Earlier this month, Secretary of State Hillary Clinton called on the United States and its allies to scale up their funding for HIV/AIDS prevention and treatment to “change the course of this pandemic and usher in an AIDS-free generation.” “No institution in the world has done more than the United States government,” Clinton said, praising President Bush’s Emergency Plan for AIDS Relief (PEPFAR) for providing anti-retroviral (ARV) treatment to people living with HIV/AIDS around the world. She called PEPFAR “one of the strong platforms upon which the Obama administration is building our global health initiative.”
But new analysis published Tuesday on the Health Affairs blog from Matthew Kavanagh and Marguerite Thorp suggests that “funding to AIDS treatment has actually fallen significantly since 2008 in both absolute dollars and as a portion of total budgets—just at a pivotal moment when investment could change the course of the epidemic”:
Taking advantage of decreasing treatment costs (as discussed more fully below), PEPFAR is continuing to enroll new people on ARVs—expanding support to reach 3.2 million people as of last year. Yet, enacting Clinton’s policy directive will require ARV access to expand much faster. In this context, reversing the decline in investments in treatment is critical—last year alone the funding could have paid for ARV access for nearly half a million more people.
According to AVERT — an international HIV and AIDS charity — funding for PEPFAR from 2009-2010, “was effectively flat-lined in contrast to the much higher previous year-on-year increases in funding, especially from 2006-2009.” “President Obama’s proposed 2011 budget included almost $7 billion for PEPFAR, representing a 1.8 percent increase on the previous year. However, according to some activists this slight increase actually represents a ‘step backwards’ due to inflation and increasing demand for treatment.” The FY2011 budget “included a 5 percent ($50 million) decrease in funding to the Global Fund compared to the previous year.”
Kavanaugh and Thorp note that new studies are showing that providing anti-retroviral (ARV) treatment could “dramatically” lower viral load and transmission rates, allowing populations to “begin to control and ultimately end the AIDS pandemic.”