ART funding is money well spent

There are fears that the supply of antiretroviral treatment (ART) to poorer countries will fall further behind target as donor funding decreases.

Approximately 5.2 million people in developing countries are currently on ART to keep their HIV under control. Many more are in need of treatment now and will be in the future, however the funding shortfall is already estimated at more than $7.5 billion.

Paul De Lay, deputy executive director of UNAIDS, has said the organisation is seriously concerned about the future of the programme. “Only about one-third of people in need have access to treatment,” he explained. “In the current economic climate even sustaining that over the long term will be a challenge.”

U.N. Secretary-General Ban Ki-Moon has called for a target of at least 13 million people to be receiving treatment by 2015, others, including the International HIV/AIDS Alliance, want 15 million, which they say will still only offer 80 per cent coverage.

If those already on the ART programme cannot maintain their treatment, it could have significantly adverse effects on their health. By stopping for a period of time, the virus in their body will develop resistance to the medication they were on and they will then require a second line combination of drugs.

This would only exacerbate the funding problem, for second line drugs are even more expensive to supply – costing up to six times more than the first-line regimen.

The international organisation Médecins Sans Frontières (MSF) carried out a study into 16 countries in Africa, Asia and Latin America that account for 52 per cent of the global AIDS burden.

This found that greater access to ART had reduced HIV-related deaths, lowered infection and deaths of tuberculosis and greatly lowered healthcare costs as people were spending less time in hospital and needed fewer supplementary medicines.

The MSF study noted that there had been great strides made in the past decade in terms of reducing drug bills and widening access. It reported that competition from generic manufacturers has driven the price of the most commonly used antiretroviral combination down from more than 10,000 dollars per patient per year to 67 dollars today – a decrease of 99 per cent.

MSF said it is understandable that there had been a drop in support for international causes following the global financial crisis and increased domestic spending pressures. However it has urged donors to look at ART funding as an investment that would pay off in the longer term.

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