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AIDS Funding Gap Threatens Treatment Targets

Elizabeth Whitman

UNITED NATIONS, Jun 10 2011 (IPS) - A staggering nine million people are still awaiting HIV treatment, yet the 22 billion dollars the Joint United Nations Programme on HIV/AIDS (UNAIDS) says is needed to give them access to medicine and care has far from materialised.

Six billion dollars is needed to close the gap and bring care to those nine million, whose treatment, in addition to the six million already being treated, according to UNAIDS, would prevent 12 million new infections and 7.4 million deaths by 2020.

The treatment target of 15 million people by 2015 was finalised and adopted by member states in a declaration Friday afternoon, at the close of this week’s High Level Meeting on HIV/AIDS at the United Nations.

However, raising the funds to reach those people is made difficult by the fact that “overall, funding for the AIDS response has now reached a plateau,” said Christoph Benn, director of the External Relations and Partnerships Cluster for the Global Fund to Fight AIDS, Tuberculosis and Malaria, in an interview with IPS.

The Global Fund is a partnership of governments, civil society, the private sector, and communities, providing about half of AIDS funding through contributions from donor countries. The other half of AIDS funding comes from countries themselves, domestically, and a small percentage also comes from the private sector.

Despite the wide array of funding sources, “The international donor community will need to step up their contribution,” Benn affirmed, echoing what members of governments, non-governmental organisations, and civil society have emphasised repeatedly this week. He added that domestic funding needed to grow as well.

Benn also cited human rights, discrimination against person with HIV/AIDS, and technological innovation as key to fighting the disease that has killed 30 million people in 30 years. Despite the importance of these other factors, however, funding remains central, because “without financial resources,” he stressed, “you simply cannot reach the targets.”

“Universal access to HIV prevention, treatment, care and support can be achieved by 2015 with a boost in funding,” UNAIDS declared similarly in a recent report.

Although the 11.7 billion dollars pledged to the Global Fund last year by donor governments for the period 2011-2013 represented an increase from the 9.7 billion dollars pledged for 2007-2010, amounts actually disbursed by governments have fallen over the past two years.

The decline can be attributed to decreases in some donor countries’ contributions, such as by Spain and the Netherlands. Italy has ceased contributing entirely, said Benn.

The “plateau” Benn described refers to overall global resources for HIV available in low and middle-income countries, many of who still rely heavily on financial support from donor countries.

Developed and developing countries: a growing divide?

One of the most important results of the AIDS movement was “a strong sense of global solidarity” that emerged from the first High Level Meeting on AIDS 10 years ago, said Benn.

Governments recognised that all countries, rich and poor, had to contribute to fight AIDS.

According to UNAIDS, in 56 countries, international donors provide 70 percent of HIV resources – a figure that underscores how vital international cooperation is. But global economic circumstances have meant that some countries have scaled back crucial contributions.

Some northern countries have “dragged their feet” in contributing to AIDS funding, Michael Kavanagh of Health Global Access Project (Health GAP) told IPS, citing the United States and members of the European Union.

Acknowledging this comment, Benn stated, “There are certainly donor countries that are more generous in this respect and some that are less generous in this respect, so… Health GAP does have a point.”

Some countries’ reluctance to contribute to AIDS funding or their decision to prioritise other funding needs has implications beyond sheer numbers. A few donors’ choice to step away from funding “in a sense threatens the whole kind of global solidarity,” Benn said. “Then, other donors might also say, ‘Well, why should we pay if others don’t?’ I mean, you are all either in this together as a community, or you’re not.”

Michel Sidibe, executive director of UNAIDS, told IPS that he thought one of the major challenges in the future was “how we will enable a new partnership between the south and north.”

Outside the realm of funding prevention and treatment of AIDS, U.N. officials and civil society leaders have urged governments to take action to fight discrimination, improve healthcare systems, and make drugs more affordable – all steps that would increase the efficiency and productivity of existing resources.

A report by Medecins Sans Frontieres/Doctors Without Borders, for instance, urged countries to decentralise distribution of antiretroviral drugs in order to reduce transport costs that limit the accessibility of care and treatment.

Still, the global community possesses the scientific knowledge and the technology to overcome AIDS, leaders have emphasised. What it lacks is political will and as a result, sufficient financial resources and implementation of knowledge.

“We really know what works” in terms of treatment and prevention of HIV/AIDS, said Michele Bachelet, head of UN Women, in a panel on Wednesday.

But it is political will that provides the impetus to achieve and carry out measures – financial, infrastructural, social, and otherwise – that reduce HIV transmission and treat those living with it.

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