BELINDA BERESFORD, Johannesburg | Friday
THE cost of curbing the worldwide HIV/Aids epidemic in lower-income countries will soar almost fivefold by 2005, reaching an estimated $9,2-billion, compared to current expenditure on the disease of about $1,8-billion. This compares with the estimated $20-billion a year that the United States alone spends on Aids domestically.
This forecast is part of research published in the prestigious US magazine Science on Friday, ahead of the United Nations General Assembly special session (UNGass) on Aids next week.
The UNGass meeting will look at an initiative to not only curtail the spread of the epidemic – at an estimated total cost of about $4,8-billion in 2005 – but also to care for those with the disease.
Science reports that $3,2-billion will be needed next year, $4,7-billion in 2003 and $6,8-billion in 2004.
Sub-Saharan Africa alone will account for about half the estimated amount needed, with most of the resources in this area being used for care and support of those already living with HIV.
UNAids estimates that about 25,3-million people in the region are living with HIV, and more than four million have full-blown Aids. Another 17-million have already died from the disease and the UN agency estimates that HIV killed tenfold more people this year than conflicts in the region.
The Science study looked at 135 middle- and low-income countries. The researchers estimate that combined national, private and international spending on Aids in such countries is currently running at between $1,5-billion and $2-billion a year.
A global campaign would need between $9-billion and $10-billion a year, and would have to be continued for a least 10 years to reverse the epidemic.
The forecast level of spending on HIV/Aids would provide 35-million women with antenatal testing and give 900 000 HIV-positive pregnant women anti-retroviral drugs to prevent transmission of the virus to their children.
UNAids estimates that there were about 1,8-million pregnant women with HIV worldwide last year and that children represented about 10% of new infections. Since the beginning of the epidemic about 13,2-million children have been orphaned by Aids and this year about 500_000 children died.
The projected global spend on HIV/Aids would allow for special prevention programmes to reach an estimated 28-million men who have homosexual relations, three million injecting drug users and almost six million sex workers. It would also allow for the provision of 6-billion condoms.
Science reports that approximately 37% of all public health expenditure would be directed at HIV/Aids if sub-Saharan governments fulfilled their pledge to allocate 15% of total public spending to the health sector.
Between a third and a half of this estimated funding could come from domestic sources, although this would vary widely from region to region. For example up to 80% may have to be provided by international sources in Africa and some areas of Asia.
Science emphasised: “The success of the struggle against HIV/Aids will depend fundamentally on effective national leadership in the most affected countries.”