Global AIDS Efforts Will Require $9.2 Billion Annually, UNAIDS Report Finds
HIV prevention and treatment in the world's 135 poorest countries will require $9.2 billion per year, according to a UNAIDS report published in today's edition of the journal Science. The report, intended to be a "financial blueprint" for the United Nation's proposed Global AIDS and Health Fund, calls for a gradual increase in spending, starting with $3.2 billion next year and "steadily" increasing to $9.2 billion in 2005, Reuters/New York Times reports. Once the fund is at its full capacity, $4.8 billion would go toward prevention efforts and $4.4 billion would be allocated for treatment (Reuters/New York Times, 2/21). Half of the treatment funds would be used to purchase antiretroviral drugs to treat "about half" of the infected individuals who are "showing symptoms of the disease," Bernhard Schwartlander, chief epidemiologist for UNAIDS and the lead author of the report, said (Reuters/Philadelphia Inquirer, 6/22). But allocating funding toward antiretrovirals could be a source of conflict because some donors to the AIDS fund, which has already received about $500 million, have indicated that they "favor spending on prevention rather than treatment," the Las Vegas Sun, reports. "If some of the donors decide they don't want to treat, that's going to cause serious problems. Countries are not going to be viable if 25% of the population are left to die," Daniel Berman, a campaign coordinator for Doctors Without Borders, said (Las Vegas Sun, 6/21).
Funding issues are "likely to dominate" the U.N. General Assembly special session on HIV/AIDS, set to begin Monday in New York, the Washington Times reports. Deputy U.N. Secretary-General Louise Frechette said Tuesday that the fund is off to a "very good start" and added that she "hope[d] to hear more commitments" during the three-day meeting. She added that contributions to the fund should be "new money" and not "reallocation[s]" of existing international aid. But some observers noted that the global AIDS fund has a "long way to go" before it amasses the projected $9.2 billion necessary to fight HIV/AIDS. "I think past experience would suggest that $9 billion to $10 billion is unachieveable, at least in the short run," one international health funding expert who asked not to be identified, said, adding that $1.5 billion in new money was a "more realistic figure." However, Mark Schneider, senior vice president of the International Crisis Group, said it is "realistic to say that [$9.2 billion] is within the realm of what the international community is able to do," adding that the United States already spends about half a billion dollars annually on international AIDS efforts and that there is "discussion" of that figure doubling (Pisik, Washington Times, 6/22). Schwartlander called the $9.2 billion projection "truly possible," noting that the "key message is that we need a lot more commitment and a lot more resources to really effectively fight the epidemic (Reuters/New York Times, 6/21). "Many countries, including some of the poorest, have shown political commitment and developed plans to scale up treatment and prevention programs," he said. Under the model used by the report's authors, the funds would allow for prenatal HIV-screening of an additional 35 million women and the administration of medications to nearly one million of those women to reduce the risk of mother-to-child HIV transmission. The funding model also provides for the annual distribution of six billion condoms worldwide. Schwartlander "cautioned" that another $1.3 billion to $2.6 billion would be needed to treat malaria and tuberculosis, two other epidemics in the developing world, because the HIV/AIDS epidemic "cannot be tackled in isolation" (Picard, Globe & Mail, 6/22).
Besides funding, references in the special session's draft declaration to HIV "vulnerable groups," such as homosexuals and sex workers, looks to be another source of contention during next week's assembly. The Vatican and Muslim leaders have formed a "philosophical alliance" in an attempt to "block" the inclusion of the language, which refers to "men who have sex with men, people who have multiple sex partners, sex workers and their clients [and] injecting drug users and their sexual partners," the Wall Street Journal reports. "We believe in one family -- it is the family of a man, a woman and their children. What we are asking others is to respect such a background while we respect their background and traditions," Fayssal Mekdad, head of Syria's U.N. delegation, said. President Bush is also "uneasy" about the language and administration officials are attempting to "broker a compromise." Representatives for Canada and members of the European Union said that the inclusion of such vulnerable groups is "vital to ensuring that health programs reach people who need them most," and added that they are not asking the Vatican or Muslim nations to "approve" of the behavior (Phillips, Wall Street Journal, 6/22).