Helen Epstein's wrong about SA's response to AIDS

via politicsweb, by Nathan Geffen

Helen Epstein is an influential journalist and regular contributor to one of the world's most prestigious literary journals, the New York Review of Books (NYRB). It is therefore unsettling that she has written an article on the NYRB blog that contains serious errors about the South African HIV epidemic and the important prevention benefits of antiretroviral treatment (ART) (see here).

In her first sentence Epstein writes, "When I first visited South Africa in 2000 to report on the AIDS epidemic there, one adult in five was HIV positive, and a million children had lost one or both parents to the disease." These numbers are simply wrong. UNAIDS estimates that by 2001 there were 580,000 children who had lost one or both parents to AIDS. This is a horrific figure, but substantially less than Epstein's. 2 The Actuarial Society of South Africa estimates the number of children who had lost a mother or both parents to AIDS by mid-2000 and they reach a considerably lower estimate of about 120,000. 3 Epstein also overstates the percentage of adults infected with HIV in 2000.

Epstein writes, "Although the HIV infection rate has finally begun to fall in neighboring countries like Botswana and Zimbabwe, it remains stubbornly high in South Africa. After studying the African epidemic for two decades, I've come to believe that shame and silence are the primary reasons ..."

She is wrong that South Africa's infection rate is not falling. Also wrong is her implication that shame and silence make the South African epidemic signally different from those in Botswana and Zimbabwe.

Read the rest.


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Donor nation support for HIV stands firm but investments remain at 2008 levels

via Kaiser Family Foundation

               

U.S. continues to account for more than half of all donor government investments.

WASHINGTON, D.C., July 18, 2012— Donor nation funding in 2011 for HIV in low- and middle income countries returned to prior levels after a drop in 2010, but has been roughly flat since the recession hit world economies in 2008, according to an annual funding analysis from the Kaiser Family Foundation and the Joint United Nations Programme on HIV/AIDS (UNAIDS).

The study found that donor governments disbursed US$ 7.6 billion in 2011 for the AIDS response in low- and middle-income countries. Overall donor government support for AIDS has been flat since 2008, which marked the end of rapid increases in donor disbursements of more than six-fold over the 2002 to 2008 period.

"International investments still account for two thirds of funding for HIV in Africa, the continent most affected by the epidemic," said Paul De Lay, Deputy Executive Director, Programme at UNAIDS. "Although more and more countries are increasing domestic investments for HIV, investments from donor governments remain an essential resource."

"The benefits of early detection and treatment have never been more clear, but countries have never been more challenged to provide needed resources. This is a critical time to keep the focus on the HIV epidemic," said Drew Altman, Kaiser Family Foundation President and CEO.

The two largest donor governments – the United States and United Kingdom – reported funding increases. The United States, the largest donor nation, reported a US$785 million increase in disbursements over 2010, but only returned to 2009 levels after reporting a delay in disbursements as the reason for last year's decline. Australia, Canada, Denmark, France, Germany, Norway and Sweden maintained or slightly increased their support, while Ireland, Italy, Japan and the Netherlands decreased funding.

Read the rest here.


[Content that is linked from other sources is for informational purposes and should not construe a Mapping Pathways position. Please look for us on Facebook here www.facebook.com/MappingPathways and you can follow us on Twitter @mappingpathways as well.]

HIV and the Law

via the Global Commission on HIV and the Law

The end of the global AIDS epidemic is within our reach. This will only be possible if science and action are accompanied by a tangible commitment to respecting human dignity and ending injustice.

Law prohibits or permits specific behaviours, and in so doing, it shapes politics, economics and society. The law can be a human good that makes a material diff erence in people’s lives. It is therefore not surprising that law has the power to bridge the gap between vulnerability and resilience to HIV.

We came together as a group of individuals from diverse backgrounds, experiences and continents to examine the role of the law in eff ective HIV responses. What we share is our abiding commitment to public health and social justice. We have listened with humility to hundreds of accounts describing the eff ects of law on HIV. In many instances, we have been overwhelmed by how archaic, insensitive laws are violating human rights, challenging rational public health responses and eroding social fabric. At other times, we have been moved by those who demonstrate courage and conviction to protect those most vulnerable in
our societies.

