PMTCT treatment helps stop the spread of AIDS by ensuring that HIV positive women do not pass the virus on to their children. Photo credit: Morgana Wingard.
Every year, UNAIDS releases a comprehensive update on the AIDS epidemic. And every year, global health advocates the world over hail the progress mentioned in the report. UNAIDS just released this year’s report on Monday, and predictably, there was much cheering: the number of kids born with HIV has been cut in half since 2001! Almost 10 million people are receiving life-saving AIDS treatment!
These celebrations are warranted because these are some pretty great achievements. Approximately 5.2 million deaths have been averted between 1996 and 2012 thanks to AIDS treatment. That’s a lot of people who are still with us today, who are still able to continue living their lives with their families. Two hundred thousand less adults were infected with HIV in 2012, and there were also that many fewer deaths due to AIDS in 2012 than in 2011. This kind of progress absolutely must be recognized and cheered.
But unfortunately, this progress comes with an asterisk. As the report goes on to indicate, progress has been made, but it’s not happening fast enough. We’re still not on track to hit the goal of reducing pediatric infections to 40,000 by 2015. Nor will we – at this rate – get to 15 million people on treatment by 2015. While there are many reasons for this, the one that sticks out is this: funding shortages. That should come as no surprise to anyone.
To hit goals on lives saved and infections averted, HIV programs will need $22 to $24 billion per year by 2015. In 2012, about $18.9 billion was available for HIV programs in low- and middle-income countries – up from the $17.1 billion available in 2011, but not on track to reach the $22 to $24 billion necessary by 2015.
Much of that projected funding gap is due to international HIV assistance remaining essentially flat in real terms between 2011 and 2012 – despite a nominal increase. Approximately $8.9 billion of last year’s $18.9 billion came from international investments – that’s only an 8 percent increase from 2011. An accompanying report from the Kaiser Family Foundation reported that 64 percent of international government spending came from the United States. In fact, if the United States’ contribution was taken out altogether, overall international spending on HIV/AIDS actually would have dropped – both in real and in nominal terms – between 2011 and 2012.
By contrast, low- and middle-income countries are stepping up their AIDS responses. What I never knew until I read this report, and what struck me hard, is that the majority of financing for HIV/AIDS programs, 53 percent, actually comes from domestic financing for HIV and not from international sources.
About 90 percent of the countries that undertook midterm reviews cited resources for AIDS as a national priority, while two-thirds of countries reporting AIDS spending data reported an increase in domestic HIV spending. Many countries, including Chad, Guinea, Kyrgyzstan and Sierra Leone, were reported to more than double their domestic funding for HIV activities.
It’s great and absolutely essential that low- and middle-income countries spend more on their national AIDS epidemics. However, the international community also needs to step up. Many countries are finalizing their budgets for the next year, and the Global Fund to Fight AIDS, Malaria and Tuberculosis is in full replenishment mode.
The news on the AIDS epidemic so far has been good. But for me, the message from this year’s report is that if we as global health advocates want to celebrate not just major progress but rather hitting goals and becoming the generation to end AIDS, now is the time to take action and encourage our governments to increase their investments in the fight against AIDS.