LONDON (AlertNet)- Years of progress in HIV treatment in Africa are under threat and the lives of HIV-positive people are increasingly threatened, a report by international medical charity Medecins Sans Frontieres (MSF) has warned.
Improved access to antiretroviral (ARV) treatment has saved lives, including the incidence of tuberculosis (TB) and new HIV infections. It has also helped strengthen health systems in many of the worst affected countries.
But as funding shrinks, these gains are threatened, the report builds on analyses made in eight sub-Saharan countries to illustrate how major international funding institutions such as PEPFAR, the World Bank, UNITAID, and donors to the Global Fund have decided to cap, reduce or withdraw their spending on HIV treatment and antiretroviral drugs over the past year and a half.
Â?How can we give up the fight halfway and pretend that the crisis is over?Â? said Mit Philips, health policy analyst for MSF and one of the authors of the "No time to quit" report.
Â?Nine million people worldwide in need of urgent treatment still lack access to this lifesaving care - two thirds of them in sub-Saharan Africa alone. There is a real risk that many of them will die within the next few years if necessary steps are not taken now.Â?
Also, the current donor retreat will prevent more people from accessing treatment and will threaten to undermine all the progress made since the introduction of ARVs, said Philips.
DOWNWARD TREND
The report said that the U.S. PresidentÂ?s Emergency Plan for AIDS relief (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 international drug purchasing facility UNITAID and the World Bank, have announced reductions over the coming years in the funding for antiretroviral drugs in Malawi, Zimbabwe, Mozambique, Uganda and the Democratic Republic of Congo (DRC).
The Global Fund, the largest funding institution in the fight against HIV/AIDS, faces a major funding shortfall. The U.S., the Netherlands and Ireland have already announced that they will be providing lower contributions to the Global Fund. In 2009-2010, contributions to already approved country grants were reduced by 8 to 12 percent.
Overall funding cuts have translated into a reduction in the number of people able to start their ARV treatment, as seen in South Africa and Uganda, and in DRC Â? where the number of new patients able to start ARV treatment has been cut six-fold.
The report predicted that if the downward trend in funding continued, ARVs would become increasingly inaccessible, which would lead to increased rates of mortality and hospitalisation among those living with HIV, and place a strain on already weak health systems.
RISK INCREASES
The report also warned that ARV patients may adopt risky strategies for coping with drug supply shortages, such as sharing pills, thereby increasing the likelihood of widespread drug resistance.
Already fragile health systems will become increasingly strained by an increasing patient load requiring more intensive care, the report warned.
MSF said it had recently been requested by the government and other actors to assist with emergency drug supplies in Malawi, Zimbabwe, DRC, Kenya and Uganda.
Â?If there is reduced funding, then it will mean more people will die, and we will have more orphans,Â? said Catherine Mango, an HIV patient from Kenya. Â?The ones that are positive often need to assist others, like their children. People will lose hope and die. It will be the end. If there are no drugs there is no future.Â?
ARV treatment is lifesaving but also lifelong. This means that the number of patients under treatment increases cumulatively each year, thus requiring incrementally growing and sustainable funding.
Â?The HIV / AIDS crisis remains a massive emergency that still requires an exceptional response. MSF calls for a sustained and renewed commitment by donors and national governments in the fight against HIV/AIDS, so that this disastrous public health crisis can be addressed appropriately,Â? said Philips.
Our Standards: The Thomson Reuters Trust Principles.