Many would say that the law can be complex and challenging and is best left alone. Our experience during this Commission has shown us a very different perspective. We have been encouraged by how frank and constructive dialogue on controversial issues can sometimes quickly lead to progressive law reform, the eff ective defence of legislation or better enforcement of existing laws. Even in environments where formal legal change is a slow and arduous process, we have witnessed countries taking action to strengthen access to justice and challenge stigma and discrimination.

Click here for the full report.


[Content that is linked from other sources is for informational purposes and should not construe a Mapping Pathways position. Please look for us on Facebook here www.facebook.com/MappingPathways and you can follow us on Twitter @mappingpathways as well.]

Investigating the Impact of Treatment on New HIV Infections

via PLoS Collections

The HIV Modelling Consortium aims to strengthen the support that mathematical modelling and related quantitative disciplines can provide to global decision-making in HIV. In November 2011 the HIV Modelling Consortium held a meeting in South Africa to focus on the cross-cutting issues of the impact of new scientific findings about HIV treatment preventing new infections. The group considered the feasibility of interventions, potential epidemiological impact, affordability, and new scientific observational studies and community trials. The nine reviews and one research article which comprise this collection arose from that meeting and provide insights into the factors which will support evidence-based decision-making in HIV prevention, with a focus on the use of antiretroviral treatment to prevent HIV transmission.

Read the rest here.


[Content that is linked from other sources is for informational purposes and should not construe a Mapping Pathways position. Please look for us on Facebook here www.facebook.com/MappingPathways and you can follow us on Twitter @mappingpathways as well.]

WHO Updates Treatment-As-Prevention Plan for HIV and TB

via iasociety.org, by Mark Mascolini

“It is certain that TasP [Treatment as Prevention] needs to be considered as a key element of combination HIV prevention and as a major part of the solution to ending the HIV epidemic.”

With that statement, the World Health Organization (WHO) issued its June 2012 Programmatic Update on Antiretroviral Treatment as Prevention (TasP) of HIV and TB, available at the link below.

As countries continue to expand antiretroviral therapy (ART) programs for HIV-positive children and adults, WHO says, “it is expected that they will concurrently identify opportunities to maximize the use of ART for prevention purposes.”

TasP should focus on specific populations—such as HIV-discordant couples and pregnant women—in whom prevention should have the greatest impact. UNAIDS issued updates and guidance for these populations “and is working with countries to address programmatic and operational challenges to inform the consolidated guidelines to be released in mid-2013.”

The Programmatic Update includes guiding principles, the evidence base for TasP, a review of the current status of national HIV treatment guidelines and implementation experience with TasP, programmatic and operational considerations, and WHO’s three priority areas:

• Develop norms and standards for treatment as prevention
• Inform programmatic and operational decisions
• Define metrics for monitoring and evaluating the impact of TasP

WHO’s Gottfried Hirnschall told attendees at a London meeting that the new TasP recommendations will almost double the number of people judged to need antiretroviral therapy, aidsmap.com reports.

Read the rest.

[Content that is linked from other sources is for informational purposes and should not construe a Mapping Pathways position. Please look for us on Facebook here www.facebook.com/MappingPathways and you can follow us on Twitter @mappingpathways as well.]

India's Involvement to the Change of HIV/AIDS

via the Hindustan Times, by Sanchita Sharma

A decade ago, New Delhi’s The Ashok turned away a dozen gay men who wanted to book a conference room at the hotel for a think-in on AIDS, which was still labelled a gay man’s disease. It took several phone calls from the senior bureaucracy at the Union Health Ministry’s National AIDS Control
Organisation (NACO) to get them a 12x12 conference room for one day.

“Five years ago, the same group of men who have sex with men (MSMs, the politically correct term for homosexuals) organised a huge convention at The Ashok, with 700 MSM and transgender participants overrunning the hotel for days. Laws may not have changed in the courts or in the books, but the law in the streets has changed, and this amazing turnaround in society’s attitude has happened because of AIDS,” says JVR Prasada Rao, former Union health secretary and National AIDS Control Organisation (NACO) chief, who was appointed the UN Special Envoy for AIDS in the Asia Pacific region this week.

