Head­way on AIDS threat­ened by slow fund­ing un­der Trump

2018 Trump bud­get could de­prive 830,000 peo­ple

Kuwait Times - - HEALTH & SCIENCE -

PARIS: Progress in beat­ing back the AIDS epi­demic risks be­ing eroded by a fund­ing short­fall set to grow un­der Don­ald Trump’s pro­posed cuts to global health projects, ex­perts and cam­paign­ers warned ahead of a ma­jor HIV con­fer­ence. If adopted by Con­gress, the 2018 Trump bud­get could de­prive some 830,000 peo­ple, mostly in Africa, from life-sav­ing anti-AIDS drugs, ac­cord­ing to cal­cu­la­tions by the Kaiser Fam­ily Foun­da­tion (KFF), a Cal­i­for­nia-based health pol­icy NGO. “We will see lives need­lessly be­ing lost,” said Linda-Gail Bekker, pres­i­dent of the In­ter­na­tional AIDS So­ci­ety (IAS) host­ing some 6,000 ex­perts in Paris from Sun­day to take stock of ad­vances in HIV sci­ence.

“We’re not talk­ing about maybe a slow­ing down... if these (US) cuts come about we could very well see a real turn­around in terms of the progress that has been made,” she said. A Trump bud­get could lead to nearly 200,000 new HIV in­fec­tions, ac­cord­ing to the KFF. It could also leave as many as 25 mil­lion cou­ples with­out ac­cess to spon­sored con­tra­cep­tives, which not only pre­vent preg­nancy but also virus spread. “I can­not tell you how anx­ious I feel... To have the fund­ing car­pet taken from un­der our feet just seems such an in­cred­i­ble trav­esty,” said Bekker.

The United States has for years been the big­gest con­trib­u­tor to the global fight against HIV in­fec­tion, ac­count­ing for about two-thirds of fund­ing by gov­ern­ments. Last year, it con­trib­uted $4.9 bil­lion (4.2 bil­lion eu­ros) to global HIV projects — 7.5 times the amount pro­vided by sec­ond-placed donor Bri­tain. Trump’s pro­posed bud­get, sub­mit­ted in May, would re­duce this amount by about $1 bil­lion, ac­cord­ing to Health Global Ac­cess Project, an ac­tivist group which crunched the num­bers.

Oth­ers must do more

The US pres­i­dent put for­ward a blue­print which, in its own words, “re­duces fund­ing for sev­eral global health pro­grams, in­clud­ing HIV/AIDS, with the ex­pec­ta­tion that other donors can and should in­crease their com­mit­ments.” The draft spend­ing plan pro­poses to “main­tain cur­rent com­mit­ments and all cur­rent pa­tient lev­els on HIV/AIDS treat­ment” un­der the Pres­i­dent’s Emer­gency Plan for AIDS Re­lief, or PEPFAR, set up by Ge­orge W. Bush in 2003. The pro­gram pro­vides anti-retro­vi­ral treat­ment (ART) to over 12 mil­lion peo­ple.

The goal of PEPFAR, said An­thony Fauci, di­rec­tor of the Na­tional In­sti­tute of Al­lergy and In­fec­tious Dis­eases (NIAID), a US gov­ern­ment re­search agency, “is to get more peo­ple who have been newly in­fected on ther­apy”-which means more money. “If you don’t in­crease it, you... have more re­spon­si­bil­i­ties that you are not able to meet.” Trump also pro­posed a 17-per­cent cut of $222 mil­lion to the gov­ern­ment’s 2017 con­tri­bu­tion of $1.13 bil­lion to the Global Fund to Fight AIDS, TB & Malaria, which pro­vides about 10 mil­lion peo­ple with ART.

“The fu­ture out­look of donor fund­ing for HIV re­mains un­cer­tain, given re­cently pro­posed cuts to HIV fund­ing by the US, amidst other com­pet­ing de­mands on donor bud­gets more gen­er­ally,” said the KFF re­port. Since the epi­demic erupted in the 1980s, 76.1 mil­lion peo­ple have been in­fected with HIV, the virus that causes AIDS. Some 35 mil­lion have died. Last year, AIDS killed a mil­lion peo­ple and in­fected an­other 1.8 mil­lion, ac­cord­ing to the UN. And while in­fec­tions and deaths are on the de­cline, the num­ber of peo­ple liv­ing with HIV re­quir­ing life­long treat­ment-con­tin­ues to grow.

Com­ing up short

Last year, 19.5 mil­lion of the 36.7 mil­lion peo­ple who needed it, had ac­cess to ART. By 2020, the UN is aim­ing for 90 per­cent of HIV-in­fected peo­ple to be on med­i­ca­tion. But to achieve this tar­get, an­nual spend­ing must reach $26.2 bil­lion (22.4 bil­lion eu­ros), ac­cord­ing to UNAIDS. In 2016, pub­lic and pri­vate fun­ders were able to muster $19.1 bil­lion for AIDS re­search, pre­ven­tion and treat­ment pro­grams in poor and mid­dle-in­come coun­tries. “We are max­i­miz­ing the use of ev­ery dol­lar avail­able, but we are still $7 bil­lion short,” UNAIDS ex­ec­u­tive di­rec­tor Michel Sidibe said this week.

The IAS con­fer­ence or­gan­is­ers warned in a state­ment that “all of the sci­en­tific chal­lenges still be­fore us are threat­ened by a weak­en­ing re­solve to fund HIV sci­ence.” The gap is set to grow larger. “It is... a dif­fi­cult mo­ment for all of us,” said French HIV ex­pert Jean-Fran­cois Del­fraissy, who will co-chair the Paris meet­ing, cit­ing a “mod­i­fi­ca­tion in fund­ing in the US” and a shift in “the po­lit­i­cal vi­sion of the US gov­ern­ment” on work­ing with other coun­tries.

Just over half of AIDS-re­lated health spend­ing came from do­mes­tic sources in 2016, but many of the poor­est coun­tries re­main heav­ily re­liant on for­eign help. Glob­ally, said the KFF, gov­ern­ment donor fund­ing for HIV dropped in 2016 to the low­est level since 2010 — from $7.5 bil­lion to $7 bil­lion. “We’ve seen two suc­ces­sive years of de­clines,” said Jen Kates, the foun­da­tion’s HIV pol­icy di­rec­tor. “This raises con­cerns about the abil­ity of the global com­mu­nity to suc­cess­fully tackle the epi­demic.” — AFP

WASH­ING­TON: This file photo shows US Pres­i­dent Don­ald Trump an­nounc­ing his de­ci­sion to with­draw the US from the Paris Cli­mate Ac­cords in the Rose Gar­den of the White House in Wash­ing­ton, DC. — AFP

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