AIDS Fight Sees Decline In Global Support

After years of slow but apparently steady progress in global efforts to combat HIV, the virus that causes AIDS, activists say the tide has been turning in the wrong direction. The global economic recession has caused donor countries to slow their contributions to the world's largest multi-lateral AIDS funding body, the Global Fund to Fight AIDS, tuberculosis and malaria. Host Michel Martin talks with Jon Leiden, spokesperson for the Global Fund, and AIDS activist Paula Akugizibwe about the implications of a decline in support for the global fight against the AIDS pandemic.

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MICHEL MARTIN, host:

I'm Michel Martin and this is TELL ME MORE from NPR News. Coming up, the decades-long effort to restore the marshlands of Iraq, an area that was drained by Saddam Hussein. One man has made it his mission to bring back an area that's called the cradle of civilization. We'll talk with him in just a few minutes. But first we want to talk about a global crisis that many of us believed was getting better. I'm talking about HIV AIDS.

After years of slow but apparently steady progress in global efforts to combat HIV the virus that causes AIDS, activists say the tide has been turning in the wrong direction. The global economic recession has caused donor countries to slow their contributions to the Global Fund to fight AIDS, tuberculosis and malaria. That fund has a budget of more than $19 billion and it accounts for a quarter of international financing to fight HIV AIDS and supports about half of the world's poor who are getting AIDS treatment.

But donors from 40 countries meeting in New York yesterday, failed to raise the $13 billion deemed necessary to just keep treating patients at current rates over the next three years. Now the Obama administration pledged $4 billion, that's a nearly 40 percent increase in the previous U.S. contribution. But activists say funding by donor countries overall is lagging so far behind that in a number of poor countries, it may already be too late.

We went to talk more about the future for AIDS funding, so we called Jon Leiden. He's spokesperson for the Global Fund to fight AIDS, tuberculosis and malaria. And we're joined in our conversation by Paula Akugizibwe. Paula is with the AIDS Rights Alliance of Southern Africa, that's a network of HIV AIDS groups based in Capetown, South Africa. And we caught up with her in New York. Welcome to you both, thank you so much for joining us.

Ms. PAULA AKUGIZIBWE: (AIDS Rights Alliance of Southern Africa): Thanks for having us Michel.

Mr. JON LEIDEN: (Spokesperson, Global Fund): Thank you.

MARTIN: And we should note that we recorded this conversation Tuesday as a Contributors' Conference was just getting underway. It's a so-called replenishment conference aimed at drawing donations from donor countries over the next couple of years. It was chaired by U.N. Secretary-General Ban Ki-moon. So Jon if I could start with you. I think it is a surprise to many people that AIDS activists are indeed as worried as they are. What is the scope of the problem? Is it that donations are not increasing fast enough to keep pace with the spread of the disease, or that donations are actually falling off?

Mr. LEIDEN: We can't say that donations are falling off just yet, everywhere. And the United States is actually holding steady and is a great force in driving things forward. I think the concern is that after 25 years of just seeing people die from this disease and having no way of dealing with it, in the last five or seven years, partly, or to a large extent due to U.S. efforts, we have actually started to see hope. So doctors can see that today's waiting list could be tomorrow's patients.

And people who may see that their neighbors are actually getting access to drugs today, may hope that they will be the ones who get access to drugs tomorrow. And we've also seen, in many countries, that infections among young people have gone down dramatically in the last five years. The concern is that the current economical crisis seems to endanger this kind of progress. And if it slows down, if the hope dies and if the people start fighting about who should get this treatment, who should be, you know - and the campaigns to keep young people HIV free, and their efforts to prevent transmission of HIV from mothers to children falter over the coming years, we have lost a whole decade. And that is what we're trying to fight.

MARTIN: Paula do you agree with that assessment?

Ms. AKUGIZIBWE: I agree with it partly. I think we have made substantial progress as Jon has said. And I would also echo his statement that a lot of this is due to contributions from the U.S. government and other governments around the world who have turned HIV from, you know, being a death sentence into a manageable condition. I would, I guess, be slightly more critical about the current situation that we face when it comes to donor input as well as national government input into HIV budgets.

I think the economic crisis has definitely put a strain on budgets all around the world, and has made it difficult perhaps, to meet some of the commitments that governments have made in various funds. But you see some of the declines in funding that have created such concern among activists were actually starting to emerge before the economic crisis.

And you know one of the observations that we have made in activism back home is that it seems that it is more a crisis of priority even over economics that is really driving the current underfunding of HIV. We do stand poised to make huge wins but currently the early signs of pledges coming in from various countries suggest that we might not be able to attain the level of funding that's needed, and I think it's something that we really cannot take lightly. And so I wouldn't be quite as optimistic, I guess, as Jon is.

MARTIN: Well, that's interesting. There is some different opinions about that. I mean, New York Times reports that in interviews with representatives from United Nations AIDS fighting agency, UNAIDS, their report suggests that for every 100 people put on treatment, 250 are newly infected, so that donations, instead of flat-lining, would actually need to be seriously ramped up in order just to keep pace. But can I just ask you, Paula, on the frontlines of your organization, what are you seeing?

Ms. AKUGIZIBWE: You know, what happened once HIV treatment became available, like I said, it came from being a death sentence, and that really profoundly affected the psyche of communities about HIV. You know, 10 years ago, people were afraid to talk about HIV because access to life-saving treatment wasn't affordable and available to most people. Once it became affordable, it completely changed the dynamic around this, and then - so now you do see increased demand because people are more willing to come forward to be tested because they know that it doesn't mean, if HIV-positive, they're going to die.

In the current funding climate, what we have seen in some countries - for example, Uganda, I think was one of the highest profile countries, but we've had anecdotal reports from Mozambique and DRC and other countries like the Lesotho, that there is certainly a declining in the availability of drugs to people, and that definitely affects how willing people are to come forward and to get tested. But it also affects the confidence that's been built up in the system, where people, you know, trusted that governments would ensure that they get this treatment. This is the year where universal access was supposed to be available, and now we're not so sure that's going to happen.

MARTIN: Well, Mr. Leiden, to that point, I'm going to give you the last word here. How do you convince governments to ramp up an effort like this at a time when their own, you know, populations will be arguing that they have significant needs? How do you make that case?

Mr. LEIDEN: I think - first of all, Paula is onto something very important, which is the world seems, perpetually, to congratulate itself on work half done rather than work well done. And I think one of the things that has happened around the AIDS pandemic is that we have seen progress, and people have said, oh, good. It's working. Let's focus on something else. And that's disastrous.

And I think that is what we need to go to governments and say - not so much that you have a moral obligation for people on the other side of the world, but that the billions of dollars invested so far will be completely wasted and we will not be able to get this momentum - this progress - for decades again if we break people's hope and if we let the investments of the past two years decay in the coming years. And I think we need to say we need to go the whole way and get this job done, and it is possible.

MARTIN: We have to leave it there for now, and I thank you both so much for taking time out of this very hectic conference schedule to speak with us.

Jon Leiden is spokesperson for the Global Fund to fight AIDS, Tuberculosis and Malaria. He spoke to us from New York.

Paula Akugizibwe is with AIDS Rights Alliance of Southern Africa, based in Cape Town, South Africa, and she was also kind enough to join us from our bureau in New York.

And I thank you both so much for speaking with us today.

Ms. AKUGIZIBWE: It's a pleasure. Thanks for having us, Michel.

Mr. LEIDEN: Thank you very much.

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