The Need For A New AIDS Strategy

As we mark the 30th anniversary of the discovery of the HIV/AIDS virus this year with a celebration of its decline, the U.S. must remember to maintain the precedent these successes have set. With spending cuts looming due to an ailing U.S. economy, the need to streamline initiatives to combat HIV/AIDS has become paramount.

With drastic funding cuts felt in all sectors, the Global Health Initiative (GHI), a branch of the U.S. government designed to promote global health by strengthening health systems and initiating projects around the world, will receive far less this year than was initially promised in 2009. The most recent statistics from UNAIDS suggest that a 100% increase in AIDS spending is needed in the year 2011 from $8 billion to $16 billion to maintain reasonable control over the virus.

Last year, Anand Reddi, a former Fulbright Scholar to South Africa, wrote that "Obama's GHI (at $8.5 billion annually) resulted in an overall decrease in PEPFAR (the President’s Emergency Plan for AIDS Relief) funding, while allocating $12 billion towards other global health initiatives including maternal and child health." Though Obama’s health strategy relies on funding these forms of diseases, Reddi notes that, “By not providing 'new' money towards maternal and child health, President Obama has de facto pitted HIV/AIDS funding against other global health priorities."

As Donald Mcneil wrote in the New York Times, AIDS activists have reacted to this strategy, insisting that as a result of shifting the focus from AIDS to child and maternal health, children will be saved only to later die of AIDS. This strategy is reflected in recent research from the Harvard Medical School that indicates a mere 100,000 people have received treatment under PEPFAR during the Obama administration, compared to the 400,000 under Bush’s term. This decrease has resulted in around 1.2 million avoidable deaths.

What may be even worse than the low level of funding provided to combat the AIDS virus is the ample research that proves such shortfalls in funding are largely due to faulty and irresponsible management, rather than a lack of funds. A government press release earlier this year pointed out that “U.S. funding falls far short of the $2 billion needed to treat HIV-infected people,” and more significantly that “this $2 billion is about the same as the U.S. is spending on several discredited weapons systems ... despite a blistering internal army report that called [them] ill-suited ... and which [then-Secretary of Defense] Robert Gates said should be cancelled due to extreme reliability issues.”

As Nicholas Kristof observed in an editorial last year, PEPFAR has never been as mindful as it should be about where taxpayer dollars have been used, as the “vast majority is eaten up in studies, air tickets, consultants, reports, overhead, and profit, usually for U.S. firms.” In addition, unlike other initiatives such as the Global Fund, “PEPFAR chooses its players – usually U.S. based contractors – and its rate of government collaboration varies dramatically.”

In contrast to these bleak figures, however, several more optimistic reports have emerged surrounding the HIV/AIDS anniversary. One such report was featured as a special in The Economist, citing the latest outcomes of the HIV Prevention Trials Network (HPTN052). The HPTN052 signaled the success of a new drug that prolongs the lives of patients while at the same time prevents transmission, therefore effectively killing two birds with one stone: treatment and vaccination. The impact of these findings, with a little more research, could be a “game changer” according to Michel Sidibé, the leader of UNAIDS.

In light of these new scientific developments, finding a resolution to the AIDS endemic has now become a tangible possibility. The Obama administration must therefore see this new possibility as a responsibility, and commit to putting an end to this virus by committing their full capabilities to this cause. We may all sympathize with the need for further cuts in spending, however this should not be an excuse but a call for action to streamline project infrastructure, to ensure that self-functioning systems are implemented, to manage funds in order to avoid superfluous spending, and to rethink the GHI strategy of child and maternal health with a focus of long-term results. AIDS has a life of its own, and each time we turn our back it will continue to grow.

Photo Credit: Ie Korrigan