REPORTING FROM JOHANNESBURG, SOUTH AFRICA -- Activists marked World AIDS Day on Thursday with warnings that severe shortfalls in global AIDS funding by donors would cost many lives, particularly in hard-hit southern Africa.
After scientific research this year concluded that aggressive treatment of HIV from an early stage with anti-retroviral medications could save lives, the Global Fund to Fight AIDS, Tuberculosis and Malaria announced last week it was canceling funding for new programs until 2014 because it had not received adequate donations.
The organization is the biggest fund offering grants to fight the diseases and provides anti-retroviral medication for about half the people in sub-Saharan Africa taking the drugs. Globally it is providing such medications for 3.2 million people.
The global financial crisis and the uncertainty created by the Eurozone meltdown are major causes of the shortfall in donations, according to analysts. Corruption in some agencies that received Global Fund grants was another issue, leading the fund to tighten its accountability procedures.
Nathan Geffen of South Africa's Treatment Action Campaign said the Global Fund was supporting millions of people living with AIDS in Africa.
"If funding is cut and no further grants are dispersed, the consensus is that many people in need of ARV [anti-retroviral drugs] for HIV, or medications for malaria or TB, are not going to get them," Geffen said. "The scale of the problem can be measured in deaths. It's as stark and tragic as that."
Some health organizations have warned that the funding shortfall could cause clinics in the region to run out of ARV drugs, causing dangerous interruptions in medication for some people.
"HIV/AIDS is a multigenerational commitment," said Dr. Peter Fourie of the AIDS Foundation of South Africa. "There's almost a sense of betrayal because the First World made a commitment at the end of the last century on AIDS funding, and then to just rip it away is very cynical.
"With the decrease in funding there will obviously be less people who will be able to be tested and less people who will be able to go on drugs," he said. "More people will die and suffer. Even if there's a lot of aid fatigue there doesn't seem to be fatigue for wars and other funding priorities."
The Global Fund had targeted $17 billion in donor funding to scale up existing programs or $20 billion to further expand the particularly successful programs, hoping to save 10 million lives between now and 2016. Simply maintaining existing programs will require donations of between $12 billion and $13 billion, but the fund will instead disburse $10 billion.
UNAIDS has estimated $28 billion to $50 billion would be needed from all sources every year from 2010 to 2015 to provide universal access to ARVs and to start to defeat AIDS. More than half the people in low-income countries who need ARVs are not getting them, UNAIDS said, and in sub-Saharan Africa more than 70% of people living with HIV are girls and young women.
"Meeting such levels of demand, requiring significantly more funds than the $10 billion provided by donors for the 2008-2010 replenishment period, clearly represents a major challenge in the midst of difficult economic circumstances," the Global Fund report on donor funds said last week.
But Simon Bland, chairman of the organization, said in a statement Thursday the Global Fund would expand access to treatment by improving the efficiency of its spending.
On the eve of World AIDS Day, the World Health Organization said that the sustained global investment in treating AIDS over the last decade had saved millions of lives, cutting AIDS-related deaths by 22% in the past five years.
But unless funding continued to increase, the momentum in fighting the disease would be lost, it warned.
"It has taken the world 10 years to achieve this level of momentum," Gottfried Hirnschall, director of WHO's HIV department, said in a statement. "There is now a very real possibility of getting ahead of the epidemic. But this can only be achieved by both sustaining and accelerating this momentum over the next decade and beyond."
-- Robyn Dixon
Photo: A patient lies in bed at the Hillcrest AIDS Center in Durban, South Africa, on Thursday. Activists predict that a shortfall of donations would cost many lives, particularly in hard-hit southern Africa. Credit: Nic Bothma / EPA