A bad turn in the global fight against AIDS | 

Flickr, Benny Sølz

As the Los Angeles Times and others reported this week, the global effort to fight AIDS has paid off with a 21 percent decline in deaths since the pandemic’s peak in 2005:

The number of people getting lifesaving (drugs) rose 20% from 2009 to 2010. Three African countries, Botswana, Nambia and Rwanda, achieved universal access, defined by UNAIDS as access for 80% or more of those eligible. Four African countries, Kenya, Ethiopia, Swaziland and Zambia, had coverage for between 60% and 80% of infected people.

In short, this international response to fight disease in poor countries has truly paid off.

Which is why it’s so painful to learn that the organization leading this response, the Global Fund for Fighting AIDS, TB and Malaria, announced this week it will have to suspend its next round of funding for these efforts due to a shortfall in donations.

Global Fund Executive Director Michel Kazatchkine said the “conversion rate” for pledges to donations (meaning, how many governments or other donors keep their promises) has dropped sharply as compared to earlier commitments made.

Some of this may be due to the economic downturn. But some may also be due to earlier allegations of financial mismanagement that caused some donors, most notably Germany, to withhold promised contributions to the Global Fund.

Many, including me, saw some of the media reports of “fraud” as a bit over-the-top given the actual amount of money alleged to have been misspent, but the public image of the initiative has suffered — and perhaps given donors the excuse they needed to renege on their promised commitments.

A crisis looms, writes Sarah Boseley at The Guardian, in which this means people will die:

There is no doubt that people who could have been spared will instead fall ill and die as a result of the drying up of funds. There is also a Damoclean sword hanging over the heads of people who are alive and well thanks to drug treatment for their HIV infection. The Global Fund – together with Pepfar (the President’s emergency plan for Aids relief) has been the main source of money to pay for drugs. Those who start the combination treatments to prevent HIV causing Aids must stay on the drugs for life. If they stop, there is a danger the virus will become resistant to the drugs they are on.

Similarly, the group variously known as Doctors Without Borders or Médecins Sans Frontières says:

The dramatic resource shortfall comes at a time when the latest HIV science shows that HIV treatment itself not only saves lives, but is also a critical form of preventing the spread of the virus, and governments are making overtures that there could be an end to the AIDS epidemic.