Tuesday, August 3, 2010

HIV/AIDS is still a disease of international emergency

Recent trends suggest that international attention on HIV/AIDS is waning and so is the funding. The global commitment to combat HIV/AIDS internationally is in some form of down turn.

An emerging perception is gaining currency that HIV/AIDS is no longer the threat it was in decades past(especially in the west) and that budgets, programmes and efforts lined up globally to respond to it should be down sized (in corporate speak).

International funding for HIV/AIDS in the developing world has been scaled down according to the international press and from the actual providers of HIV/AIDS care such as Dr Peter Mugyenyi, Head of the Joint Clinical Reseatch Centre (JCRC) in Kampala,Uganda.
PEPFAR the most important funder of HIV/AIDS treatment in Sub Saharan Africa is 'flat funding' AIDS programmes in Africa according to the International Treatment Preparedness Coalition (ITPC)2010 report and a Medicine San Frontiers report of 2009. The implication is that AIDS treatment centres in Sub saharan Africa cant enroll new patients because they have no budget lines to support their life-long treatment due to funding 'flat-lining'.

The global financial crisis is the first excuse thrown about to explain the declining funding from western donors for the HIV/AIDS response in countries which cant cope unaided but reports show that political factors in western donor countries are equally at play.

It has been reported in 'The New York Times', 'The Boston Globe' and in the 'Huffington Post' in the US that the Obama administration is intent on scaling down on PEPFAR funding in favour of promoting a proposed new maternal and child health initiative in the developing world. It is understood that Dr Ezekiel Emmanuel has been pushing this line within the Obama administration. Politically speaking,PEPFAR was a Bush administration initiative with enormous success and the Obama administration is in need of a similar international success.

Clearly, maternal and child health too is a continental emergency and the recent July 2010 AU summit in the Ugandan capital was called solely on the subject. However, to cut AIDS treatment funding at the moment and to renege on promises to incrementally scale up funding to treat the increasing number of patients in need of anti retroviral therapy would be nothing short of tragic.

In Uganda, 100,000 new patients are added to list of those in need of AIDS treatment(ART) , in a country where only a half of those eligible for treatment get it(a continental record nevertheless). HIV/AIDS prevalance rates in some Sub Saharan African countries such as Uganda are on the increase and more not less funding is needed from international donors but also from African governments which should do more to shoulder the burden of treatment of their own citizens. The World Health Organization (WHO)issued new guidelines requiring that patients be put on AIDS treatment earlier than initially recommended hence increasing the treatment burden further.

The Global fund on AIDS,Malaria and TB is finding difficulty raising funds from western donors and is incapacitated in calling successive rounds of funding AIDS treatment in poor countries.
Now is not the time to play politics with human lives in Sub Saharan Africa. For millions of patients who depend on PEPFAR and the Global Fund monies for their drugs,this is a matter of life and death.

PEPFAR may go down as one of the few successes of the Bush administration and failing it inorder to promote a new global health initiative for political expedience is failing humanity needlessly.

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