Kaisernetwork.org (Washington, DC)
29 October 2008
Global Challenges
Global Financial Crisis Could Harm HIV/AIDS Funding, Piot Says
[Oct 29, 2008]
The current global financial crisis could harm HIV/AIDS funding and increase the factors that make people vulnerable to the disease, UNAIDS Executive Director Peter Piot said on Tuesday during an event at the Center for Strategic and International Studies, CQ HealthBeat reports. According to Piot, as rising food and energy costs drive more people into poverty worldwide, the factors that drive the spread of HIV also could increase. "That must have an impact on the spread of HIV, although it's not so clear," he said, adding that it is certain that low-income countries will be more affected by and vulnerable to the financial crisis when it comes to providing HIV/AIDS treatment. For example, 100% of the cost to provide 50,000 HIV-positive people in Rwanda with antiretroviral drugs at the end of last year was paid by donors -- such as the Global Fund To Fight AIDS, Tuberculosis and Malaria and the President's Emergency Plan for AIDS Relief -- according to Piot. He added that Brazil receives no donor funding to provide similar treatment services to its HIV-positive citizens.
Countries likely will not feel the effects of the financial crisis on HIV/AIDS "in the next six or 12 months because of commitments that have been made in better times," Piot said, adding that he wonders if it will be possible to continue enrolling 700,000 to one million people in drug treatment programs over the next few years. "If not, deaths will go up again, deaths from AIDS, no doubt about it," he said, adding, "We estimate that even if (funding) continues at the same level, deaths will go up to about three million per year by 2011."
Piot also praised the Bush administration and Congress for continuing PEPFAR, which he said is an "unprecedented program that has saved millions of lives." Piot added, "It is quite rare in international development that you can count so easily, you can measure, the impact of actions, and yet this has been the case when it comes to what PEPFAR has done, and it's unprecedented in international development." In addition, Piot commended President Bush and Secretary of State Condoleezza Rice for their comments at the recent White House summit on international development about how the U.S. should not reduce aid. "I hope that the next president will follow along the same lines," Piot said.
Jennifer Kates -- vice president and director of HIV policy at the Kaiser Family Foundation -- said it is difficult to assess how the financial crisis will affect future funding levels. "How the financial crisis plays into that, we still don't know," she said.
Piot will leave his position at UNAIDS at the end of the year to head the new Institute for Global Health at Imperial College London (Vadala, CQ HealthBeat, 10/28).
A kaisernetwork.org webcast of the event is available online.
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WHO Says HIV/AIDS-Related Deaths Will Peak in Next Five Years, Then Decline
[Oct 29, 2008]
The World Health Organization on Monday in its updated Global Burden of Disease report reduced an earlier forecast of HIV/AIDS mortality rates, AFP/Yahoo! News reports. According to WHO, the number of HIV/AIDS-related deaths worldwide is expected to peak in the next five years -- from 2.2 million in 2008 to a maximum of 2.4 million in 2012 -- before declining to 1.2 million in 2030.
WHO previously had said HIV/AIDS-related deaths would rise from 2.8 million in 2002 to 6.5 million in 2030, assuming that antiretroviral drugs reached 80% of HIV-positive people worldwide by 2012. Colin Mathers, WHO coordinator for epidemiology and the burden of disease, said, "Deaths (from HIV/AIDS) will continue to increase somewhat for a few years ... by 2030 they would have declined from current levels today" (AFP/Yahoo! News, 10/27). Mathers added that the report "builds in the revisions to HIV mortality and more optimistic projections of HIV deaths that" WHO and other U.N. agencies have "produced, which suggest that the epidemic may have peaked, or will peak in the next five years or so, and then AIDS deaths will start to decline."
The study also predicts that the percentage of deaths worldwide linked to noncommunicable diseases will increase from 60% to 75% by 2030. It adds that this means people will live longer and increasingly die from cancers and heart disease rather than infectious diseases at an earlier age. According to the report, the leading causes of death worldwide are heart disease, stroke, pneumonia, chronic respiratory disease, diarrhea, HIV/AIDS and tuberculosis (Schlein, VOA News, 10/27).
The study is available online (.pdf).
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Many Zambian Citizens Concerned About Future of Fight Against HIV/AIDS After Upcoming Presidential Election, Reuters Reports
[Oct 29, 2008]
Despite progress in the fight against HIV/AIDS in Zambia, some of the country's citizens are concerned that the disease will not be a priority of the next president, who will be elected on Oct. 30, Reuters reports. According to Reuters, Zambians have said that the two main candidates -- acting President Rupiah Banda and opposition leader Michael Sata -- have not openly discussed HIV/AIDS during their campaigns.
Clementina Mumba, chair of the Treatment Advocacy and Literacy Campaign, said the candidates have remained silent on HIV/AIDS issues because of the stigma associated with the disease. Mumba said, "I am surprised not a single politician has declared he is HIV-positive, not even one minister or legislator has done that. This portrays a picture that HIV/AIDS only infects the poor." Mumba added, "During the election campaign, not a single candidate has said what they will do to tackle HIV/AIDS."
Reuters reports that more than one million of Zambia's 12 million people are HIV-positive. Ministry of Health spokesperson Cassius Banda said HIV prevalence among adults ages 14 to 49 declined to about 14% in 2007, down from 16% in the previous decade, and United Nations data reveal that nearly 56,000 people died of AIDS-related causes in 2007, down from 78,000 in 2001. However, advocates say that many more people die in their homes, unable to get treatment and unaccounted for because of the stigma attached to the disease. In addition, although the government said it has provided 170,000 people with no-cost antiretrovirals -- compared with 10,000 in 2003 -- scientific projections show that 370,000 people still are in need of the drugs. Access to treatment and a shortage of medical staff -- many of whom have migrated to the United Kingdom and other Western countries for better-paying jobs -- also pose issues to people living with HIV, and many Zambians say that they need more than no-cost antiretrovirals, Reuters reports (Shacinda, Reuters, 10/27).
Link to this story.
Mozambique Health Official Calls for Research Into Culture To Understand Spread of HIV
[Oct 29, 2008]
Mozambique's Deputy Health Minister, Aida Libombo, recently said that more research into the cultural habits of Mozambicans is needed to determine how these factors contribute to the spread of HIV, AIM/AllAfrica.com reports. Speaking at the National Youth Meeting in the province of Sofala, Libombo said that young women ages 15 to 24 are most at risk of HIV in the country. She added that the risk factors for HIV among women in Mozambique are poverty, an inability to negotiate the use of condoms, early initiation of sexual activity and sexual abuse. In addition, widowhood can increase a woman's risk of HIV because of the cultural tradition of a widowed woman having sex with a male relative of her late husband, Libombo said, adding that risk factors for men include excessive alcohol and drug use.
According to AIM/AllAfrica.com, participants at the meeting suggested that the government provide female condoms to all provinces. Libombo said that although female condoms are available in private pharmacies, they are expensive and not many are sold. Female condoms will be included in a shipment of 700 million condoms being sent to Mozambique in the near future and will be distributed at no cost through a government partnership with UNAIDS.
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