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Maintaining focus in access to ARV medicines

21 July 2015 Mark Hollis

'and we've come so far'……The opening line of Take That's 1995 classic chart toping hit Never Forget, could have fit perfectly for the launch of UNAIDS' latest report on the fight against HIV. There was also likely lots of slapping on the back as the rather extensive report laid down plenty of good news. We learnt that rates of new infection are now falling and that some 15 million people (out of close to 37 million people) are receiving treatment with antiretroviral medicines.

Hang on! Should we really be celebrating if only half of all people currently living with HIV are receiving treatment? Well….to me the report was written by extreme optimists….'the glass half full types'. This is perhaps a given when we consider the dark days of the AIDS crisis in the 90s. Indeed I remember an especially bleak lecture at university in 2002 on the economic impact of the AIDS crisis where the lecturer laid down a bleak outlook for many Sub-Saharan African economies. As we left the lecture theatre I remember our lecturer saying to us "don't worry it might not be that bad". Given how different things could have been now, the report may reflect something of a sense of relief.

I think it a universal hope that in 15 years time we look back at the situation we can see now and feel that as much progress has been made in those 15 years as was made up until now. This could well be the case if the current trajectory is maintained. However, what I fear the UNAIDS report whitewashes over is the very real funding crisis facing HIV treatment programs.

The emergence of austerity and new diseases fighting for funding preference have placed a serious strain on healthcare resources, this prompting international agencies to consider how they are funding HIV treatment programmes in middle income countries. Whilst funding is being scaled back from international donors, we have not seen much in the way of political will on the part of these governments to scale up government support for HIV treatment programs.

This is not biting yet, but already people are warning that gains made so far are at risk. My real worry is that reports such as this by UNAIDS may in fact serve to provide fuel for governments to falsely justify restrained spending on HIV programs. Whilst I think it important to celebrate where we are and what we have achieved, I think it essential that future goals and a strategy for how these can be achieved remain at the forefront of focus.

Mark Hollis is a life sciences analyst for IHS
Posted 21 July 2015

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