Geneva, 27 March 2012 — The recent cancellation of the Global Fund’s Round 11 is endangering the historic advances already made in the fight against HIV/AIDS and tuberculosis, stated the international medical organisation Médecins Sans Frontières (MSF) during the AFRAVIH conference (Francophone Alliance of Health Workers against HIV) in Geneva.
There is no time to lose. MSF calls on all stakeholders to reaffirm their commitment to put 15 million people on treatment before 2015 and to support promising new medical strategies to help achieve this goal. MSF also calls for an emergency donor conference to ensure that new funding possibilities are available from 2012 onwards.
"Thanks to the political will that existed during the past decade significant progress has been made in the treatment of AIDS and generic drugs could be developed” says Dr Annick Antierens, MSF’s deputy medical director. "It is unthinkable that due to a lack of political commitment and funding, these achievements are now threatened."
The hope of controlling the HIV/AIDS epidemic has never been greater. The decentralisation of care, achieved by task delegation and involving the community, has allowed scaling up HIV treatment. Getting patients on treatment early keeps them healthy, it avoids overloading health facilities and it reduces the spread of the virus. And better drugs are available, such as tenofovir which is less toxic and easier to take on a daily basis than previous ones.
In its report Losing Ground, MSF highlights the consequences of the lack of funding for people living with HIV/AIDS and tuberculosis in the countries where it works. Many countries have taken steps to scale up programmes to prevent the transmission of HIV from mother-to-child, and to increase the screening and treatment of infants. The current disengagement of donors could halt these promising initiatives.
Today, in Malawi, Lesotho and Uganda, those who are waiting for treatment see their hopes dashed, as the rate at which people are put on treatment is slowed down. In the Democratic Republic of Congo, treatment is already being rationed: only 2,000 new patients were started on treatment in 2011 – five times less than in the previous year – and antiretroviral (ARV) coverage remains below 15 percent. In Myanmar, there is already evidence of a major treatment gap for multidrug-resistant TB: 9,300 new cases are diagnosed each year while only three percent are treated.
"Thousands of lives are at stake. Highly promising medical strategies could be implemented, but the current political volte-face is a real blow," says Dr Antierens. "Medical teams will yet again face the dilemma of having to choose amongst patients who all need treatment. Moreover, it is not ethical to test patients without offering them treatment.”
Unavoidably, the current funding shortfalls will have social and public health impacts. Provision of health care will remain centralised, while costly and inefficient. Improved treatments won’t be rolled out even though they have less side effects and favour adherence. Finally, the multidrug-resistant TB epidemic will continue to spread regionally and globally.
The lack of visibility on funding beyond 2014 jeopardises hopes of scale up for these chronic diseases. Who will take the risk to start treating new patients when funding is not assured beyond a year or two?
Médecins Sans Frontières (MSF) is an international, independent, medical humanitarian organisation that delivers emergency aid to people affected by armed conflict, epidemics, natural disasters and exclusion from healthcare.
MSF has been running HIV/AIDS programmes since 1990, and provides ARV treatments to 222,000 patients in 19 countries.