Washington — The international movement to beat the AIDS epidemic has achieved more in the last 10 years than anyone would have thought possible in 2002. Eight million people around the world are receiving life sustaining treatment to control HIV infection and prevent the development of AIDS. Millions more need it as governments around the world develop strategies on how to sustain and expand the population now receiving treatment.
The Global Fund to Fight AIDS, Tuberculosis and Malaria and the President's Emergency Plan for AIDS Relief (PEPFAR) have been two of the primary sources of funding for medicines, treatment, care and support that is saving the lives of HIV-infected persons. But about 7 million more people worldwide are eligible for treatment and have not yet received it. The questions facing international health planners now are whether treatment can be expanded and can it be sustained.
"We can have universal coverage, we can have sustainability," said Global Fund General Manager Gabriel Jaramillo as he participated in a panel discussion July 26 looking at future needs and costs.
The panel was convened at the XIX International AIDS Conference being held in Washington July 22-July 27.
A key predictor of how AIDS funding could unfold in the years ahead came before the conference began. The Joint United Nations Programme on HIV/AIDS (UNAIDS) released findings July 18 showing that low- and middle-income countries had devoted $8.6 billion for their response to the epidemic in 2011, exceeding the amounts provided by international donor organizations and nations for the first time.
Appearing on the same panel with Jaramillo, U.S. Global AIDS Ambassador Dr. Eric Goosby said financial investment from the affected countries will be critical to future success.
"In order to achieve a durable response to HIV, TB and malaria, both donor and recipient countries must sustain political and financial commitment to the effort," Goosby said.
The ambassador said further that hard-hit countries need to develop clear-cut strategies for addressing the epidemic to demonstrate their responsibility and capability to cope with the crisis. Maintaining accountability on how AIDS funds are spent, and collaboration between local and international efforts will also be important, Goosby said.
With coordinated efforts and unified vision, Goosby said, the combined efforts of international agencies and local governments can decrease the cost of care delivery overall, while helping more people
"In this time of global financial constraint, it is more important than ever that we work towards one united response to save the most lives possible," Goosby said.
Ethiopia has done a "remarkable job," said Jaramillo, in how it has worked with international donors to devise a local strategy for improving health care. Drawing on support provided by both PEPFAR and the Global Fund, Ethiopia has greatly expanded treatment for persons with HIV/AIDS, Jaramillo said, and built a health care system that is now reaching 92 percent of the country's population.
"HIV mortality is down 50 percent in Ethiopia today," said Jaramillo. "Malaria deaths are down 40 percent, and TB mortality is down 32 percent."
Ambassador Goosby said the United States applauds recent reforms instituted by the Global Fund to bring greater effectiveness and efficiency to the distribution of resources.
About 23,000 delegates from more than 190 countries attended the weeklong AIDS conference in Washington, participating in scores of workshops, lectures and discussions about their mission to contain the AIDS epidemic and reduce the suffering it brings to persons living with HIV/AIDS, their families and communities.
The conference was an opportunity for the Obama administration to build support for its goal to create an AIDS-free generation in the years to come through treating the ill and preventing the spread of the disease.