U.N. Urges Quadrupling of Global AIDS Spending to Meet 2010 Treatment Goal

By Craig Timberg
Washington Post Foreign Service
Wednesday, September 26, 2007

JOHANNESBURG, Sept. 25 -- The United Nations' AIDS agency on Tuesday called for the world to quadruple its spending on the disease in order to reach the U.N. goal of providing universal access to effective treatment by 2010.

Agency officials said current spending on AIDS, totaling about $10 billion a year mainly from international donors and the governments of affected nations, would leave two out of three adults who need antiretroviral drugs without them. Efforts to prevent new infections also would fall far below target levels.

"We simply are not spending enough or doing enough," Michel Sidibe, deputy executive director for UNAIDS, said in a conference call with reporters.

The United Nations in 2006 set a goal of providing universal access to treatment, care, support and prevention efforts by 2010. Many nations have endorsed that goal, but even the rapidly growing rate of global AIDS spending is insufficient to meet it, according to a 36-page report due to be issued Wednesday.

The report says that spending $42 billion a year by 2010 would allow massive new resources to be deployed, including 427,500 medical personnel and 1.5 million teachers. Bolstered programs would be able to distribute 10 billion condoms and provide 2.5 million circumcisions.

With the extra resources, U.N. officials said, four out of five of those in need of antiretroviral drugs would get them, compared with one in four who get them now. In the report, a level of 82 percent is regarded as universal access because even where services are adequate, not all people with AIDS will use them.

The increased spending, officials said, also would halve the number of new infections, though the report does not make clear how this goal would be reached.

Prevention programs have stalled in much of sub-Saharan Africa, the region with the bulk of the world's estimated 40 million HIV infections. The U.N. report recommends using about $150 million a year to improve the availability of circumcision, which recent research has shown reduces the rate of HIV infections by about 60 percent. But the overwhelming majority of the scaled-up prevention spending envisioned by the report would be devoted to strategies that have shown, at best, only modest success in controlling the epidemic in the hardest-hit areas.

Global spending on AIDS has grown by a factor of 30 over the past decade, driven mainly by international donors such as the Bill and Melinda Gates Foundation; the Global Fund to Fight AIDS, Tuberculosis and Malaria; and President Bush's $15 billion anti-AIDS program, which he has proposed doubling.

The U.N. report also estimates the cost of an alternative scenario in which universal access to treatment would be reached by 2015 instead of 2010. That would require a tripling of current annual spending levels.

"If we maintain current rates of progress, we are unlikely to achieve universal access by either 2010 or 2015," said Paul DeLay, a top policy official for UNAIDS.

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