At Front Lines, Global War on AIDS Is Falling Apart

During the last decade, the per-patient cost of AIDS treatment fell to less than $100 a year in poor countries, and donors stepped up to make the drugs available to some patients there. However, the global recession has sparked a collapse in donor support.

For every 100 people put on antiretroviral drugs, 250 are newly infected with HIV, according to UNAIDS. Three million people are newly infected each year, a figure that outpaces the 2 million AIDS deaths annually; thus, the total number infected swells by 1 million each year.

More lives could be saved by focusing on available cures -- costing $1-$10 -- for diseases that kill infants and children, some donors have decided. In comparison, the lifetime cost of AIDS treatment in Uganda is $11,500 per patient, according to its AIDS Commission.

Uganda is the first country where major clinics supported by the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) are turning away new AIDS patients. A U.S.-run program in Mozambique has been instructed not to open more clinics. Nigeria and Swaziland have experienced drug shortages, while Tanzania and Botswana are paring down treatment slots, according to Doctors Without Borders.

"The consistent answer I hear is 'We love you, we hear you, we acknowledge the fund's good results, but our budget is tight, our budget is cut, it's the economic crisis,'" said Dr. Michel Kazatchkine, executive director of the Global Fund to Fight AIDS, TB and Malaria.

"Sometimes you wonder if you're doing people favors," said Dr. Natasha Astill, a British AIDS specialist working in a remote region of Uganda. "You start them on drugs, you give them hope, and then you're not sure you can keep it up. We all knew these drugs were for life."

"I'm worried we'll be in a 'Kampala situation' in other countries soon," said Dr. Eric Goosby, U.S. global AIDS coordinator.

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