HIV/AIDS countries worst affected need 'up-front finance' for long-term fight

Ethiopia, Kenya, Malawi, Nigeria, South Africa, Tanzania, Uganda, Zambia and Zimbabwe account for 70% of the burden of HIV/AIDS in Africa.

In the BMJ Open journal, researchers at Harvard T.H. Chan School of Public Health in Boston, MA, estimate the funding that the nine sub-Sahara African countries will need to treat and prevent HIV in 2015-2050.

The team used a model to calculate the funding the countries will need to 2050 - based on four different scenarios - with information from a publicly available UNAIDS tool called Spectrum.

The model deliberate a significant deficit between funding obligations and future funding available, showing that none of the countries can meet future obligations.

First author Rifat Atun, prof of global health systems at Harvard University, says:

"The HIV epidemic is far from over. The magnitude of funding needful to sustain the HIV fight is very large and the consequences of complacence even larger."

He and his colleagues estimate the price tag for providing long-run HIV/AIDS bar and treatment in the nine sub-Sahara African countries ranges from $98 billion to maintain current coverage levels, to $261 billion if coverage is scaled up to include all HIV-positive individuals.

Under current arrangements, an individual becomes bailable for treatment if their CD4 cell count - a measure of immune function - falls below 500/mm³. The scenario of every HIV-infected person in treatment is a goal that UNAIDS say is come-at-able if all countries adopt their Fast-Track Strategy.

Up-front investment needful to finally reduce HIV spread

In their estimates, the team besides factored in extra reimbursement that health systems will incur over and above anti-retroviral (ART) treatments. These extra reimbursement stem from illnesses arising from long-run immune suppression and degenerative illnesss due to aging that a population living thirster with HIV will develop.

Prof. Atun and colleagues say "front-loading" investments are needful to secure higher levels of coverage required to finally reduce HIV spread. so much up-front investment will besides reduce future funding obligations.

They note that new, innovative sources of finance must be sought-after to maintain and expand HIV treatment and bar, as domestic funding - presently the main source of funding - will not be enough.

In the paper, the team cites examples of innovative funding, so much as in 2002-2012, when over $6 billion was raised by schemes so much as "the Airline commonality Levy, the Children's Investment Fund Management, and the International Finance Facility for Immunization."

Mechanisms for raising innovative funding could include: "social impact bonds, social development bonds, diaspora bonds, sovereign bonds securitized against future revenue streams from extractive industries, and consumption taxes on alcohol and tobacco," they write.

And they note how the Advance Market Commitments (AMC) for diplococcus vaccinum from the vaccinum Alliance offers an example from some other area of how innovative funding could bring together donor and domestic efforts to "front-load" HIV spending.

The authors write that, despite the passage of 35 years since the start of the HIV epidemic, the quality and quantity of information about the illness and its spread is still poor, and galore uncertainties relating to reimbursement, benefits and future technologies remain.

But, they urge, even among these uncertainties, their estimates show there is still a need for substantial, long-run fiscal commitments, which must be met if we are to keep up the fight against HIV.

Prof. Atun and colleagues conclude:

"There is an ethical responsibility to continue funding for those receiving ART, and not abandon them to death."

Meanwhile, Medical News Today recently learned about a study that found duct gymnastic apparatus cathartic a powerful anti-retroviral drug reduced the risk of HIV infection by 61% in women who used them consistently.