As donors cut back on funds for HIV treatment, new data is revealing how many millions of impoverished Africans have been unable to get life-saving medicine even before the latest cuts.
Donor governments in Europe and elsewhere, suffering from the global economic slowdown and concerned about corruption in some recipient countries, are drastically reducing their support for a crucial health fund: the $22-billion Global Fund to Fight AIDS, Tuberculosis and Malaria, which is the biggest source of money for combating the world's three deadliest infectious diseases.
The fund has saved millions of lives in Africa over the past decade, but this week it made the shocking announcement that it is cancelling its next round of grants because of a budget shortfall. It will only provide emergency funding to try to keep existing programs alive.
The damage will be substantial, since the Global Fund provides more than 70 per cent of HIV medicine in the developing world. Yet even without the budget cuts, there is already a huge gap between what is provided and what is needed in many African countries.
In the Democratic Republic of Congo, for example, only 12 per cent of those eligible for antiretroviral medicine are currently receiving it, according to the latest data from Medecins Sans Frontieres (Doctors Without Borders). This means that 300,000 people are deprived of medicine that could save their lives.
Many government and private clinics in Congo have been affected by the lack of funds. At least one organization that was treating 12,000 HIV patients, for example, was recently forced to close several of its treatment sites.
"In a climate of extreme poverty and violence, seeking treatment at alternative sites is often not feasible, often leading to interruption – or termination – of treatment," MSF said in its new report. "HIV treatment and care in the DRC is in the grip of a downward spiral caused by funding shortfalls and disbursement delays."
In Zimbabwe, the supply of antiretroviral drugs has increased dramatically since 2006, reducing the number of annual deaths by 42 per cent, but this progress is jeopardized by the budget cuts, MSF says. Shortages of HIV medicine could affect more than 86,000 patients next year, and nearly 113,000 patients by 2014.
Other African countries are in the same boat. In Mozambique, for example, more than half a million people are eligible for HIV treatment, but only 247,000 are getting medicine, and the situation is expected to grow worse. "The country now faces a severe funding gap," MSF says.
Meanwhile, the cancellation of the next round of grants by the Global Fund is continuing to send shock waves across Africa. The cancellation "will not only mean that overall HIV response will be dramatically slowed, but could spell treatment interruptions and rationing," a coalition of southern African health groups warned today. It said the cuts are "criminal" and "devastating" and will have "severe repercussions" for millions of people.
Geoffrey York