Safe and sound, legally

 Change in social attitude is fantastic, no doubt, but it is not enough to keep new infection down. Legal environment around people most at risk — homosexuals, injecting drug users and sex workers — has to change to encourage them to seek HIV-prevention and treatment services that have been proven to cut down new infections dramatically, not just in India but everywhere around the world.

Last year, the HPTN052 study — HIV Prevention Trials Network’s study that was declared the Breakthrough of the Year 2011 by the journal Science — showed that if an HIV-positive person adheres to antiretroviral therapy (ART) used to treat AIDS, the risk of transmitting the virus to their uninfected sexual partner is reduced by 96%.

In March this year, the Africa Centre for Health and Population Studies reconfirmed the HPTN findings by presenting data showing that in areas where ART uptake is high (greater than 30%) people who do not have HIV are 38% less likely to get infected with the virus as compared to areas of low uptake (less than 10%).

With 7.4 million on HIV treatment globally, new HIV infections have fallen in 33 countries since 2001, though mostly in Africa and Asia. UNAIDS credits the halving of India HIV-infected people to 2.39 million to both improved data collection methods and an actual fall in new infections because NACO provides 4.48 lakh people free anti-retroviral therapy (ART), which lowers the HIV load in the body and lowers the risk of infecting partners while helping the infected live healthier and longer.

Read the Rest.


[Content that is linked from other sources is for informational purposes and should not construe a Mapping Pathways position.]

UNAIDS Prevention Advocate Michel Sidibé's Approach to the Fight Against AIDS

viaNew York Times, by Donald G. McNeil Jr.

Shortly after Michel Sidibé became executive director of the United Nations’ AIDS prevention agency, a court in Senegal sentenced nine gay men, all AIDS educators, to eight years in prison for “unnatural acts.” In one of his first moves as the new chief of U.N.AIDS, Mr. Sidibe flew to Senegal to ask its aging president, Abdoulaye Wade, to pardon the men.
Mr. Sidibé, the son of a Muslim politician from Mali and a white French Catholic, asked the president — who is married to a white Frenchwoman — if he had ever suffered discrimination.
“Oh, Sidibé, you have no idea,” came the reply. “And for not marrying a Muslim.”

“Then, Uncle,” Mr. Sidibé said, using the African way to politely address an older man, “why do you accept that men here are put in jail for eight years just for being gay?”

Mr. Wade thought about it and promised to call his justice minister. Shortly afterward, the charges were dropped.

Asked if his predecessor — Dr. Peter Piot, a Belgian and one of the discoverers of the Ebola virus — could have gotten the same results, Mr. Sidibé said, “Without doubt, it would have been more difficult. It would be very automatically perceived as ‘the white people moralizing to us again.’ Since I’m African, I can raise it in a way that is less confrontational.”

Asked about that, Dr. Piot laughed and agreed, saying he sometimes thought his African missions, like those of the U2 singer Bono, “felt like a junior Tanzanian economist and Hugh Masekela coming to Washington to scold Congress for its budget deficit” — with Congress having to grin and bear it because it needed Tanzania’s cash.
Mr. Sidibé, 59, is a former relief worker, rather than a physician, and, along with English and French, he speaks West African Mandingo, the Tamashek of the Tuaregs and other languages.

With a combination of bonhomie and persistence, he has delivered difficult messages to African presidents very persuasively in his three years in office: Convince your men to get circumcised. Tell your teenage girls not to sleep with older men for money. Shelve your squeamishness and talk about condoms. Help prostitutes instead of jailing them. Ask your preachers to stop railing against homosexuals and order your police forces to stop beating them. Let Western scientists test new drugs and vaccines, despite the inevitable rumors that Africans are being used as guinea pigs.

“You can’t say ‘no’ to Michel,” said Dr. Piot, who hired him away from Unicef. “I was at a conference in Ethiopia in December, and for the first time, I felt I was hearing ‘ownership’ of AIDS by African countries. They weren’t talking so much about the donors, but about it as their own problem. I think he had a lot to do with that.”

