From the Director
Forcing a Retreat

In Asia and Around the Globe, Funding Cuts Jeopardize Advances on HIV/AIDS

Annette Sohn, M.D.

July 2010 - Over the past year, newspaper reports, opinion pieces, editorials, and emails forwarded throughout the HIV community have been cautioning against growing cuts in funding for HIV/AIDS programs. An intense effort has been under way to mobilize all sectors of the HIV community to challenge the belief that HIV programs are overfunded. 

Over and over again we have had to prove that dollars spent on prevention, treatment, and research are worth the investment today to save lives and dollars tomorrow. But this is an argument being lost daily in clinics around the world where patients are being turned away because of the lack of funding for antiretroviral drugs.

At TREAT Asia, we recently learned that we are losing one of our core programs. For the past five years, we have been part of a program funded by the government of the Netherlands to enhance the global response to HIV through the first regional-level HIV drug resistance monitoring programs in Asia and Africa. With a blanket rejection of our preliminary renewal proposal, all of our consortium partners have now lost this key source of funding, which will impact almost 100 community organizations that have been working to mitigate the impact of the HIV epidemic around the world.

"This is a disaster," said Ton Coenen, executive director of Aids Fonds and Stop AIDS Now in the Netherlands, "especially for those programs targeting the most vulnerable groups of people, such as injecting drug users, and men who have sex with men. The Dutch government is not allocating the money anymore. Now the great work these programs are doing will have to stop."

Without support for innovative programs to deliver care and conduct research, it is unclear how health systems faced with decelerated funding can make the progress needed to stop this expanding epidemic. amfAR Vice President and Director of Public Policy Chris Collins recently wrote, "We cannot hope to establish sustainable health services in developing countries as waiting lines for AIDS treatment grow" (Boston Globe, 17 April 2010).

As TREAT Asia moves into its tenth year, we continue to see the positive results of our efforts to build a pipeline of innovation for HIV research, education, and community programs in the Asia-Pacific region. The novel approaches being led by Dr. Rossana Ditangco in the Philippines are just one example (see page 8). Dr. Ditangco took what she learned from the Dutch-funded HIV drug resistance monitoring program and used it to implement a national system for improving the quality of HIV clinical management in the Philippines.

Biostatistics mentoring that TREAT Asia is now providing to her staff will facilitate analysis of resistance data, which can then be used to help the Philippine government determine how to utilize the country's limited resources more efficiently. If we stop investing in these types of activities, how will it be possible to create the sustainable solutions that health systems so desperately need?

In recent years, there has been an effort to downplay the use of terms like "fight" and "battle" among some global HIV programs such as those of the United Nations. But as funding is cut, HIV/AIDS programs are closing. Communities are losing their access to care. Researchers are losing their grant support. People should not have to die before we recognize that the "war" is not over.