New report confirms fears of people living with HIV: Treatment rationing escalating

Rationing Funds, Risking Lives: World Backtracks on HIV Treatment, the new report from the International Treatment Preparedness Coalition (ITPC), documents early warning signs resulting from the global pullback on AIDS commitment and funding: caps on the number of people enrolled in treatment programs, more frequent drug stock outs, and national AIDS budgets falling short.

"AIDS is not over. ITPC's report clearly shows that the response is being starved, not over-funded. Governments, North and South, cannot afford to put the clock back and return us to the days when HIV was a death sentence," said Aditi Sharma of ITPC, coordinator of the report.

The effect of government budget cuts and flatlined funding from major donors like U.S. PEPFAR (President's Emergency Plan for AIDS Relief) and the Global Fund to Fight AIDS, Tuberculosis and Malaria are already being felt in the developing world. The Fund would need $20 billion over the next three years to help meet the health-related Millennium Development Goals (MDGs), but G8 nations and other donors are warning that raising even $13 billion (the lowest target which will mean a dramatic slow-down in pace of delivery) is a "huge stretch."

"In my home country, Uganda, for the first time since 2004, some HIV-positive men and women who are in need of life-saving antiretroviral treatment are being turned away because of funding cuts. Our greatest fear is that we may have to ration HIV medications for those already receiving treatment. How do you tell an HIV-positive mother that she can no longer have the drugs she needs to stay alive? ITPC's report makes it painfully clear that Uganda is not alone in facing an escalating treatment crisis," said Peter Mugyenyi of the Joint Clinical Research Centre in Uganda and author of the foreword.

As evidence mounts that AIDS treatment is inexorably linked with other health issues, including maternal health and tuberculosis, ITPC argues that it will not be possible to build sustainable, credible health systems as the waiting lines for AIDS drugs grow.

"Providing access to AIDS treatment for four million people has been the most ambitious public health effort in history," said ITPC's Gregg Gonsalves. "Around the world thousands of doctors, nurses, legislators, and activists helped make treatment scale-up possible. Now a few power brokers and politicians who claim AIDS receives too much money seem intent on bringing to an end this remarkable effort, in effect saying to millions of people: drop dead. Without treatment, this is certainly their fate."

Rationing Funds, Risking Lives documents numerous gains in providing access to HIV treatment in six countries. However, people living with HIV often struggle to afford medicines for opportunistic infections, transport costs, food, and second-line medications and continue to face stigma and discrimination. Programs to prevent vertical transmission of HIV run contrary to WHO guidelines in several countries and fail to reach most women.