THIRTY YEARS after AIDS made its deadly debut, a future without the disease is finally within reach. One of the biggest scientific breakthroughs of 2011 was the discovery that antiretroviral drugs don’t just prolong the lives of people with HIV, the virus that causes AIDS; they also render infected people virtually non-contagious. Putting people on these life-saving medicines early enough could effectively end the spread of HIV.
But just as science is on the verge of winning the battle, financial resources and political will are flagging. 2010 was the first year that HIV/AIDS funding around the world decreased, according to the Kaiser Family Foundation.
The Swiss-based Global Fund to Fight AIDS, Tuberculosis and Malaria - which supports 3 million people with HIV drugs - is so cash-strapped that it won’t provide any new grants until 2014. Due to the European financial crisis, Italy and Spain - once important donors - haven’t met their pledges. The fund has been forced to ask middle-income countries - including China, Brazil, and Mexico - to fend for themselves.
In the United States, the situation is slightly better, at least on the financial front. Congress cut funding for the President’s Emergency Plan for AIDS Relief by 2 percent - disappointing, but hardly the crushing blow that AIDS activists feared. The United States still plans to spend $4.5 billion on global AIDS relief, a pool of money that funds antiretroviral drugs for 4 million people in the developing world, at a cost of about $350 per person per year. President Obama announced last month that the United States would set a goal of providing drugs to an addition two million people, even if funding remains flat. Efficiencies - such as sending the drugs by boat rather than planes - have already allowed the United States to meet prior targets ahead of schedule.
Far more disturbing than the slight reduction in funds is a stipulation that Congress attached to the money: None can be spent on needle exchange programs. At a time when the global public health establishment is looking for proven, cost-effective ways to fight the spread of HIV, ideologically motivated limitations like this unnecessarily tie their hands. That mandate could be a death sentence for people in Ukraine and Vietnam, where the AIDS rate is fueled by intravenous drug use.
The world still has a long way to go in the fight against HIV. So far, about 6.6 million people in the developing world have access to antiretroviral drugs, out of some 30 million infected people, half of whom are already sick. Only a quarter of the 2 million children who need the drugs are getting them, along with about half of pregnant mothers who will pass the virus on to their newborn babies without them. The new science of HIV tells us that even people who feel healthy should be taking the drugs, especially infected people with uninfected spouses.
In light of all this, providing universal access to HIV treatment and preventative services seems daunting. But it is doable. A study published in The Lancet estimates that it would cost - at most - $24 billion per year. That’s just $8 billion more than the world currently spends, including the health budgets of developing countries. Such an investment would reap a swift return: fewer infected people and lower costs in the long-run. An estimated $40 billion would be saved over the next decade on antiretroviral drugs alone. That makes the failure to enact such a plan penny-wise butpound-foolish.