AIDS funding in crisis: Who is to blame?

AIDS funding is in crisis.  In its 2010 annual report UNAIDS demonstrated that although there has been progress towards reaching MDG 6 as well as achieving the goal of universal access to HIV prevention, treatment, care and support, the global village have fallen far short overall of achieving MDG 6 target – of halting and beginning to reverse the spread of HIV by 2010.   Looking at major donors like theUnited States, financing for the global AIDS epidemic has been flat lined. The Global Fund to Fight AIDS, TB and Malaria (GFATM) at its October 2010 replenishment, fell $10billion short of the amount it needs in 2011‐2013 to continue the massive success and scale up of interventions that have been seen recently.

In face of this funding crisis, World Health Organization states that there are more than 33 million people living with HIV/AIDS worldwide, and the majority of them are in sub-Saharan Africa.  In sub-Saharan Africa, where a majority of people earn less that US$1 a day the direct medical cost of AIDS has been estimated at about US$30 per year per person. Overall public health spending is less than US$10 per person per year in most African countries. Although the recent increase in the provision of antiretroviral drugs (ARVs), which significantly delay the progression from HIV to AIDS has brought hope to people living with HIV across the world; has also put increased strain on healthcare workers because providing ARVs requires more time and training than is currently available.

Despite substantial increase in AIDS funding, the funds have not been able to equal the need, UNAIDS estimates that an investment of at least $22 billion will be needed by 2015. The UNAIDS and Kaiser Family Foundation further observed that funding from donor governments for the AIDS response in low- and middle-income countries in 2010 fell by 10 percent from the previous year’s level.  Although the 11.7 billion dollars pledged to the Global Fund in 2010 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.  This situation has partly been attributed to global economic crisis and general donor fatigue.

As a follow up to the previous global commitments on universal access to treatment, this year’s UN High Level Meeting UNAIDS on AIDS resolved to treat 15 million people by 2015.  This will only be possible if donor governments and recipient governments work together for a common good; as UNAIDS believes that future progress will only depend heavily on the joint efforts of everyone involved in the HIV response.

The scarcity of HIV funds is being felt on the ground.  Tearfund Partners working on an integrated HIV project inMalawihad this to say during their last report in August this year:

“Since the project started, implementation experienced a number of significant changes both locally and globally. Challenges like credit crunch, reduction in the amount of funding disbursed… Unavailability of HIV Testing and Counselling (HTC) kits in most of Health facilities in Malawi reduced the number of people willing to know their HIV status. Sector members planned to open more clinics, but there was a shortage of HTC kits available across Malawi and we were unable to run the clinics. The lack of HTC kits also had a negative impact on the efforts to reduce transmission of HIV from Parents to the unborn children as the health facilities could not provide the service”

This example as well as other several similar stories from the grassroots indicates that there is an urgent need for predictable actions in raising AIDS funds to adequate levels.  Who is to blame for this mess?  Those in leadership (key policy makers) both at donor and recipient level are to blame. Funding gaps threatens the progress that has already been made in the response to HIV/AIDS for these past 30 years since the epidemic was discovered.

What should be done to avert this funding situation? There is a need to form new workable partnerships between the North and South in terms of equal responsibility, accountability and mutual trust in the context of tangible global political will.  The Global Fund needs to be replenished adequately.  Donor governments need to be encouraged to increase their funds in line with their national GDP.  Developing countries need to scale up ‘innovative funding mechanisms’ that can assist in replenishing their health budgets.  Civil Society groups need to continue to make their useful noise in making sure that promises are being fulfilled.

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