Costs for Antiretroviral Drug Treatment, HIV Prevention, AIDS Orphan Care in Developing Countries Will Be $12B by 2005, UNAIDS Report Says
The cost of providing antiretroviral drug treatment, care for AIDS orphans and HIV prevention in services in developing countries is expected to reach $12 billion by 2005 and could reach $20 billion by 2007, according to a report released Monday by UNAIDS, the San Francisco Chronicle reports. The bulk of the increase reflects the cost of expanding treatment from fewer than 500,000 people to six million HIV-positive people by 2007, as well as the provision of essential services, according to the report (Russell, San Francisco Chronicle, 7/13). According to the report, titled "Financing the Expanded Response to AIDS," funding for next year is still anticipated to fall short by $6 billion in 2005, even though total global spending to combat HIV/AIDS increased from $1.2 billion in 2000 to $6 billion in 2004. UNAIDS researchers used new data from 78 countries on "actual costs" for prevention, care, treatment, orphan support, policy, advocacy and administrative programs to complete the report. Bilateral support for the efforts to combat the HIV/AIDS pandemic has increased 64% among leading donor countries between 2000 and 2002. UNAIDS predicts that bilateral spending will reach $1.3 billion by the end of 2004, according to a UNAIDS release.
According to the report, the United States is the leading bilateral donor "in terms of absolute dollars," the release said (UNAIDS release, 7/12). The House Appropriations Committee on Friday approved by voice vote a $19.4 billion foreign aid spending bill for fiscal year 2005, Reuters reports. The foreign aid bill provides $2.2 billion for HIV/AIDS, tuberculosis and malaria initiatives. Some critics have called the amount "inadequate" compared with the funding provided for the war on terror and post-war Iraq, Reuters reports (Willard, Reuters, 7/9). Although the approved funding -- most of which will go to AIDS programs -- meets President Bush's request for FY 2005, an appropriations subcommittee allocated a larger portion of the money to the Global Fund to Fight AIDS, Tuberculosis and Malaria than Bush had requested. Bush's proposed FY 2005 budget, which is $1.9 billion more than the total amount the subcommittee approved, includes $2.8 billion for international HIV/AIDS, TB and malaria programs. That amount includes $1.45 billion for the State Department Office of the Global AIDS Coordinator, which will administer the President's Emergency Plan for AIDS Relief, and $200 million for the Global Fund. Because the draft spending bill would double the requested Global Fund contribution to $400 million, less money would go to PEPFAR. The $2.2 billion approved by the House subcommittee combined with an anticipated $600 million in funding from the Labor-HHS-Education appropriations bill would bring overall global AIDS, TB and malaria spending to $2.8 billion for FY 2005 (Kaiser Daily HIV/AIDS Report, 6/24).
Funding Gap Getting Worse?
UNAIDS Director of Evaluation Dr. Paul De Lay said, "Unless more resources are directed toward the global response, the gap between the need and available resources will grow significantly in coming years" (UNAIDS release, 7/12). The situation could be worsened by a lack of inexpensive second-line treatments for HIV-positive people who develop resistance to first-line drugs, according to the Chronicle. Because about 10% to 20% of people living with HIV/AIDS who take antiretroviral drugs develop resistance, some advocates predict the costs for providing second-line treatments to cause a "sort of balloon payment down the road," the Chronicle reports.
Advocates are "step[ping] up their campaign" for wealthy countries to increase their donations to the Global Fund. Richard Feachem, executive director of the fund, said that it would not be possible to reach the fund's 2005 $3.5 billion goal if wealthy countries do not increase contributions, according to the Chronicle (San Francisco Chronicle, 7/13). U.N. Special Envoy for HIV/AIDS in Africa Stephen Lewis said that funding concerns have put efforts to combat HIV/AIDS "on the knife's edge of the chasm," adding, "Either we continue the flow of funds and continue to increase treatment and make people feel there's hope, or we suffer a dreadful setback in responding to the pandemic." Ambassador Randall Tobias, head of the State Department Office of the Global AIDS Coordinator, said that the United States is "certainly going to continue to contribute to the Global Fund," but he added, "We need to put more emphasis on getting [the money already contributed to the fund] put to work." Global AIDS Alliance President Paul Zeitz said that the funding situation amounts to a "battle between a U.S. go-it-alone approach and multilateralism" (Nakashima, Washington Post, 7/13).