Geneva, Switzerland -- The U.S. and Canada--along with other leading industrialized nations--need to reset priorities and step up their support to fight the alarming spread of HIV infection in the developing world, says a University of California San Francisco AIDS policy specialist.
Worldwide, an estimated 30.6 million adults and children are now living with HIV/AIDS, with 5.8 million new infections occurring last year alone. More than 90 percent of these cases are in developing countries.
"The potential for averting HIV infection is there, but more funding is needed to put effective prevention programs in place and to train health care professionals," said Steve Morin, director of the Policy Center of the UCSF AIDS Research Institute (UCSF ARI).
Morin took part in a panel discussion on mobilizing international resources here today (July 2) at the 12th World AIDS Conference.
The basic prevention package needed in developing countries to stem the epidemic, he said, includes condom marketing programs, treatments for sexually transmitted diseases, education in the schools, information through the mass media, condom promotion among prostitutes and clients, a safe blood supply, and needle exchange programs.
"We know prevention programs are effective, but we've found that countries in all parts of the world face four key challenges in their efforts to increase HIV funding for the international community," he added. They are:
- Pressure to fund HIV treatment rather than prevention.
- Need to prove the cost-effectiveness of prevention programs.
- Donor fatigue. Despite ongoing funding support for HIV/AIDS programs, infection rates are increasing.
- U.S. domestic politics. "The Balanced Budget Agreement calls for a 12 percent reduction in international affairs funding," Morin said. Eleven industrialized nations provide significant funds for AIDS expenditures in the Third World: Australia, Canada, Denmark, France, Germany, Japan, Luxembourg, Netherlands, Norway, Sweden, and the United States.
The U.S. Agency for International Development (USAID) has designated $121 million for AIDS international prevention efforts in 1998, with the majority of resources directed to country-level programs in Africa, Asia, and Latin America. USAID contributions for AIDS showed a steady increase from 1988-93, but over the past five years the funding has remained flat, Morin noted.
The National Institutes of Health (NIH) is carrying out international AIDS research with $58 million in funding for 1998, Morin said. Much of this work is done in collaboration with individual nations and focuses on systematic testing of promising HIV prevention interventions, such as vaccine development, reducing mother-to-child transmission of HIV, controlling the spread of STDs, and changing high-risk behavior patterns.
A key component of the global AIDS effort is an international training and research program for health professionals coordinated by the Fogarty International Center at NIH. More than 1,300 trainees from 90 countries have participated. UCSF is one of the training centers for this program.
"What has been lacking to date is leadership. The United States and other industrialized countries must make global AIDS a priority," Morin said. In addition, he called on the Group of Eight, a group of the world's most advanced industrialized nations also known as the G-8, to put international AIDS prevention on their agenda for immediate action.