NEW YORK - November 30 - Around the globe, people are gathering on World AIDS Day to mourn needless deaths and to condemn lackluster progress in comprehensive treatment, care, and prevention programming. Health GAP released the following statement and an analysis of the U.S. global AIDS program, PEPFAR, and multilateral efforts available at: www.healthgap.org/wad05.doc
"Although the World Health Organization (WHO) organized a credible initiative to place 3 million people living with AIDS on treatment by the end of 2005 (as "3 by 5²), stingy donors and persistent under-capacity in health care delivery produced planned failure a 1/3 realization of the 3-by-5 goal.,² said Brook Baker of Health GAP. "The lack of success in meeting 3-by-5 goals risks making the G-8¹s latest promise of universal access to treatment by 2010 both cynical and illusory unless there are serious commitments to addressing the shortfalls now,² continued Baker.
According to UNAIDS, prevention efforts are reaching fewer than 20% of those in need. U.S.-initiatives in particular refuse to deliver comprehensive, scientifically-based prevention messages and instead preach abstinence and faithfulness only in societies where 50% of youth are sexually active and marriage carries an even greater risk of infection than being single.
Of the 6.5 million people currently in clinical need of antiretroviral (ARV) treatment, only a little over 1 million are actually obtaining the life-saving medication they require. "World AIDS Day this year was supposed to be a celebration of an important milestone in the global fight against AIDS. Unfortunately however, we are here today confronting a colossal failure in meeting the WHO 3 by 5 initiative," said Jamila Headley of Health GAP.
"The disappointing and dangerous lack of access to HIV treatment comes from a shameful lack of financial commitment to the Global Fund, trade and patent barriers blocking affordable ARVs, particularly second line and second generation ARVs, serious health care worker shortages and weak health systems for care and treatment delivery in developing countries, all exacerbated by a failure of political leadership to seriously engage with these challenges," stated Asia Russell of Health GAP and an NGO representative to the Global Fund.
Funding the Global Fund
Activists continue to press for increased funding for the Global Fund to Fight AIDS, TB, and Malaria, which was established in 2001 to provide efficient, multilateral means for financing public health efforts required for combating these three infectious diseases which collectively kill 15 people every minute.
The Global Fund is currently disbursing money for its fifth round of grants, which is scheduled to implement 26 technically sound, local-level health projects in 20 countries. However, due to sizeable shortfalls in funding, officials at the Global Fund report that they are currently not able to meet all current Round 5 grant commitments. Moreover, launching and approving Round 6 in 2006 may be impossible since the Global Fund is under-funded by $3.3 billion for 2006-07.
According to Jen Cohen of Health GAP, ²The fair share¹ for U.S. contributions this year to the Global Fund is $700 million, but so far, only $450 million has been approved. "The U.S. government must act now to keep its promise to contribute one-third of the Global Fund's total financial needs. The leadership of the House and Senate, including Senator Frist, must make it a high priority in the next few weeks to secure the remaining $250 million," said Dr. Cohen. This could be achieved by approving the $100 million earmarked for the Global Fund in the Labor and Health and Human Services spending bill and approving an additional $150 million in the Avian Flu supplemental appropriation bill by the end of the year.
Strengthening Health Systems
Activists also insist that it is critical to strengthen health care systems in developing countries. "Just below the surface of the recent 3 by 5 failure and other international health care challenges is a broad and insidious structural problem of under-staffed and ill-equipped health systems. The global AIDS community has recognized over the past year that there will be no major, meaningful advances against the HIV pandemic until a million more health workers are hired in Africa alone," said Aaron Boyle of Health GAP. "Not only should we educate, train, hire, and retain more professional-level staff, we should also compensate the tens of thousands of
community- and home-based workers, mostly female, who provide prevention, treatment, and end-of-life care to people living with AIDS.²
According to UNAIDS, unless comprehensive prevention efforts are matched with greatly expanded treatment, the death toll will continue to mount. "Failing on treatment is bad enough, but for the U.S. government to fuel the pandemic with evangelic messages that ignore women¹s vulnerability and the realities of human sexuality is criminal² according to Sharonann Lynch of Health GAP. "The U.S. has created an artificial condom shortage in Uganda; it refuses to fund comprehensive sex education for youth; and it gags comprehensive family planning services and simultaneously undermines efforts to work with sex workers by requiring an anti-prostitution oath by service providers² said Lynch. "While politicians mouth pious statements of concern, the very same day they condemn people to death.²