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Funding Falls Short for Global Fight Against AIDS

Aprille Muscara

UNITED NATIONS, Oct 6 2010 (IPS) - The 11.7 billion dollars pledged Tuesday to replenish the Global Fund to Fight HIV/AIDS, Tuberculosis and Malaria for the coming three years falls significantly short of the 20 billion dollars hoped for, threatening to undo the progress made in the fight against these diseases – the three largest infectious killers in the world.

The 8.3 billion dollar funding shortfall “will result in the death of millions of people from otherwise treatable diseases. Ambitious country programmes, which could mean the difference between life and death, may no longer be feasible,” said Dr. Jennifer Cohn, HIV/AIDS policy advisor for Doctors Without Borders.

The publicly and privately financed Global Fund dispenses money to countries to support programmes that treat and prevent the three infectious diseases.

These programmes are estimated to have saved some 5.7 million lives – results that Global Fund Executive Director Michel Kazatchkine said were not expected even three years ago. But as a consequence of Wednesday’s underfunding, Kazatchkine worries that these gains could be reversed.

“The total amount pledged today, if it were to be the last word from donors, is not enough to meet even the lowest estimate of demand that we have for the next three years, and not enough to meet the Millennium Development Goals,” he said.

Three funding scenarios ranging from 13 to 20 billion dollars were proposed for 2011-2013 to scale up the Fund’s programmes, with each amount corresponding to different paces and time tables for achieving the health goals.

With even the minimum target amount not reached, Kazatchkine said that countries would not be able to scale up their programmes as fast as had been hoped. As a result, lives will continue to be lost.

Even now, “people are dying from preventable and treatable diseases,” he said. “This is the reality of the world… people who do not access care die of diseases, and this is a scandal.”

Although no programmes will be cut as a result of the funding shortfall, the effort to scale up the Fund’s work was deemed necessary to achieve Millennium Development Goal (MDG) targets.

Goal six is to combat HIV/AIDS, Tuberculosis (TB) and Malaria. Experts have estimated that a one-third reduction of TB deaths – except those due to drug-resistant strains – can be achieved by the 2015 MDG deadline. And universal coverage of bed nets – to protect from malaria-carrying mosquitoes – is achievable by as early as 2012, they said.

Most notable is the prospect of ending deaths due to malaria – one of the world’s oldest killers – within the next five years. If achieved, this eradication would represent one of the greatest health triumphs of our lifetime.

But, as the Global Fund is the largest multilateral funder of efforts against these three diseases, health officials and non-governmental organisations worry that its shortfall in resources for the coming three years puts possibilities for success in real jeopardy.

Kazatchkine said that if no further pledges are received, difficult decisions would have to be made down the road – potentially affecting the health and livelihood of millions.

For instance, Carol Nawina Nyirenda said, a country might have to choose between seeking resources for a TB programme or an HIV/AIDS programme. But these are closely interlinked – TB is the number one cause of death for those living with HIV/AIDS.

Nyirenda, the national coordinator for the Community Initiative for Tuberculosis, HIV/AIDS and Malaria in Zambia, told IPS that the gap in funding will have real effects for people on the ground.

For every two people who receive treatment for HIV/AIDS, five new people are infected. As it stands now, the Global Fund will be able to continue to provide resources to treat the first two people. “But what happens to the five new infections?” Nyirenda asked. Without the necessary resources, “the Global Fund will not be able to manage those five new infections.”

This will have far-reaching consequences, she fears. Much of the progress made on combating HIV/AIDS can be attributed to the reduction of social stigma surrounding the disease, significantly easing the way for people to get tested and seek treatment.

But if people aren’t receiving treatment, she told IPS, “It will bring back the stigma.”

People spend sometimes one to two years on waiting lists to receive treatment, she explained. If this becomes more prevalent, or they don’t receive treatment at all, others in their community will be discouraged. “Then they think, ‘What’s the point of going for testing?’” Nyirenda said. “So if they don’t have treatment, what happens? They’ll die early.”

“The gap is worrying,” she told IPS. “Whether we like it or not, people are going to die.”

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