The Swiss-based Global Fund to Fight AIDS, Tuberculosis and Malaria - which supports 3 million people with HIV drugs - is so cash-strapped that it won’t provide any new grants until 2014. Due to the European financial crisis, Italy and Spain - once important donors - haven’t met their pledges. The fund has been forced to ask middle-income countries - including China, Brazil, and Mexico - to fend for themselves.
In the United States, the situation is slightly better, at least on the financial front. Congress cut funding for the President’s Emergency Plan for AIDS Relief by 2 percent - disappointing, but hardly the crushing blow that AIDS activists feared. The United States still plans to spend $4.5 billion on global AIDS relief, a pool of money that funds antiretroviral drugs for 4 million people in the developing world, at a cost of about $350 per person per year. President Obama announced last month that the United States would set a goal of providing drugs to an addition two million people, even if funding remains flat. Efficiencies - such as sending the drugs by boat rather than planes - have already allowed the United States to meet prior targets ahead of schedule.
Far more disturbing than the slight reduction in funds is a stipulation that Congress attached to the money: None can be spent on needle exchange programs. At a time when the global public health establishment is looking for proven, cost-effective ways to fight the spread of HIV, ideologically motivated limitations like this unnecessarily tie their hands. That mandate could be a death sentence for people in Ukraine and Vietnam, where the AIDS rate is fueled by intravenous drug use.