Thanks, in part, to Mr. Sidibé’s intensive lobbying, South Africa and China are rapidly revising their approaches to the epidemic, and he hopes Russia and India soon will too. And the notoriously conservative African Union has created a committee to help populations it previously ignored: homosexuals, prostitutes and drug abusers.

Mr. Sidibé is from so deep in Africa that his professional career actually began in Timbuktu, helping Tuareg nomads. (His grandfather, he said, was a Fulani nomad in the same desert.)
He has the African shtick down. He calls anyone younger than him “my brother” or “my sister.” He seems to remember, and hug, everyone he has met before, from drivers to senators to journalists. He regales guests at cocktail parties with long parables about chameleons that he learned as a teenager in circumcision school (a bonding ritual that many African men remember with a mix of fondness and terror — a cross between boot camp and a bar mitzvah, but ending with a collective bris, sometimes done with a spear blade.)

Read the Rest.

 

[Content that is linked from other sources is for informational purposes and should not construe a Mapping Pathways position.]

Mapping Pathways 2011: The year in voices

Original content from the Mapping Pathways blog team

“We are on the verge of a significant breakthrough in the AIDS response. The vision of a world with zero new HIV infections, zero discrimination, and zero AIDS-related deaths has captured the imagination of diverse partners, stakeholders and people living with and affected by HIV. New HIV infections continue to fall and more people than ever are starting treatment. With research giving us solid evidence that antiretroviral therapy can prevent new HIV infections, it is encouraging that 6.6 million people are now receiving treatment in low- and middle-income countries: nearly half those eligible.” - Michel Sidibe, UNAIDS Executive Director, World AIDS Day report


Earlier this month, WHO and UNAIDS released a World AIDS Day report providing a snapshot of goals and progress made in 2011 toward HIV/AIDS prevention. We thought we’d provide a snapshot of the Mapping Pathways project as well – but through the voices of some of the most memorable and inspiring people we spoke with this year.

APRIL:
“It’s been like Christmas every day since July at the International AIDS Conference in Vienna when the CAPRISA study results came out… We’ve gotten over this first hurdle; we’ve proven that we can create new ways to prevent HIV through the use of ARVs taken orally or applied topically but now we have to figure out how to get that pill, or gel, or whatever into the right hands in the right place at the right time. We’re grappling with all the problems that come with success.” - Jim Pickett: ‘Success! Now what?’
   
MAY:
“There is a threat – still distant but definitely visible – that we will lose this astonishing success through complacency… We can make AIDS rare – and eliminate it entirely from rich countries – using technologies that we already have. The question is whether we have the will to do it.”  - Mark Chataway: Using antiretrovirals to prevent new infections

“There’s still so much we don’t know, and these are open questions rather than being settled questions… we can’t prove that the intervention worked, and we can’t prove that the intervention didn’t work … There are still things to be learned.”  - Julie Davids: FEM-PrEP closure update – What does ‘futility’ mean exactly?

“I think whenever the field starts to go on emotion, we get into trouble… Human behavior keeps messing up the plot.”  - Dr. Linda-Gail Bekker: Of Mice, men, and microbicide trials   

JUNE:
 “I put the word MSM on the board, and do you know what one woman participant said? She said, ‘By MSM do you mean men who have sex with men? Yes, they must die; and if not, they must be killed!’ I was so taken aback. I thought, ‘Oh my God, this is where the advocacy has to start from.’” - Brian Kanyemba: A snapshot of advocacy in Africa

“The level of efficacy seen in the HPTN052 study is stunning, and is extremely important on several fronts. First, in terms of the potential of this strategy to reduce transmission, it is clearly an effective option… Of course, there are some issues associated with this strategy as well.”  - Dr. Joe Romano: Thoughts on the microbicide pipeline and the recent HPTN 052 results

“I believe that it is a political, economic and human tragedy that the first time our country has had a national HIV/AIDS strategy is exactly at the same time that we’re being told there are no resources to put it fully into place... We are, in significant ways, being restrained from putting our best minds and hearts at the forefront of this effort. When we get to the end of the day, there are good ideas, and then there are good ideas that are fully funded.”  - Julie Davids: The economic effect of HIV/AIDS in the US

