Mapping Pathways is a multi-national project to develop and nurture a research-driven, community-led global understanding of the emerging evidence base around the adoption of antiretroviral-based prevention strategies to end the HIV/AIDS epidemic. The evidence base is more than results from clinical trials - it must include stakeholder and community perspectives as well.

07 December 2011

AIDS Battle Risks Being Derailed by Global Financial Crisis

via Nature, by Meredith Wadman

Thirty years after AIDS was first recognized as a human scourge, major recent gains in treatment and prevention risk being derailed by the global financial crisis.

On 23 November, the Global Fund to Fight AIDS, Tuberculosis and Malaria announced that it will not fund new grants for prevention and treatment until 2014, owing to “substantial budget challenges in some donor countries”. The fund's HIV activities run the gamut from counselling and testing pregnant women in India to providing medications to infected children in Kenya.

And on 7 December, a report from Policy Cures in Sydney, Australia, a group that monitors global research and development for neglected diseases, showed that public and private funders last year cut their commitments to HIV/AIDS research targeted at the developing world by US$67.5 million, or 5.9%. The decline was due entirely to cutbacks by wealthy nations, which slashed spending by $72.6 million; poorer countries actually increased funding by $5.1 million. Where research is concerned, “AIDS had a bigger drop in dollar terms than any other disease”, says Mary Moran, the executive director of Policy Cures and the lead author on the report.

The threat comes even as US President Barack Obama last week promised that the United States will step up its worldwide attack on AIDS. Breaking the White House's past reticence on the issue, he urged nations to honour their unmet pledges to the Global Fund.

“Countries that have committed to the Global Fund need to give the money that they promised,” he said on 1 December, World AIDS Day. “Countries that haven't made a pledge, they need to do so,” he added, singling out emerging nations such as China that are recipients of funds “but now are in a position to step up as major donors”.

The United States has given $6.1 billion to the Global Fund since 2004, and last year pledged to contribute $4 billion between 2011 and 2013. Congress approved $1.05 billion in 2011, meaning that allotments must increase substantially in 2012 and 2013 to honour the pledge. Obama has asked Congress to provide $1.3 billion in 2012, but Senate lawmakers have so far resisted the increase.

Obama pledged to increase by 50% — to 6 million — the number of people receiving antiretroviral therapy (ART) worldwide by 2013 through the President's Emergency Plan for AIDS Relief (PEPFAR), the nation's major global treatment and prevention programme. He also said PEPFAR would aim to provide ART to an additional 1.5 million pregnant women with HIV in the next two years. The international promises came with no new money immediately attached. But Obama has asked Congress to provide nearly $7.2 billion — a 6% increase — for PEPFAR in 2012, part of the unfinished budget bills still being debated.

Advocates said that his speech marked a significant turning point. “This is the first time he's signalled that he's going to champion global HIV in this way,” says Jennifer Cohn, an assistant professor of infectious diseases at the University of Pennsylvania in Philadelphia, and a policy adviser in Nairobi for Médecins Sans Frontières (MSF; also known as Doctors Without Borders). “Whether or not this gets translated into the president's 2013 budget request, or what Congress chooses to protect during the 2012 budget negotiations — that's what I'm waiting to hear.”

Read the rest.

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