treatment gap in Africa
Backtracking by international donors in funding HIV/AIDS risks undermining
years of positive achievements and will
cause many more unnecessary deaths, humanitarian aid group Médecins Sans
Frontières (MSF) warns in a new
Titled “No time to quit: HIV/AIDS treatment
gap widening in Africa”, the MSF
report builds on analyses made in eight
sub-Saharan countries to illustrate how
major international funding institutions
such as PEPFAR, the World Bank,
UNITAID, and donors to the Global
Fund have decided to cap, reduce or withdraw
their spending on HIV treatment
and antiretroviral drugs (ARVs) over the
past year and a half.
Through its medical humanitarian work
in the majority of the worst-affected countries
in sub-Saharan Africa, MSF has
recently started to observe a worrisome
turn-around among the donor community.
After years of political willingness and
financial commitment to combat
HIV/AIDS, donors now seem to be disengaging
from the fight, leaving behind
people who are still in dire need of lifesaving
treatment. In 2009-2010, MSF
carried out in-depth field analyses in eight
key countries – Malawi, Mozambique,
Zimbabwe, South Africa, Lesotho, Kenya,
Uganda, and Democractic Republic of
Congo (DRC) – where it has been
providing HIV/AIDS care and treatment
for several years. The findings confirm
MSF’s concerns in terms of donor backtracking
on commitments to scale up the
fight against the HIV/AIDS epidemic.
Now, this disengagement is becoming visible in the field and the level of HIV
is beginning to deteriorate.
“How can we give up the fight halfway
and pretend that the crisis is over? Nine
million people worldwide in need of
urgent treatment still lack access to this
lifesaving care – two-thirds of them in
sub-Saharan Africa alone. There is a real
risk that many of them will die within the
next few years if necessary steps are not
taken now. Also, the current donor
retreat will prevent more people from
accessing treatment and will threaten to
undermine all the progress made since the
introduction of ARVs” says Dr Mit
Philips, Health Policy Analyst for MSF
and one of the authors of the report.
The US President’s Emergency Plan for
AIDS relief, PEPFAR, reduced its budget
for the purchase of ARVs in 2009 and
2010, and also introduced a freeze on its
overall HIV/AIDS budget. Other donors,
such as UNITAID and the World Bank,
have announced reductions over the
coming years in the funding for antiretroviral
drugs in Malawi, Zimbabwe,
Mozambique, Uganda and the
Democratic Republic of Congo (DRC).
The Global Fund, the largest funding
institution in the fight against
HIV/AIDS, faces a major funding shortfall.
The US, the Netherlands and Ireland
have already announced that they will be
providing lower contributions to the
Global Fund. In 2009-2010, contributions
to already approved country grants
were reduced by 8-12%.
Overall funding cuts have translated into
a reduction in the number of people able to
start their ARV treatment, as seen in South
Africa and Uganda, and in DRC – where
the number of new patients able to start
ARV treatment has been cut six-fold.
Already fragile health systems will become
increasingly strained by an increasing
patient load requiring more intensive care.
Drug stock-outs and disruptions in drug
supply are already a reality, and will
become more frequent if sufficient
funding is not made available. MSF has
recently been requested by governments
and other actors to assist with emergency
drug supplies in Malawi, Zimbabwe,
DRC, Kenya and Uganda.
“If there is reduced funding, then it will
mean more people will die, and we will
have more orphans. People will lose hope
and die. It will be the end. If there are no
drugs there is no future,” says Catherine
Mango, an HIV patient from Kenya.
ARV treatment is lifesaving, but also
lifelong. This means that the number of
patients under treatment increases cumulatively
each year, thus requiring incrementally
growing and sustainable funding.
“The HIV/AIDS crisis remains a massive
emergency that still requires an exceptional
response. MSF calls for a sustained and
renewed commitment by donors and
national governments in the fight against
HIV/AIDS, so that this disastrous public
health crisis can be addressed appropriately,”
Dr Philips emphasises.
Médecins Sans Frontières is an international medical
humanitarian organisation that delivers aid to people affected
by armed conflict, epidemics, natural disasters or exclusion
from health care in more than 60 countries around the world.
of upload: 15th Aug 2010