November 18, 2010
By Matthew O. Berger
WASHINGTON, Nov 17, 2010 (IPS) – Over the past several years, the number of people needing treatment for HIV/AIDS has risen, but so has the amount of funding for the treatment and prevention of the disease. The United States has been at the forefront of that funding, but with the new emphasis in Washington on reducing government spending that may be about to change.
Even though the U.S. lags behind many European countries in terms of global health contributions as a proportion of GDP, it remains the single largest funder of health assistance to developing countries.
This is why the new U.S. Congress that was elected earlier this month and will take office in January is somewhat concerning to global health advocates. Republicans will take control of the U.S. House of Representatives and have made it clear that reducing government spending in order to close the government’s budget deficit will be a top priority.
This platform was laid out in September, when House Republicans made what they called a “Pledge to America”. Among their proposals was reducing so-called non-security- related spending for fiscal year 2011 to fiscal year 2008 levels, meaning this spending would be 21.7 percent below what President Barack Obama has requested.
And the preliminary recommendations from a panel commissioned by Obama to look at ways of reducing the federal budget deficit includes cuts to a foreign aid budget many NGOs say is already too small.
It is far from clear how many of these proposals will succeed in getting implemented, nor how spending cuts would be distributed across programmes, but it is widely expected that there would be steep cuts to HIV/AIDS programmes and research – as well as other areas of global health and foreign assistance funding.
Most frustrating for NGOs is that those cuts would come just U.S.-funded AIDS work is seeing strong successes.
In the first four years after former U.S. President George W. Bush started the President’s Emergency Plan for AIDS Relief, known as PEPFAR, in 2003, deaths from HIV/AIDS in targeted countries dropped by over 10 percent, according to a 2009 study.
Also credited to PEPFAR is the fact that between 2003 and 2010, U.S. spending on global health has more than doubled, reaching 10.5 billion dollars this year. HIV/AIDS currently accounts for an estimated 62 percent that spending.
President Obama has called for another increase of 741 million dollars in funding for global health programmes for the fiscal year 2011, bringing the U.S.’s total funding level to 63 billion dollars over six years under their Global Health Initiative. Funding for HIV/AIDS programmes would rise by 3.6 percent.
Health groups say these funds are needed because even with ramped-up spending in recent years, more than nine million people in developing countries who need HIV/AIDS treatment do not have access to it.
And as the number of people with HIV/AIDS grows, there will be an even greater need for access to treatment, since infected people must continue taking the anti-retroviral drugs for the rest of their lives.
If budget deficit-wary U.S. policymakers get their way in Washington, it could have a devastating impact on progress being made against HIV/AIDS both domestically and abroad, warns Chris Collins, vice president and director of public policy at the American Foundation for AIDS Research (amFAR).
Collins spearheaded a report released by amFAR last week that details how cutting U.S. spending back to fiscal year 2008 levels, as Congressional Republicans have proposed, would impact U.S. spending on AIDS programmes and research.
U.S. funding for HIV/AIDS programmes abroad would see a 13.1 percent reduction if those cuts were made, the report says. Domestic programmes would face a 6.5 percent cut while funding for AIDS research at the U.S. National Institutes of Health would be cut by eight percent.
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