Punishing Success? Risks of faltering HIV funding

Ten years ago, Médecins Sans Frontières (MSF) began pioneering HIV/AIDS treatment in South Africa and Thailand. Today, millions of lives have been saved and people on treatment are able to live longer and enjoy a better quality of life. At the end of 2009, MSF was providing antiretrovirals (ARVs) to more than 160,000 patients in over 27 countries. In Khayelitsha in South Africa alone, more than 13,550 patients are benefiting from the HIV care that MSF is providing in collaboration with the local authorities.

This progress is now under threat. There are now worrying signs that international donors are capping, reducing or withdrawing their funding for HIV/AIDS. The Global Fund to Fight AIDS, Tuberculosis and Malaria, which funds around two-thirds of all HIV/AIDS treatment in developing countries is currently facing a major funding shortfall. Donors are going back on their promises to fund and provide universal access to HIV care.

The main U.S. initiative to combat the global HIV/AIDS pandemic, the President's Emergency Plan for AIDS Relief, known as 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 the Democratic Republic of Congo (DRC), Malawi, Mozambique, Uganda, and Zimbabwe.

For some countries, this means a cap on their funding or restricting the numbers of those put on treatment, as seen in South Africa and Uganda, and in DRC – where the number of new patients has been cut six-fold. Already fragile health systems will become increasingly strained by an increasing patient load requiring more intensive care. What this means is that more patients are now being turned away from clinics and, as though we have regressed ten years, doctors are being forced to ration HIV drugs. There is also a risk that the new recommendations of the World Health Organization that call for the earlier initiation of improved drugs cannot be implemented.

MSF’s Campaign for Access to Essential Medicines  is a team of medical, scientific and advocacy experts that explores and champions solutions to the medical challenges MSF staff face in the field. Today, the Campaign is working with other health activists to demand that the international community adhere to their promises to fight HIV/AIDS, while supporting ambitious and innovative methods to ensure that the cost of drugs stays affordable.

We are also encouraging countries to make use of legitimate flexibilities in international trade rules to overcome the barriers to medicines posed by patents on drugs and to encourage, through competition, the development of affordable generic medicines. We are pushing pharmaceutical companies to participate in UNITAID’s patent pool for HIV/AIDS medicines which could help speed up the availability of affordable, generic versions of new drugs.

We are at a critical point in fighting this disease, and this is not the time to turn back. HIV/AIDS remains an emergency.  Much has been achieved but there are still nine million people who don’t have access to the medicines they need. Donors and governments must not be allowed to throw away the gains we have so far made, but instead must move forward and commit to continued and increased funding in order that we may bring this devastating pandemic under control.
More on the Campaign’s activities on access to medicines and medical innovation: www.msfaccess.org