By Avit Ndayiziga
As the number of people living with HIV increased to 39.9 million in 2023 from 39 million in 2022, and approximately 630,000 individuals lost their lives to AIDS-related illnesses worldwide in 2023. The UN official regrets that funding for HIV dropped by 5% from 2022 to 2023, falling far short of the $29.3 billion needed for the AIDS response in developing countries by 2025 to stay on course to eliminate AIDS as a public health threat by 2030. Thus, calling for resource boost and human rights protection.
During the official opening press conference of the 25th International AIDS Conference, co-animated by several highly-ranking officials in eradicating HIV, including Sharon Lewin, who serves as the president of IAS and international co-chair, Winnie Byanyima, the Executive Director of UNAIDS, Chris Collins, the president and CEO of Friends in the Global Fight Against AIDS, Tuberculosis, and Malaria, Andre Klepikov from Alliance for Public Health Ukraine who also served as the regional co-chair for the conference, John N. Nkengasong, the Global AIDS Coordinator and Senior Bureau Official for Global Health Security and Diplomacy of the US department since 2023, and Jay Mulucha, a prominent transgender advocate leading Fem Alliance Uganda, UN official Winnie Byanyima highlighted several key points, shining a light on achievements as well as setbacks.
“Nine years ago, only 47% of individuals living with HIV were receiving treatment. Fast forward to today, and that number has increased to 77%, marking a significant 30% improvement over the past nine years. Despite this progress, the global community is falling short of its goal to end AIDS by 2030. The fact that someone dies from an HIV-related illness every minute remains a pressing crisis. In certain regions, new infections are not declining but rather increasing. Eastern Europe and Central Asia are experiencing a rise, while the Middle East, West Africa, and Latin America are also witnessing new infections.”
Funding human lives, not wars
However, she warned that cutting down the aid dedicated to HIV responses shows not the lack of funds but the value placed on people and thus, it will cost more to keep people alive. “The global HIV response is facing a shortfall of $9.5 billion. This growing gap is concerning, as some donors start hesitating, saying they have contributed enough and could shift their focus elsewhere. They argue that the costs are becoming unsustainable. However, these same donors have allocated over $500 billion in the past two years towards conflicts such as the war in Ukraine. When compared, the $9.5 billion needed for the HIV response is just a fraction (less than 0.02%) of what has been spent on a single conflict. This demonstrates that supporting the HIV response is indeed affordable. Failing to address this funding gap would ultimately result in higher costs to sustain the lives of those affected.” She complained, mentioning that “the number of people living with HIV increased to 39.9 million in 2023 from 39 million in 2022. Tragically, approximately 630,000 individuals lost their lives to AIDS-related illnesses worldwide in 2023.
Despite efforts to achieve the 95-95-95 targets, progress stands at 86-89-93. By the end of 2023, $19.8 billion was allocated to AIDS response in low- and middle-income countries, with around 59% coming from domestic sources. Unfortunately, funding for HIV decreased by 5% from 2022 to 2023, falling far short of the $29.3 billion needed for the AIDS response in these countries by 2025 to stay on course to eliminate AIDS as a public health threat by 2030. She noted.
Chris Collins, the president and CEO of Friends in the Global Fight Against AIDS, Tuberculosis, and Malaria backs her, saying “If we were to backtrack on our commitments to AIDS, the immediate consequence would be the resurgence of the disease. It’s important to note that there is no program more dedicated to saving children’s lives than PEPFAR. Thanks to this program, 5.5 million babies born to HIV-positive mothers have entered the world free from the virus. Additionally, PEPFAR has provided care to 7 million orphans, vulnerable children, and caregivers. This remarkable track record is why, during every discussion on funding authorization this year, we witnessed individuals from various political and social backgrounds coming together to passionately support PEPFAR.
Domestic funding grapples with debts
However, Collins disagrees with Winnie, highlighting that relying on domestic funding would be the most effective way to maintain HIV interventions.
“Domestic funding is crucial for supporting the fight against HIV. Let me share some numbers with you. In 2020, a study examined healthcare funding in low- and middle-income countries. That year, $12.156 billion was spent, with half coming from out-of-pocket expenses. Governments contributed 42%, while donors provided 12%. To ensure the sustainability of the HIV response, it is essential to maintain domestic funding effectively and efficiently.”Chris noted
While Byanyima agrees with domestic funding, however, she recognizes the severe challenges that low and middle-income countries face due to debt, preventing them from saving resources to finance HIV and other projects. “It is crucial to focus on mobilizing domestic resources But the debt burden on many countries affected by HIV, coupled with the economic impact of Covid-19, must be taken into consideration. Increased domestic investment is undoubtedly necessary. Therefore, restructuring the debt is essential to free up resources for crucial sectors like healthcare, education, and social protection, which are vital in the fight against AIDS.” She concluded by saying that the debt resolution will be spoken about at the Summit of the Future, which will take place at the United Nations Headquarters in New York in September for countries around the world to get together and look at how this debt problem can be solved.
She stressed the importance of prioritizing spending on essentials for people, rather than on less critical matters, especially considering that those at risk of HIV are often economically disadvantaged. Access to necessary services should be free for those who are unemployed, and affordable for those who are employed. It is crucial to minimize out-of-pocket expenses to ensure that everyone can access the support they need.