By 2031 developing countries could need an estimated $35 billion to fight HIV/AIDS – three times the amount currently spent, according to a Health Affairs study published Tuesday, the New York Times reports. The analysis – based on economic models that assumed condoms, drugs and circumcision would be widespread – found that “even under the best case … more than one million people would be newly infected each year. (About 2.3 million were infected in 2007.) Achieving that outcome would cost $722 billion over 22 years, or nearly $8,000 for each infection prevented,” the newspaper writes. The researchers did not assume in their modeling that microbicides or vaccines would be readily available during the time frame examined.

The newspaper writes: “Rapidly developing countries like Brazil, China, India, Mexico and Russia should be able to pay for fighting their own relatively small epidemics, the authors said. Southern African countries will need only some help, despite having the world’s highest AIDS rates. But much of Africa, and especially Kenya, Mozambique, Uganda and Zambia, will remain heavily dependent on donors” (McNeil, 11/2).

“We are on the verge of a serious crisis,” said study co-author Robert Hecht, who manages a group specializing in health programs in low- and middle-income countries, Agence France-Presse reports. “The cost of fighting the epidemic for treatment and prevention is rising very rapidly around the world, especially in southeastern Africa,” while support for programs targeting the disease is becoming “scarcer and scarcer” in the face of the “global recession and also because of competition for development funds in other area[s],” Hecht said.

“But the funding shortfall is also ‘a moment of opportunity,’ Hecht said, ‘because it’s a chance for government officials and external funders to take a hard look at what they have been doing and to find ways to spend the money that is available in a more efficient way to cut down on waste,'” the news service writes.

The study was one of several published in the November/December issue of Health Affairs and funded by the Bill & Melinda Gates Foundation focused on the “challenges facing world policymakers on HIV/AIDS prevention and treatment,” the news service writes (11/3).

The journal also includes several studies on neglected tropical diseases (NTDs), including one that examined the role that small biomedical companies in the developing world are helping develop treatments for NTDs, Inter Press Service reports. “Everyone thinks multinational drug companies can provide the vaccines and diagnostics for neglected tropical diseases. Our research shows that it’s small biomedical companies in the developing world that are doing it,” said study co-author Peter Singer of the McLaughlin-Rotman Centre for Global Health at the University of Toronto.

“Singer and his colleagues document for the first time the innovative products and capabilities of 78 homegrown, small to medium-sized health biotechnology companies in Brazil, China, India and South Africa,” the news service writes. “Collectively, these companies produced 123 products, including vaccines, drugs and diagnostic tests, for all neglected tropical diseases (NTDs), as well as the ‘Big 3’ – malaria, tuberculosis and AIDS.”

“We are not calling for replacement of the charity of multinationals. Rather, we are pointing out that there is a well of affordable innovation in developing countries themselves that has not been fully tapped,” Singer said. The study authors propose the creation of a not-for-profit service, which they call the “Global Health Accelerator (GHA) project,” that “would help get innovative NTD-related health products to distant markets by connecting a diverse international community of biotech innovators, facilitate public-private partnerships, provide business support services, and operate as an independent hub linking companies, investors, and interested parties,” the news service writes.

“We think of the Global Health Accelerator as a FedEx for new drugs, vaccines and diagnostics to combat neglected tropical diseases,” Singer said (Leahy, 11/3).

A Health Affairs press release highlights additional pieces that appear in the November/December issue of Health Affairs (11/3).