UNAIDS: Global economic crisis expected to disrupt HIV prevention and treatment programmes

A new report from UNAIDS and the World Bank, released on July, 6th, indicates that in 22 countries in Africa, Europe and Central Asia, the Caribbean, and Asia and Pacific, HIV prevention and treatment programmes may face disruption this year.

Reports from agency staff in 71 countries indicate that eight countries are already facing shortages of antiretroviral drugs or other disruptions. Together, these countries are home to more than 60% of people worldwide receiving AIDS treatment.

However, there is a lot of uncertainty regarding the extent to which these programmes will be affected, as the effects of the crisis are still to impact most of the governments’ budgets that support AIDS treatment. In particular North Africa, Latin America, the Middle East and most of Asia appear to be less vulnerable to the economic crisis’ impact.

According to the report,

much is at risk: increased mortality and morbidity, unplanned interruptions or
curtailed access to treatment, with increased risk of HIV transmission, higher
future financial costs, increased burden on health systems and reversal of
economic and social development gains.

The report recommends the following actions:

Use existing funding better―especially in countries facing cuts in their national AIDS response budgets, governments and aid agencies should provide technical support to reallocate resources from low- to high-impact prevention and treatment programmes. All countries should seek ways to make programmes more efficient and more cost-effective.

Address urgent funding gaps―countries with a high reliance on external funding for HIV should strengthen collaboration between national authorities and major international funders to identify and address impending cash-flow interruptions and arrange bridge financing as necessary to avoid cash-flow interruptions.

Monitor risks of programme interruption―a simple warning system could be established to anticipate and minimize treatment interruptions. A key component of such a system would be to carry out regular surveys to identify “vulnerable” countries and provide tailor-made financial and policy assistance.

Plan for an uncertain environment―the uncertainty that many respondents note calls for contingency planning: contingency plans could consider changes that could be made to ensure continued access to treatment and realistic expansion plans, and to maintain the most effective, highest priority prevention activities under alternative potential funding scenarios. The report recommends that resource mobilization strategies include sources of finance that can be sustained over the long term.