Geneva, 15 December 2010 – The Global Fund to Fight AIDS, Tuberculosis and Malaria has announced its rejection of ambitious proposals to turn back the AIDS epidemic in several high-burden sub-Saharan African countries. Countries whose proposals were rejected have been left with no option but to reapply for funding, but the Global Fund board decided it will be at least one year before these funding decisions are made. Today’s rejections will hamper scale up of HIV treatment and implementation of state-of-the art strategies to prevent the spread of the virus, according to international medical humanitarian organization Médecins Sans Frontières (MSF).
The World Health Organization and other experts have recognized that early initiation of treatment is key to turning back the AIDS pandemic. For example, in a two-year study by MSF in Lesotho, patients who started treatment earlier were 68% less likely to die, 27% less likely to get new infections such as tuberculosis and 39% more likely to remain in care compared to patients who started treatment when their disease was more advanced.
However, countries’ proposals to initiate early treatment, implement WHO guidelines and aggressively reduce transmission both between mother and child, and between adults, have been denied.
For example, Malawi’s proposal to reduce transmission may have been regarded as too ambitious. The proposal focused heavily on tackling transmission of HIV from mother to child by providing lifelong HIV/AIDS treatment to all HIV-positive pregnant women. They had also planned to spend more to retain health workers and scale up voluntary male circumcision to help slow down the spread of HIV. Similarly, Uganda’s proposal was rejected, which had planned to dramatically increase its coverage rates of prevention of mother-to-child transmission, which currently stand at just under 50%.
Other countries are in a similar situation: Swaziland, Mozambique, DRC and Zimbabwe are among the high-burden countries that will receive no additional funds for AIDS treatment or prevention by the Global Fund in 2011.