DURBAN, South Africa – A decline of more than a USD $1 billion (USD) in government funding to address human immunodeficiency virus (HIV) in low to middle income countries has health experts worried that it will jeopardize the advances made in the HIV response and put vulnerable groups at increased risk. It is the first decline in donor government funding in 5 years.
“Key populations – men who have sex with men, sex workers and people who inject drugs – are threatened more than anyone when global donors pull out. These programs are not likely to be picked up by local governments. It is not inevitable that funding will decline, we have to absolutely need to continue this fight,” said Chris Beyrer, president of the International AIDS Society, which organized the 21st International AIDS Conference happening in Durban, South Africa from July 18 to 22.
A joint report by the UNAIDS and the Kaiser Family Foundation showed that donor funding declined from $8.6 million (P406 million) in 2014 to $7.5 million (P354.1 million) in 2015. Adjustments made for foreign exchange fluctuations still showed an overall decline in donor funding.
Since 2006, 5 donor countries have accounted for over 80% of the total assistance for HIV intervention in low to middle income countries. The United States is largest donor in the world, accounting for 66% of of donor funds, followed by the United Kingdom (UK), France, Germany, and the Netherlands.
The report found that funding for HIV declined in 13 of 14 donor governments. A number of these countries like Germany, Italy, and Sweden are struggling to cope with the strain of the refugee migrant crisis where more than 1 million refugees and migrants made their way to Europe in 2015.
“The refugee crisis is certainly putting pressure on these countries’s aid budgets. We’re not saying that is less important – the refugee crisis needs attention, but we should not lose the gains in HIV that we’ve made over the years. I was here in 2000, I don’t want to go back to that again,” said Jennifer Kates, Vice President and Director of Global Health and HIV Policy at the Kaiser Family Foundation.
In 2000, the International AIDS Conference was also held in Durban, South Africa and the sentiment on HIV then was very different.
Advocate Anele Yawa described it as controversial. “The Mbeki years were the dark years, the years of denial,” Yawa recalled, referring to the era of then South African President Thabo Mbeki who questioned the science that indicated that AIDS was caused by the HIV virus.
Mbeki also doubted the efficacy of anti-retroviral therapy. Mbeki’s denial prevented access to ART or at the very least, made it affordable.
There were protests demanding that ART be made more accessible and more inclusion of women in the HIV response.
Today, there are more than 17 million people around the world who are on life-saving anti-retroviral therapy, mother to child transmission of HIV is nearly eliminated, and there are talks of an HIV vaccine.
While it is still unclear if the funding decline is blip or an indicator of things to come, it is these gains that experts fear will be jeopardized if funding further declines.
“The effects of BREXIT have yet to be assessed, but the UK is the second biggest funder of the Global Fund. The US is the top funder and we don’t know yet what the changes in leadership in November will bring.”
“We can look at other donors – private corporations, foundations, and individual donors but it is unclear if this will fill in the gap,” said Kates.
Globally, there are an estimated 36.9 million people living with HIV (PLHIV).
An estimated 7 million PLHIV are in South Africa while sub-Saharan Africa has most serious HIV and AIDS epidemic in the world with almost 25 million people living with HIV, or accounting for more than 70% of the world’s total HIV infections.
UNAIDS estimates that total funding for HIV, a combination of in-country and donor government funding will need to increase by at least $7.2BN by 2020 to put the global health community on the right track to possibly ending AIDS by 2030. – Rappler.com