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AIDS Treatment Gap Widening in Africa

   Joe DeCapua 27 May 2010

   The  medical aid group â Doctors Without Borders â is warning of âdire
   consequencesâ due to a flatlining of international AIDS funding.

   The  group  â  also known as MSF â has released a new report called No
   Time  to Quit: AIDS treatment gap widening in Africa. Itâs based on an
   analysis  of  HIV/AIDS  related  programs  in seven countries: Malawi,
   Mozambique, Zimbabwe, South Africa, Lesotho, Kenya, Uganda and DRC.

   The  report  says  donor  countries  are  âbacking  awayâ  from  their
   commitments to HIV/AIDS.

   Emi  MacLean,  U.S.  director  of the Essential Medicines Campaign for
   Doctors  Without  Borders,  says  there  are four million people alive
   today   thanks   to   donor   funding   for   AIDS   drugs,  known  as
   anti-retrovirals  (ARVs).  But she says progress could be reversed by
   a shortage of funds.

   âFor  the past year, we at MSF have become increasingly alarmed by how
   the  HIV/AIDS  treatment landscape is shifting.  The global Fund (for
   AIDS,  Tuberculosis  and  Malaria) and the countries that fund itâ¦are
   all  beginning  to  retreat  from  their commitments to the global HIV
   response,â she says.

   She says the trend may indicate âgoing back to a time of more rationed
   care and treatment.â

   Shortfalls

   âThe  Global  Fund  is  facing a severe shortfall in funds to meet the
   demand,  with  various  countries,  including  the  U.S., announcing a
   reduction  of  contributions  to  the  fund.  The funding limitations
   threaten  a  core  principle  of  the  Global  Fund  â  that demand by
   countries  and  quality of proposals will drive funding choices,â says
   MacLean.

   The  Doctors  Without  Borders  report bases its findings on anecdotal
   evidence from its teams in Africa.

   âPatients are being shuffled around from one clinic to another because
   of  limited  treatment  slots.   There are now new waiting lists; and
   doctors  and nurses facing the agonizing choice of which patients they
   should treat â a patient who arrives very sick with late stage AIDS or
   the  patient  not  yet sick, but who needs treatment and will get sick
   quickly without it,â she says.

   MSF  teams  in  Zimbabwe,  South Africa and Uganda report HIV infected
   people are not getting into treatment programs as soon as they should.

   âA  letter  from  the  U.S.  Centers  for Disease Control in Uganda to
   PEPFAR  implementing  partners  suggests  that  rationing  to  be âthe
   sickest  patients, eligible pregnant women, children, pedi (pediatric)
   HIV  patients  and  family  members of persons on ART (anti-retroviral
   therapy),ââ she says.

   MacLean says such rationing âmoves programs backwardsâ¦even though the
   science  and  the  medical  advice  is unanimous that treatment should
   start earlier.â

   VOA  has  requested a response from PEPFAR (Presidentâs Emergency Plan
   for AIDS Relief) officials to the MSF report.

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