International HIV/AIDS Spending Falls Short of Need, Global HIV Prevention Working Group Report Says
Annual global spending on HIV/AIDS prevention and treatment falls far short of current and future needs, with only one-fifth of individuals at risk for HIV infection having access to prevention programs, according to a report released yesterday by the Global HIV Prevention Working Group, the San Francisco Chronicle reports (Russell, San Francisco Chronicle, 5/14). The Working Group, which was convened in 2002 by the Bill & Melinda Gates Foundation and the Kaiser Family Foundation, is comprised of nearly 40 experts in public health, clinical care, biomedical, behavioral and social research and people affected by HIV/AIDS around the world (AP/New York Times, 5/14). According to a Working Group release, the report, titled "Access to HIV Prevention: Closing the Gap," is the first region-by-region analysis of access to prevention programs and spending levels compared with projected future need. The report states that most people with the greatest need do not have access to prevention programs (Working Group release, 5/13). According to the report, 5% of at-risk pregnant women have access to antiretroviral treatment to prevent mother-to-child HIV transmission; 12% of high-risk individuals have access to HIV counseling and testing; 24% of high-risk individuals have access to HIV/AIDS education; and 42% of people in need have access to condoms (Agence France-Presse, 5/14). The report also indicates that 19% of injection drug users have access to harm reduction programs. In addition, the report found that access to treatment is "even more limited." The group suggests both prevention and treatment be further integrated (Working Group release, 5/13).
"Twenty years into the AIDS epidemic, most people in the world still don't have access to effective HIV prevention," Helene Gayle, director of the Gates Foundation's global HIV/AIDS program and co-chair of the Working Group, said (Agence France-Presse, 5/14). She added, "A dramatic scaling up of HIV prevention, combined with increased access to treatment for the millions already infected, can control and ultimately reverse AIDS" (Williams, Financial Times, 5/14). The $1.9 billion spent on global HIV prevention in 2002 falls $3.8 billion short of the $5.7 billion UNAIDS says is needed annually by 2005 for HIV/AIDS prevention, according to the report. Kaiser Family Foundation President and CEO Drew Altman said, "The resource needs are acute, but to date too many donor governments have not contributed their share" (AP/New York Times, 5/14). Gayle said, "This isn't going away. Either we pay now or we pay later" (Sternberg, USA Today, 5/14).
The report recommends increasing global HIV/AIDS funding three-fold by 2005; scaling up prevention programs in all regions; integrating prevention and treatment programs; improving infrastructure; focusing policy reform and international aid on issues such as stigma, poverty and gender equality that facilitate the spread of HIV/AIDS; and accelerating research on effective prevention strategies, according to the Working Group release. "There is no magic bullet to prevent the spread of HIV," David Serwadda of the Institute of Public Health at Makerere University in Kampala, Uganda, who is co-chair of the working group, said, adding, "Only a combination of approaches that addresses the needs of different populations at risk can be effective" (Working Group release, 5/13).
In an interview with kaisernetwork.org, Gayle comments on U.S. efforts to fund the global fight against HIV, saying, "I am cautiously optimistic. I think that this has been a very encouraging sign that there has been recent increased vigor around the discussion of this as an important global issue for us and the rest of the world." Gayle adds that the Working Group plans to "develop some reports that even go deeper into some of the regional issues -- particularly in Africa that has already been very hard hit -- but also in Asia which is a part of the new wave and the emerging epidemic globally." HealthCasts of the report's release and Gayle's complete interview are available online.