A key year in the fight to end AIDS

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Three important events will be held in 2016 aiming to end this pandemic by 2030

By PABLO TRILLO (SALUD POR DERECHO)

Source: EL PAÍS

MARCH 2, 2016

In a twitter, Michel Sidibe, Executive Director of UNAIDS (Joint United Nations Program on HIV and AIDS) said that if there is no sufficient funding for AIDS, the pandemic will bounce back and all efforts made up to date will have been wasted. Efforts that have brought us to the current time, where almost half of the 35 million people with HIV have access to antiretroviral treatment.

However, this great collective work, orchestrated by groups of patients, activists, civil society organizations and the commitment from some governments cannot be considered as finished. Currently, out of all people living with AIDS, 17 million are not aware that they carry the virus and 22 million do not have access to treatment against a disease that killed 1.2 million people in 2014.

Last September, the United Nations member states signed the Sustainable Development Goals (SDGs), the continuation of the Millennium Development Goals (MDGs). They stressed an ambitious and forceful goal: ending AIDS epidemic by 2030. Something feasible, no doubt, if there is an adequate political will. 2016 will be a key year to learn about the viability of this goal, and we have to check several dates in the calendar: three very important events that will set the lines to be followed by civil society and governments from all over the world, among them, the next Government of Spain.

United Nations High Level Meeting on AIDS (June 8 to 10, New York, U.S.A.)

AIDS has had a place of preference in the UN program since the beginning of the millennium. In 2001, 198 governments attended the special session of the United Nations General Assembly on HIV/AIDS. That was a meeting at the highest political level as a result of the alarm of an epidemic that was rapidly spreading and whose ravages affected the whole world. The Declaration of Commitment on HIV/AIDS was signed at that meeting, where the Heads of State and Governments faced HIV/AIDS as a matter of global security and created a strategic framework with goals for financing, prevention, treatment and research and an extraordinary period of sessions on ending AIDS.

Those extraordinary meetings, produce the High Level Meetings in 2006, 2008 and 2011 to discuss both the successes and failures in the commitments previously undertaken. Joint declarations were also signed such as the Political Declaration on HIV/AIDS 2011, which set new goals, as the already achieved 15 in 15: that by 2015 there would be 15 million people under treatment.

The 2016 high level meeting that will be held from June 8 to 10 at the United Nations headquarters in New York, will analyze the successes and shortcomings in the past five years in the fight against the disease. They will also analyze the many and real challenges still prevailing. Among many others: make treatments available to everyone, reduce their cost, encourage scientific research for new discoveries, achieve essential goals in prevention, eliminate once and for all stigma and discrimination, prioritize care to women and children, support low and medium income countries increasing funding during the next years. Whatever it takes not to leave anyone out and end the pandemic by 2030.

AIDS International Conference (July 17 to 22, Durban South Africa)

The world’s largest conference on health or development is held every two years: the AIDS International Conference. About 20,000 scientists, researchers, politicians, civil society, groups of patients and many more public health professionals, gather to “promote scientific excellence and research, foster individual and collective action, multisectoral dialogue and constructive debate” and to build a joint and global response to AIDS.

This year the event will take place in Durban, South Africa. It is a symbolic location for the fight against this disease. The thirteenth conference was held there in 2000, surrounded by many protests demanding affordable access to AIDS treatment. The meeting was closed by Nelson Mandela who demanded from his Government and the governments of the world a faster action in the fight against the virus, with access to treatments and prevention programs, especially in South Africa, where 4 million people were living with HIV virus that was rapidly spreading more than in any other country.

The 2000 conference was an inflection point and a wake-up call on the fight against AIDS. By then, treatments would cost around 9.000 Euros per patient, being unaffordable to governments of developing countries, and consequently, to their population. In fact, that year only 700.000 people in the world had access to treatment. After the death of millions of affected people and the tremendous effort of groups of patients, activists and organizations such as the Treatment Action Campaign or Doctors Without Borders, among many others, the price of treatments has gone down to 90 Euros at present, thanks to the inflow of generic medication. Due to this and much more, the AIDS 2016 of Durban will be special. Politicians, scientists, opinion leaders and groups of patients will set the way towards 2030, without forgetting another key date: 2020. We will see then if we have achieved the ambitious goal 90-90-90: that 90% of people living with HIV know their diagnosis, that 90% of affected people have access to treatment and, that 90% of people under treatment do not have viral load.

Conference on Funds Replenishment for the Global Fund to Fight AIDS, tuberculosis and malaria

In 2002, thanks to the political momentum of the international community, the Global Fund to Fight AIDS, Tuberculosis and Malaria was created, a partnership between governments, civil society, private sector and persons affected by these diseases, which gathers and invests more than 3.500 million Euros per year and, currently provides treatment to more than half of 15 million people globally. In addition, it fiercely fights tuberculosis (which already kills more people every year than AIDS) and malaria. In its last report it states that since 2002, 17 million lives have been saved thanks to the investments made. It aims to reach 22 million by the end of 2016.

The Global Fund funding comes mostly through donor countries, private organizations and philanthropists that provide the money with which the Fund supports programs managed by local experts in the most affected countries and communities. Every three years, the Fund faces the challenge to get the necessary funding to implement such programs. At the end of the year (date and location are not known yet) the donor countries will gather to announce their financial contributions to meet the needs of the Global Fund in the next three years (2017-2020).

Like Sidibe, at the Global Fund they are also aware that the lack of strong investment would cause a slowdown in the journey and resurgent epidemic, with alarming social and economic costs. They even say that maintaining the current investment costs will not suffice to achieve the goal: more investment is needed.

Current global investment on AIDS amounts around 20.000 million Euros a year. In 2014, more than half of funds came from affected countries; the rest came from international grants, private and philanthropic grants and through multilateral organizations, such as the Global Fund. In the next four years we should see strong commitments and high investment levels. We should see the annual investment peak by 2020: 30.000 million Euros. From there on, it will go down until 2030, when investment will be below 27.000 million and where, if nobody is left out (especially the youngest ones and the especially vulnerable populations) and the stigma and discrimination are eliminated, we could say that AIDS is not a public health problem anymore.

The Spanish contribution

Today, official data rank Ayuda Oficial al Desarrollo (AOD) in 2014 at 0,13% of the gross domestic income, that is, the same level than in 1982, when we moved from assistance recipients to donors. Spain, that in the past decade donated more than 650 million Euros to the Global Fund (as its fifth largest donor) has not contributed one Euro in the past 4 years, and it is not anymore a key actor in the fight against AIDS.

In Salud por Derecho, alarmed by this serious situation, during the elections campaign we launched our initiative Comprometidos. We asked the presidential candidates and their political parties a real commitment with the Global Fund, to give Spain back the fundamental role in this fight that should come to an end. PP and Ciudadanos did not join the commitment, but PSOE, PODEMOS, UP-IU, UPyD and Unió stated through letters, e-mails and messages: we will watch the new government and will remind it about its responsibility.

Pablo Trillo is a journalist and Works at the NGO Salud por Derecho.