JULY:
“Sex sells. People in the commercial world use sex to sell things like cars, toothpaste, pens…almost anything! Why not use sex to sell safer sex?”  - Anne Philpott: How sexy sex can help prevent HIV transmission

“Working with vulnerable populations like transgender individuals and men who have sex with men (MSM) was really an eye opener. These are people who often have nothing to their name (often not even a roof over their head), are disowned by society and their families and are completely discriminated and stigmatized against. Yet a number of them were keen to help spread awareness about HIV/AIDS, prevention options and vaccines so that others may benefit from the information and not get infected with HIV. This degree of humanity is truly remarkable.”  - Dr. Sonali Kochhar: PrEP in India

AUGUST:
“My sense is that many people are still very uncomfortable and not quite able to figure out why we’re talking about PrEP in the Indian context. Many senior people in the field feel the focus needs to be on TLC+.”  - Anjali Gopalan: Notes from India – concerns and challenges around PrEP

“The matchmaking started because people living with HIV don’t disclose their status to their parents. In India, when the boy is 30 or the girl is 24-25, the parents want them to get married. They start looking for partners and the person who is infected is unable to talk freely to them and say, ‘Look, I have HIV and I can’t get married.’ That’s when they come to me and ask, ‘My parents are planning to get me married to an HIV-negative person – now what do I do?’ So we say okay, we’ll look for someone for you."  - Dr. Suniti Solomon: A modern-day HIV love story

“Clearly if people abstained from sex, or had sex with partners they knew to be uninfected, or used condoms 100% of the time, we wouldn’t have the HIV epidemic. But obviously, spreading billboards all over the world has not cut it.” - Dr. Linda-Gail Bekker: Safe-sex education – too little, too much?

“Placebo controlled trials are essential for the evaluation of the safety and efficacy of new products.  The placebo control group in a clinical trial provides the means of establishing any specific safety issues with a product, as well as the effectiveness of the product at preventing HIV transmission… Once a microbicide product has been adequately shown to prevent HIV transmission, it will no longer be possible to run placebo controlled trials, and the “window” will be closed."  - Dr. Joe Romano: What happens when the ‘placebo window’ closes?

SEPTEMBER:
“It boggles me that I still have to make the case for understanding the relational and contextual nature of HIV transmission and the need to recognize that people and technologies are interactive and interdependent."  - Judith Auerbach: Addressing social drivers of HIV/AIDS

“Even among groups of experts, I have noticed people getting confused – misapplying data, conclusions, or assumptions...”  -  Lori Heise: Tricky Terminology in HIV Prevention – Microbicides and Oral PrEP

“Giving gay men more information about their health only empowers them to make informed decisions. The fear that gay men will take PrEP, forego condoms and become out of control disease spreaders, harkens to the days when men feared women would become crazed nymphomaniacs thanks to the new birth control pill.” -Alex Garner: Open letter Urges that PrEP debate should be based on ‘facts not misinformation’

OCTOBER:
“Firstly, we need to work out whether this result is true or not. But even if it is true, it’s quite possible that we need to balance the benefits of avoiding an unwanted pregnancy against the small increased risk of acquiring HIV infection.”  - Dr. Tim Farley: Hormonal contraceptives and HIV – the grey area

“It’s really critical we know what research is and is not being done, what evidence does and does not exist, so that we have a solid understanding of the implications of these technologies in various social, economic, cultural, and political contexts that exist in different countries. It’s only then that we can begin to think about investing in them and the best ways to implement them."  - Molly Morgan Jones: Mapping Pathways so far – the ‘literature review’

NOVEMBER:
“If you’re talking about early treatment, you’ll have one person saying, ‘This is a quantum leap from where we are now, and it’s operationally impossible.’ And then you’ll have another person saying, ‘Well, if you have cancer, the doctor doesn’t wait till you’re half dead to give you the treatment, and so we should have been doing this years ago.’ And both are very valid points; it’s just how do you get those two people, who are equally important in making this happen, make it happen?” - Daniella Mark: It’s a question of ‘how’ in South Africa Part 1 & Part 2

DECEMBER:
“PrEP … is hard as hell to figure out. Hard as hell. But that’s what we have to do – we have to be right there, at the hardest place possible, trying to get the answers.” - Jim Pickett: Triumphs and Trials in 2011


[Content that is linked from other sources is for informational purposes and should not construe a Mapping Pathways position.]

