding & Financing
“African nations are not receiving adequate international funding to fight HIV/AIDS, leaving them to face catastrophic consequences without enough medication, an independent, global medical and humanitarian organization said Thursday,” the Associated Press reports. “In a statement released in Johannesburg ahead of the [AIDS 2012] conference in Washington starting July 22, [Medecins Sans Frontieres (MSF)] said African countries worst affected by the pandemic were the least able to provide ‘the best science’ available to fight it,” the news service writes.
Noting that Washington, D.C., has an adult HIV prevalence rate higher than some southern African countries that receive PEPFAR funding, GlobalPost writes that the International AIDS Conference, to be held in the U.S. for the first time in 22 years starting Sunday, has highlighted “that America is nowhere close to an AIDS-free generation at home.” The news service continues, “Attendees hope AIDS 2012 will help set the agenda, both globally and domestically, as leaders, activists, and advocates from around the world discuss the achievements made and the goals ahead.” GlobalPost notes that it co-produced a segment examining the U.S. HIV/AIDS epidemic with PBS NewsHour that aired on Thursday (Judem, 7/19).
The Washington Blade compares U.S. HIV/AIDS efforts under the administrations of former President George W. Bush and President Barack Obama. According to the news service, “Some praise the Obama administration for laying out a comprehensive plan and bumping up domestic funding to confront the epidemic, while others yearn for the Bush days because of the global initiatives the Republican president started.” The article goes on to highlight major accomplishments and criticisms of each administration (Johnson, 7/19).
Ahead of the XIX International AIDS Conference next week, UNAIDS on Wednesday launched a new report, titled “Together we will end AIDS” (.pdf), “that shows that a record eight million people are now receiving antiretroviral therapy [ARVs], and that domestic funding for HIV has exceeded global investments,” the U.N. News Centre reports (7/18). “In all low- and middle-income countries, the availability of antiretroviral drugs grew by more than 20 percent in just one year, compared to the latest figure of 6.6 million people covered in 2010, said the report,” Agence France-Presse writes (Sheridan, 7/19). “At that rate, the world should meet a U.N. goal of having 15 million people [in low- and middle-income countries] on treatment by 2015, the report found,” the Associated Press adds (Neergaard, 7/18). “Fewer people infected with HIV globally are dying as more of them get access to” ARVs, “particularly in sub-Saharan Africa,” Reuters notes (Beasley/Miles, 7/18). AIDS-related deaths “dropped 5.6 percent to 1.7 million in 2011 from the previous year,” Bloomberg writes, adding that deaths “peaked in 2005 and 2006 at 2.3 million and have been going down since then, according to the report” (Pettypiec/Langreth, 7/18).
A funding analysis released on Wednesday by the Kaiser Family Foundation (KFF) and UNAIDS found that “[f]unding to fight HIV/AIDS in low- and middle-income countries has remained flat at $7.6 billion,” Politico Pro reports (7/18). “Overall donor government support for AIDS has been flat since 2008, which marked the end of rapid increases in donor disbursements of more than six-fold over the 2002 to 2008 period,” according to a KFF/UNAIDS press release (7/18). The report examines donor government funding to recipient countries, as well as contributions to multilateral organizations such as the Global Fund to Fight AIDS Tuberculosis and Malaria and UNITAID, according to the Center for Global Health Policy’s “Science Speaks” blog.
In this post in the Center for Global Development’s (CGD) “Global Health Policy” blog, Jenny Ottenhoff, policy outreach associate at the center, says “four big issues will impact U.S. support for the global response to the [AIDS] epidemic over the coming year.” According to Ottenhoff, these issues include the FY 2013 budget; the upcoming presidential election; “looming, automatic, across-the-board spending cuts that will be triggered under sequestration in January 2013”; and the potential reauthorization of PEPFAR, which will be decided in 2013. “These storm clouds over AIDS funding could turn out to have a silver lining if austerity creates pressures to improve the global response to AIDS in ways that make it more effective and efficient,” she writes (7/18).
Gains In Child Health, Education Threatened By Increase In Malnutrition, Save The Children Report Says
“More children survived past their fifth birthday and attended school at the end of the 2000s than a decade before, but a rise in acute malnutrition could undermine these unprecedented gains,” according to a report released Thursday by Save the Children, AlertNet reports. Between 2005 and 2010, “1.5 million more children suffered from wasting or acute weight loss … than in the first half of the 2000s,” the news agency reports, adding, “This happened as high, volatile food prices and increasingly extreme weather made food less affordable for many poor families, tipping some into crisis” (Nguyen, 7/19). According to the report, Japan is the best place for children, and Somalia “is ranked last among the nations considered following a food crisis last year which killed tens of thousands of children,” the Independent notes. “According to Save The Children, the overall proportion of acutely malnourished children grew by 1.2 percent during the previous decade,” the newspaper writes (Diaz, 7/19).
The goal of an “AIDS-free generation” “requires an ambitious implementation-science agenda that improves efficiency and effectiveness and incorporates strategies for overcoming the stigma and discrimination that continue to limit the uptake and utilization of [treatment, prevention and care] services,” AIDS 2012 Co-Chair Diane Havlir of the University of California-San Francisco School of Medicine and Chris Beyrer of the Johns Hopkins Center for AIDS Research write in a New England Journal of Medicine opinion piece. They note that “[r]esearch efforts on HIV vaccines will also probably be key, and the field has been reinvigorated” by recent study results. “A combination approach to prevention that includes HIV treatment can generate tremendous gains in the short term by curtailing new HIV infections, but ending the AIDS epidemic will probably require a vaccine, a cure, or both,” they write.
Optimism surrounding the science of HIV treatment and prevention “is tempered by less auspicious trends, particularly shrinking budgets for global health in the U.S. and around the world,” Victoria Fan, Amanda Glassman, and Rachel Silverman of the Center for Global Development (CGD) write in the center’s “Global Health Policy” blog. “In this increasingly austere budget climate, generating ‘value for money’ (VFM) is a top concern for global health funding agencies and their donors, who want the biggest bang for their buck in terms of lives saved and diseases controlled,” they write, noting that a CGD-convened working group has produced a draft background paper (.pdf) on the Global Fund to Fight AIDS, Tuberculosis and Malaria. The paper identifies “priority challenges” for the fund, which the authors discuss. They invite readers to comment on the consultation paper on the blog or by email (7/18).