The global response to HIV/Aids is falling far short of what is needed to turn around the pandemic, with only a tiny minority of those affected receiving treatment and prevention programs patchy, UNAids warned Tuesday. Two reports from UNAids at the Bangkok International Aids conference revealed that Aids prevention programs had yet to have a significant impact on the spread of the virus, according to the World Bank press review.
Much more money is needed to step up the response to the pandemic, says UNAids. In 2001 the UN special session in New York called for 9,2 billion US dollar. UNAids has now increased that estimate to 12 billion by 2005, and 20 billion by 2007.
Of the 20 billion dollar, it says, 10 billion is needed for prevention, 7 billion for treatment, 2 billion for orphan care and 1 billion for policy, advocacy and administration. The estimate includes drug treatment for just over 6 million people – around 52 per cent of those who will need it by then.
But the chances of raising that level of funding look remote. This year 6 billion US dollar will be available when the need is 8 billion. In 2005, UNAids predicts that 8 billion will be raised of the 12 billion needed. By 2007 there will be a 50 per cent shortfall, with only half of the required 20 billion dollar forthcoming.
Not surprisingly, U.N. Secretary General Kofi Annan has made an outspoken attack on a worldwide lack of commitment to fighting AIDS. In an exclusive interview with the BBC, Annan said the fight against terrorism was overshadowing the HIV/AIDS epidemic. He expressed disappointment that the U.S. and Europe were not doing enough to help the global fund. Annan said the priority now was to move forward, commit more funds, and show leadership – from politicians, private business and the wider community.
The New York Times reports that waste and inefficiencies from duplication of donors efforts are emerging as major obstacles as the world increases spending to stop the HIV epidemic, a panel of experts said at the 15th International AIDS Conference.
In a session on why donors fail to work together, there was agreement among participants about some steps toward better coordination of donation efforts in poor countries. They included standardizing measures to monitor the costs and outcomes of prevention efforts, and accepting a set of principles compiled by the United Nations and aimed at better use of the influx of new resources.
But there were no formal solutions, in part because participants said it would take more time to resolve the complexities involved in the relationships between donors and recipient countries.
Private-sector donations exceed government donations in the AIDS effort, said Hank McKinnell, the chief executive of Pfizer, who moderated the session. But that influx creates tensions. The government staffs of most poor recipient nations are small, yet they have to respond to myriad expectations from the donors.
Some poor countries do not have the infrastructure to be able to put money donated to fight HIV to good use, experts have said. The International Aids Conference in Bangkok heard the health systems in sub-Saharan African and Asia in particular are in a poor state.
Consequently, the World Bank has warned, money is not going where it is needed the most. Keith Hanson, from the World Banks Africa Aids team, said: – We simply do not have enough trained serving physicians and nurses and clinical officers in most developing countries and especially in Africa.
What is needed, is a more long term approach by donors – a realization that investment in basic infrastructure will in time make a real difference in the fight against Aids.
Meanwhile, the U.S. government, already the worlds largest source of money to fight AIDS, faced demands on Monday from international AIDS officials, policymakers and activists to give a larger share to the Global Fund to Fight AIDS, Tuberculosis and Malaria, the main multinational fund to combat the disease.
The Bush administration has proposed annual payments of 200 million US dollar to the fund, an amount criticized by many, one of whom who said the United States should give the fund five times that much.
A top U.S. official at the Bangkok-conference said the Global Fund, launched in 2002 with U.S. support, has shown success at raising money, but that much of the money is “just sitting there” waiting to be spent.
Only about 430 million dollar of 3 billion in the fund have been disbursed, said the official, Randall L. Tobias, U.S. global AIDS coordinator. – We are certainly going to continue to contribute to the Global Fund, but more money this year would simply go into an account in the World Bank, he said.
The New York Times further reports that an exodus of African nurses puts infants and the ill in peril. The nursing staffs of public health systems across the poor countries of Africa – grossly insufficient to begin with – are being battered by the growing flight of nurses discouraged by low pay and grueling conditions.
In May, African countries banded together at the annual assembly of the World Health Organization to urge developed nations to compensate them for their lost investment. The brain drain of health professionals from Africa, and, more broadly, the severe staffing shortages, will be an issue at the 15th International AIDS Conference in Bangkok.
Kilde: www.worldbank.org