Medical Male Circumcison's Potential Yet to Emerge in Practice

via The Financial Times, by Andrew Jack

Tzameret Fuerst whips two plastic rings out of her handbag and prises them together around her forefinger with a black rubber band, simulating a simple way to carry out male circumcision that she hopes will soon be widely adopted across Africa.

“This is a safe, simple, non-surgical device that needs no anaesthetic and is scaleable in resource-limited settings, using nurses to carry out the procedure in tents in rural areas,” she says. “It’s virtually painless, completely bloodless and does not require a sterile setting.”

The PrePex device that her company Circ MedTech has developed is one of a growing number of experimental tools in search of a market that has the potential to help radically reduce HIV transmission.

But circumcision is also a practice that – despite the evidence – has yet to be adopted as much or as fast as experts had hoped.

Many years after observational studies indicated that circumcised cultures had lower HIV prevalence, progress remains extremely slow. In 2005, the results of the first carefully randomised controlled clinical trials in Orange Farm in South Africa demonstrated that sexual transmission was reduced by 60 per cent in men who were circumcised.

A recent estimate published by UNAids highlighted a jump in adult male circumcisions, especially in Kenya, South Africa and Zambia. But with 555,000 interventions in men aged 15-49 across sub-Saharan Africa by the end of last year, less than 3 per cent has been achieved of a target of 21m set for 2015 to reduce significantly new infections in the region.

“It’s going to be a big challenge to reach this target,” concedes Gottfried Hirnschall, head of the World Health Organization’s HIV programme.

International organisations have publicly endorsed the importance of circumcision, and a number of guidelines have been established, but the response so far has been haphazard and funding remains modest.

Read the rest.


[Content that is linked from other sources is for informational purposes and should not construe a Mapping Pathways position.]

How to get to zero: Faster. Smarter. Better - UNAIDS World AIDS Day Report 2011

[Content that is linked from other sources is for informational purposes and should not construe a Mapping Pathways position.]

The Beginning of the End of AIDS

via The Huffington Post, by Sheila Nix

Everyone loves a good "they said it couldn't be done" story. From a man on the moon to a personal computer in every home, the nostalgic in each of us loves to reflect about how, throughout history, individuals have run up against the status quo, defied the odds, and achieved something inspirational for society at-large. Those of us in the AIDS advocacy community have experienced our fair share of doubters telling us "it can't be done."

30 years ago when HIV/AIDS cases were first documented, it was a mysterious infection that couldn't be treated. Positive diagnosis was a death sentence. With no treatment, stigma and fear grew, representing what Dr. Anthony Fauci calls "the dark years." But with scientific innovation came the discovery in 1987 of AZT, the first drug approved to treat HIV. Over the next few years, AZT was replaced with more sophisticated combination drug therapy, and by 1996 highly active antiretroviral therapy had been developed. The new drugs were hugely expensive, however, costing $10,000 per year or more. Many HIV-positive people feared that without Magic Johnson's checkbook, they wouldn't be able to get the drugs they needed to keep them alive. Today, AIDS treatment costs just a few hundred dollars per year in poor countries -- a victory for HIV-positive communities around the world.

In the early 2000s, as President Bush and bipartisan Congressional leaders were launching a program called PEPFAR and as the Global Fund to Fight AIDS, Tuberculosis, and Malaria was just getting started, the doubters loomed large. Many believed there was no way to get antiretroviral treatment to millions -- particularly in Africa where some infamously suggested "Africans don't have watches" and so couldn't be expected to take drugs in a consistent manner. Others argued that mobilizing the financing required to hit PEPFAR and Global Fund targets was impossible. Yet global funding for AIDS skyrocketed, growing six-fold between 2002 and 2008. African leaders also stepped up, committing to spend 15% of their budgets on health. Today, the results speak for themselves: 6.6 million HIV-positive people, including those in remote communities, are alive today because of treatment, and countless others have remained HIV-negative thanks to prevention efforts.

