The HIV/AIDS mailbox…
Dear readers
AN ANNOUNCEMENT made Monday by US officials at the Fifth International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention in Cape Town, South Africa that the Obama administration will continue to fund HIV/AIDS research, prevention and treatment efforts as part of a more comprehensive global health strategy, is good news for PLWHA. This news comes on the heels of the recently released World Bank Report which presented the stark reality that “in 2009, the global crisis is expected to negatively impact AIDS treatment programmes in one-thirds of countries surveyed, home to 61% of those on antiretroviral treatment.” The Caribbean was cited as one of those countries.

“Much is at risk,” the World Bank report said, citing:
• treatment that is keeping 3.4 million people alive and healthy;

• the plans and global promises to expand access to the other two-thirds of all people with HIV who urgently need treatment now (whose numbers grow daily)

• and efforts to further reduce the number of new infections, now 2.7 million each year.

Simply put, it meant that where money could not be found to pay the cost of continuing treatment for persons in the affected countries, treatment for those PLWHA would have had to be stopped – something which has serious implications.

Giving details of the implications of such a move, the World Bank pointed out:

“Stopping treatment is deadly, and has other costs on society.

– If treatment stops, people quite soon become sick and die. Countries know all too well, the desperate consequences for households (children orphaned, loss of human capital, increased household poverty), and the cost to businesses and public agencies that lose skilled, experienced staff.

– People who stop treatment become far more infections.

– Disrupted treatment diminishes drug effectiveness, requiring use of extremely costly second-line drugs and placing additional demands on health systems to monitor their use.”

Noting that the impact varies across regions, the report named the countries most likely to be affected: Sub-Saharan Africa, the Eastern and Central Europe, the Caribbean and Asia and the Pacific.

It projected the following changes to be brought about by the global crisis:

• Declines in external funding and budget cuts which would leave people in 15 developing countries highly exposed to the risk of treatment interruption. There are 1.7 million people on treatment in these countries, and far more who also need it, the report said.

• The health sector will come under additional stress. “Interruptions or cuts in treatment will result in more people with HIV-related illnesses. The demands on health systems would be exacerbated if doctors and nurses lose access to treatment. Reduced household incomes may push more patients towards public health services at a time when their budgets are being cut.”

• Prevention efforts are jeopardized: Additionally, the report states that 34 countries representing 75% of the people with HIV expect prevention programmes for people most at risk of infection to be affected. “This is extremely worrisome – less prevention that results in more new infections will mean greater future treatment needs and large cost increases,” the World Bank said, adding: “The welfare and economic costs to affected families are obviously very high.”

Offering recommendations on how to best cope with the frightening scenario, the report posits:

• The core challenge is to maintain and expand access to HIV treatment and prevention: This requires:

• A more rigorous push for efficiency and cost-effectiveness, adding that development partners can assist countries to better prioritize resource allocation across prevention and treatment programmes. It advised that ‘evidence-informed, results-driven’ programmes will be more efficient and effective.

• Donor ‘safety net’ funding to ensure continued access to drugs and other supplies;

• Assisting countries to strengthen their ability to forecast future drug demand and

• Establishing a monitoring system to track and minimize treatment interruptions.

One of the benefits of funding for treatment programmes, includes starting treatment earlier for those persons in need of it.

“Starting treatment at a higher CD4 cell count leads to less illness, more complete immune recovery, longer survival and lower long-term costs. One study, for example, found that it cost nearly three times as much to treat a person who starts therapy with fewer than 50 cells/mm3,”the scientists were quoted as saying at the Conference on Monday.
Shirla
We urge you to keep reading the HIV/AIDS Mailbox and if you’ve any concerns, please contact us on warohiv@yahoo.com, or mail your letters to:
Guyana Chronicle HIV/AIDS Mail Box
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Bel Air Park
Georgetown