BMJ Publishes Opinion Pieces On HIV/AIDS Funding Levels

BMJ in its Feb.17 issue published two opinion pieces examining funding levels for efforts to combat HIV/AIDS worldwide. Summaries of the opinion pieces appear below.

• Roger England, BMJ: Efforts to fight the spread of HIV are "receiving relatively too much money," much of which is used "inefficiently and sometimes counterproductively," England of the Health Systems Workshop in Grenada, West Indies, writes. He adds that HIV programs are not "so cost-effective that they justify this disproportionate" funding. According to England, the "success" of HIV lobbyists and advocates "promoting HIV as exceptional" has led to "excessive" funding to combat the virus. England says the disproportionate funding of HIV is having "deleterious effects" on health care, such as "aggravating chronic shortages" of health workers, who are pulled toward "well-funded HIV programs." England says that more health aid should be "used to strengthen health systems that can integrate funding at the country level and allocate it to evidence-based priorities through effective delivery organizations." He also calls for a "global basket fund" to "transfer sustainable and predictable funding to countries, avoiding the hugely unpredictable aid flows from fickle donors," and he recommends that the Global Fund To Fight AIDS, Tuberculosis and Malaria "abandon disease dedicated support to become this fund" (England, BMJ, 2/17).
  
  
• Paul de Lay et al., BMJ: Although HIV/AIDS has become one of the "make or break forces of this century," UNAIDS estimates the current funding pledges to combat the pandemic "are only half what is needed for a comprehensive response," de Lay -- UNAIDS director of evaluation -- Robert Greener -- UNAIDS economics adviser -- and Jose Antonio Izazola -- UNAIDS senior adviser for resource and finance analysis -- write. "The cost of inaction against AIDS is huge, far greater than for any other public health crisis," they write, adding that HIV/AIDS "threatens" many of the U.N. Millennium Development Goals, "especially those related to poverty and health." According to the authors, controlling the spread of HIV/AIDS requires "predictable and sustainable international funding," as well as more efforts to ensure that "countries who are able to do so invest more of their own money in AIDS and health in general." They add that HIV/AIDS is a "development problem with multisectoral causes and effects" and that efforts to combat the disease require a "similar response, with many components lying outside the health sector" (de Lay et al., BMJ, 2/17).

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