At least 1m people will die in sub-Saharan Africa and elsewhere, The New York Times reports researchers and advocates said, if funding cuts proposed by the Trump administration to global public health programmes are enacted.
The report says the US currently spends more than $6bn annually on programmes that buy antiretroviral drugs for about 11.5m people worldwide who are infected with HIV, the virus that causes Aids. The Trump administration has proposed slashing those programs by at least $1.1bn – nearly a fifth of their current funding, said Jen Kates, a vice president at the Kaiser Family Foundation. “These are lifesaving interventions, and these levels of reductions will significantly curtail service delivery,” Kates said.
Hari Sastry, director of the State Department’s Office of US Foreign Assistance Resources, said in the report that everyone now receiving drug treatments under the programmes would be allowed to continue, even if the funding cuts were approved.
“We will currently maintain those patients on the treatment,” Sastry said. He did not explain how that would happen if funding dropped by roughly 20%, but the programmes have wide bipartisan support on Capitol Hill, where they may be shielded from the proposed cuts.
The report says much of the success of anti-Aids efforts in Africa has come from a guarantee in many countries that people who test positive for HIV can immediately receive treatment.
With a huge share of Africa’s population reaching sexual maturity in the next four years, the virus could again imperil much of the continent if fewer people are treated, said Brian Honermann, deputy director at amfAR, a foundation that invests in Aids research.
Aids treatment not only keeps people alive but prevents them from spreading the virus to others, Honermann noted. “If you cut the funding by this much, I think there’s a real risk we will backslide, and a whole lot more people will become infected,” he said.
The report says much of the US government’s funding for Aids treatment and research is funneled through the President’s Emergency Plan for AIDS Relief (PEPFAR), which was established in 2004 by President George W Bush in an effort to save Africa from an epidemic that threatened to kill much of the population of entire countries, like Botswana and Namibia.
President Barack Obama expanded PEPFAR, and combined with the Global Fund and other international efforts, the report says, the spending is widely credited with arresting the Aids epidemic. About 37m people worldwide are infected with HIV, including nearly 2m children. About 1m people died of Aids in 2015, and 2m were newly infected that year.
The report says PEPFAR funds anti-Aids activities in more than 60 countries. But Sastry is quoted as saying that the Trump administration planned to ensure that the US was “focusing our efforts in the 12 high-burden countries to achieve epidemic control.” He did not name those 12 countries, but in past years, the programme focused much of its work on a dozen African countries, as well as Haiti, Vietnam and Guyana.
The Trump administration has also proposed eliminating $524m in funding for contraceptives and other family planning efforts that mostly benefit women in developing nations.
According to the report, Melinda Gates, co-founder of the Bill & Melinda Gates Foundation, said in a statement posted on her Facebook page that the proposed family planning cuts “would lead to more unintended pregnancies, more maternal deaths.”
“This budget threatens to trap millions more families in a cycle of poverty,” she said.
The report says it is unclear how many lives could be lost as a direct result of the budget cuts, but the Global Fund estimates that every $100m invested saves about 133,000 lives. An amfAR calculation found a similar effect, suggesting that the administration’s proposed cuts to Aids programmes alone could cost more than 1m lives and orphan more than 300,000 children.
“All of these programmes have multiplier effects beyond just those immediately served by them,” said J Stephen Morrison, who directs global health work at the Centre for Strategic and International Studies. “For the first time ever, after 15 years of steady growth, we’re going to see a radical regression that will have huge effects.”
[link url="https://www.nytimes.com/2017/05/23/world/africa/cuts-to-aids-treatment-programs-could-cost-a-million-lives.html?_r=0"]The New York Times report[/link]