It is becoming increasingly clear that Aids is going to be a loser in the struggle by wealthy governments to cut back on spending in all areas, including development. The numbers from the UK’s Department for International Development (DfID) published on the Global development website on Wednesday tell the tale.
Of course, that was about bilateral aid and many Aids campaigners will be hoping the UK will make up the shortfall in contributions to the Global Fund to fight Aids, TB and Malaria. And DfID and other governments and funding bodies will rightly point out that people with HIV will benefit from increased spending on other programmes – especially those for maternal and child health.
Nonetheless, there are cold shivers running down the spines of campaigners and treatment providers in poor countries. They don’t want more stories about Aids drugs running out in Uganda and clinics that are having to turn new patients away. Aids drugs are for life, not just for Christmas – to distort the old advertising slogan about responsibility and pet animals. If people who start antiretroviral therapy have to stop, they will probably develop resistance and the drugs will no longer work for them even if they eventually get a new supply.
So a new study from the expert number-crunchers at the Results for Development Institute in Washington DC, Harvard School of Public Health and Imperial College in the UK – with help from the Global Fund – is timely. It makes the economic case for investing in Aids treatment programmes. It’s not just humane to keep people with HIV alive and healthy, says the study – it actually saves money. That may just be the only argument in these straitened times that funders will readily listen to.
The study, published by the free-access journal PloS One, is specifically aimed at helping donors wrestle with their dilemma of how best to spend their waning development budget.
The 2008-10 global recession, flattening aid budgets and fiscal tightening in many Aids-affected countries are threatening the ability of donors and countries to continue scaling up ART. In this context, policymakers deciding whether to commit additional resources to ART programmes will want to consider not only the cost and health impacts of programme continuation, but also the likely economic benefits of doing so.
They went about it by analysing the costs and benefits of continuing to treat the 3.5 million people in 98 countries who will be supported by Global Fund-financed programmes at the end of this year. Against the treatment costs they set the restored productivity of people able to work again, the savings in unneeded orphan programmes and delayed costs of medical treatment for tuberculosis and other infections that afflict those with HIV at the end of life.
Keeping these 3.5 million people alive and well would cost $14.2bn in 2011-12, they reckoned – but the financial savings would amount to between $12bn and $34bn. Robert Hecht, of Results for Development, thinks the savings will outstrip the cost. “It looks very favourable. The way we did it, the calculations are conservative,” he told me. This is the paper’s conclusion:
These results suggest that, in addition to the large health gains generated, the economic benefits of treatment will substantially offset, and likely exceed, program costs within 10 years of investment.
Let’s see whether DfID and other donor governments are convinced.
Original Article by Sarah Boseley at The GuardianSTAY UPDATED
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