An additional 30%-50% of HIV-positive people are eligible to take life-saving ARVs immediately under the new WHO treatment guidelines.
But this is a dream unless resources – which are flatlining or declining – are increased substantially.
The scale-up in ARV treatment has been slowing down since last year.
By 2009, 5.2 million people were on ARVs – compared to only half a million in 2003 – following consistently increased funding from 2001 to 2008.
The International AIDS Society released a report this week that warns “universal access cannot and will not be achieved without a substantial increase in resources for AIDS”.
IAS President Elly Katabira says: “At this critical juncture in the international AIDS response, we should not be talking about doing more with less, but doing more with more.”
The IAS report Universal Access: Right Here, Right Now reflects “the principal debates around universal access during the XVIII International AIDS Conference (AIDS 2010) in July.
“The report also takes stock of progress to date and reveals the scale of the future challenge for HIV treatment and prevention at a time when new infections are outstripping those receiving treatment by five to two.”
The XVIII International AIDS conference in Vienna closed today after positive reports during the week on the first partially effective ARV-based microbicide, progress on male circumcision, promising results on new antiretroviral treatments and some reports of lower incidence around the world.
But the funding of treatment remains a concern, and delegates at the conference launched what they called “Treatment 2.0″ – an effort to make AIDS money go further given donor cuts.
Dr Julio Montaner, AIDS 2010 Chair, President of the International AIDS Society said: “Billions of people stand in solidarity with us in our drive for universal access.
“We must rally their support behind Michel Sidibé’s Prevention Revolution and Treatment 2.0 initiative and UNAIDS to ensure that world leaders do not turn their backs on their pledge to reach the goal of universal access.”
Professor Nicoli Nattrass, Director of the AIDS and Society Research Unit at the University of Cape Town told the Ecumenical Advocacy Alliance: “The days of the big numbers are gone. Treatment 2.0 means doing more with what we’ve got.”
Another rallying point at the conference was around better rights and evidence-based programmes for injecting drug users.
By today 12725 people had signed the Vienna Declaration, the official declaration of the conference, calling for “more rational and scientifically sound drug policies to strengthen HIV prevention for people who use drugs”.
AIDS 2010 attracted 19,300 participants from 193 countries with 248 sessions covering science, community and leadership on the agenda.
The XIX International AIDS Conference will be held in Washington, DC, in the US in July 2012.
The Tanzanian government was heavy-handed this week in preventing a peaceful HIV/AIDS demonstration by activists.
The AIDS and Rights Alliance for Southern Africa reports that police detained nine of its leaders for questioning for five hours and escorted them to the airport to wait for their flights out.
The activisits handed over a memorandum titled “health is wealth” to musician Yvonne Chaka Chaka and the UN Goodwill Ambassador for the region, Christoph Benn, calling for increasing funding for HIV, TB and malaria.
The AIDS and Rights Alliance for Southern Africa said the activists, from more than ten African countries, were meeting in Dar Es Salaam to discuss advocacy strategies on the “urgent need for resource mobilisation for universal access to HIV prevention, treatment and care and for replenishment of the Global Fund in October 2010″.
No charges were issued or arrests made.
But ARASA reported that the group had “to proceed to the airport to wait through the night, under police supervision, until their flights departed from the country the following day.”
The detainees were: ARASA leaders Paula Akugizibwe and Lynette Mabote; Bactrin Killingo, James Kayo and Netsayi Dzinoreva from the International Treatment Preparedness Coalition; Linda Mafu and Soraya Matthews from the World AIDS Campaign; Sydney Hushie from the Global Youth Coalition on HIV/AIDS; and Michael O’Connor from the Global Fund to fight AIDS, TB and Malaria.
Imagine a world where no children are born with HIV. This is within reach by 2015 says Professor Michel Kazatchkine, executive director of the Global Fund to Fight AIDS, TB and Malaria.
“Malaria may be eliminated as a public health problem within a decade in most countries where it is endemic,” according to projections from the Global Fund’s 2010 Results Report.
“Tuberculosis prevalence in many countries is declining and the international target of halving TB prevalence could be met by 2015,” states the report, released this week.
To achieve this “the current rate of scaling up of health investments for the three diseases (must be) at least maintained and ideally accelerated further.”
Kazatchkine said: “No other area of development has seen such a direct and rapid correlation between donor investments and live-saving impact as these investments in fighting AIDS, TB and malaria.”
Global Fund-supported programs saved at least 3 600 lives per day in 2009 – and an estimated total of 4.9 million since the creation of the Global Fund in 2002, according to this report.
But, to sustain these achievements, the fund needs donors to commit to replenish its finances in October this year.
To see what a difference these projects can make, look at the Access to Life photos. This is a joint advocacy project by The Global Fund and Magnum photo agency that, through pics, video and test, portrays the lives of 30 people from nine countries from their initiation of ARV treatment and through the first four months
Medecins Sans Frontieres warned this week, again, that declining international donor funds could reverse the dramatic gains made in AIDS treatment, particularly across Africa.
Launching the report ‘Punishing success? Early signs of a retreat from commitment to HIV/AIDS care and treatment’, Dr Tido von Schoen-Angerer said: “We think we are at a very dangerous turning point.”
The director of MSF’s campaign to provide essential medicines, he said: “The donors are getting cold feet about commitment to longterm, chronic disease.”
If the funding of antiretroviral treatment is reversed, lives will be lost.
The South African government’s spending on HIV/AIDS programmes – announced yesterday for 2009/2010 – is roughly the same amount as the US government is spending in our country on HIV/AIDS programmes.
Finance Minister Pravin Gordhan said that the total funding for HIV and AIDS programmes would be R4.4 billion in 2009/2010.
The US PEFPAR (President’s Emergency Plan for AIDS Relief) funding to South Africa in the 2008 financial year was almost R4.5 billion ($590.9 million).
Both South Africa and PEPFAR have increased funding for HIV prevention, care and treatment by roughly four times in the last four years, since 2005. Antiretroviral treatment was rolled out in the public health system for the first time in 2003.
South Africa now has about 650 000 people on antiretroviral treatment and it is estimated an additional 300 000 people will need treatment every year. By March next year, an estimated 900 000 South Africans will be on treatment.
The Treasury has made a commitment to funding treatment but it still looks like South Africa is highly dependent on foreign donors to sustain the scale of its HIV/AIDS programmes.