In spite of these achievements, economic recessions have a unique way of allowing the "it can't be done" mantra to reemerge. Indeed, as budgets constrict and leaders turn their attention inward, it's easy to see why a renewed push on global AIDS doesn't seem possible. Yet 2011 marks a critical inflection point in our fight against AIDS. Game-changing studies have offered exciting new tools in the fight to prevent HIV -- including new data that shows treatment works as prevention, reducing the likelihood of passing on HIV by as much as 96%. Collectively, these advances show that bending the curve on AIDS is possible in our generation.

Read the rest.

[Content that is linked from other sources is for informational purposes and should not construe a Mapping Pathways position.]

Uganda Needs to Re-Discover its Prevention Success of the 1990s

via AllAfrica.com, by Henry Zakumumpa

"The trouble for us in Uganda is that we are falling behind in global efforts to rein in new HIV infection rates an endeavor we were renowned for in the 1990s.

What is troubling is that many more people in Uganda are going to need AIDS treatment because of the spike in new HIV infections, driven primarily by married couples, but also because people with HIV/AIDS are now living longer, at a time when western donor countries are actually cutting AIDS funding.

Many AIDS treatment centres in Uganda are already turning away new patients due to donor funding caps, with some centres tragically sharing drugs amongst their patients. What is going to happen when thousands of Ugandans newly require AIDS treatment and they are turned away at treatment centres?

Sadly, Uganda's losing HIV prevention effort is out of step with the rest of the world where prevalence is actually going down. Even the worse- hit Southern African countries have registered a 25% reduction in HIV prevalence according to UNAIDS."

Read the rest.


[Content that is linked from other sources is for informational purposes and should not construe a Mapping Pathways position.]

Kaiser/UNAIDS study finds drop in overall disbursements for AIDS response in 2010, seven out of 15 governments report reductions

Via the Kaiser Family Foundation.

Funding disbursements from donor governments for the AIDS response in low- and middle-income countries fell in 2010, dropping 10% from the previous year’s level, according to an annual funding analysis conducted by the Kaiser Family Foundation and the Joint United Nations Programme on HIV/AIDS (UNAIDS).

The study found that donor governments disbursed US$ 6.9 billion in 2010 for HIV prevention, treatment, care and support--US$ 740 million less than in 2009. The decrease was due to a combination of three main factors: actual reductions in development assistance, currency exchange fluctuations, and a slowdown in the pace of U.S. disbursements, which was not a budget cut.

Of the 15 governments surveyed, seven--Australia, Germany, the Netherlands, Norway, Spain, Sweden and the United States--reported a year over year decrease in their disbursements as measured in their own currencies. The figures presented in the report are in US dollars, consistent with international standards and other reporting mechanisms.

Due to currency fluctuations, when measured in US dollars, Australia showed a slight increase in its AIDS funding contribution even though it contributed less in its own currency. Conversely, there was a slight decrease in Denmark’s contribution despite the country’s increased funding level in its own currency.

"AIDS is a smart investment even in this difficult economic environment. We have to look beyond the near-term costs and recognize the long-term benefits," said Michel Sidibé, Executive Director of UNAIDS. "Donors need to make and follow through on commitments today to reduce costs in the future."

The overall drop in disbursements was primarily attributed to a reduction in disbursements by the United States, the largest donor nation, which accounted for 54% of total donor disbursements in 2010. While the United States Congress appropriated similar levels of funding for the AIDS response in 2010 as in 2009 (approximately US$ 5.5 billion in each year), disbursements from the United States declined from US$ 4.4 billion in 2009 to US$ 3.7 billion in 2010. This slowdown stems from new requirements established by Congress for the United States President’s Emergency Plan for AIDS Relief (PEPFAR). Some funds appropriated in 2010 will be disbursed in later years.

"With U.S. funding delayed but not eliminated to this point, this year’s drop in spending may be a temporary blip, though its impact on services may be real," said Drew Altman, Kaiser Family Foundation President and CEO.

Read the rest here.

[Content that is linked from other sources is for informational purposes and should not construe a Mapping Pathways position.]