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 Wednesday 03 October 2007
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GLOBAL: UNAIDS counts the cost of universal access

Photo: Allan Gichigi/IRIN
More than 70 percent of people in need did not have access to anitretroviral treatment in 2006.
JOHANNESBURG, 26 September 2007 (PlusNews) - UNAIDS has attached a price tag of US$42 billion to achieving the goal of universal access to HIV prevention, treatment, care and support by 2010, more than four times the amount currently being spent on fighting the global pandemic.

In a report released on Wednesday, UNAIDS urged governments and donors to rapidly increase their funding for AIDS; merely maintaining current spending levels would see the gap between provision and need widen over the next several years and the epidemic worsen, the agency warned.

"Had the world made prudent investments 10-20 years ago ... much smaller amounts would be required today," the report commented. "This same principle holds true today - we cannot afford the costs of inaction."

UNAIDS presented three different scenarios for global AIDS responses, depending on levels of spending and the pace of scale-up.

The ideal universal access scenario, to which countries committed at the High Level Meeting on HIV/AIDS (UNGASS) in New York in 2006, would mean dramatically scaling up resources, so as to reach 14 million people with treatment by 2010, equivalent to about 80 percent of those in need (100 percent is considered unfeasible, given that HIV testing and treatment are voluntary).

UNAIDS estimates that universal access would require training 1.5 million teachers, educating 13 million sex workers, providing 10 billion condoms, performing 2.5 million male circumcisions, and supporting 19 million orphans and vulnerable children.

In the scenario where scale-up continues at current rates, only 4.6 million people will be on antiretroviral therapy (ART) by 2010 at a cost of about US$15 billion.

A third scenario takes into account the different targets countries have already set for themselves and their varying capacities and resource constraints. Paul De Lay, director of the department of evidence, monitoring and policy at UNAIDS, which compiled the report, explained that the "phased scale-up" scenario was "more realistic but less aspirational".

According to this scenario, countries would prioritise interventions depending on the type of epidemic they were faced with. Using this approach, UNAIDS estimates that most countries would achieve universal access by 2015, at a cost of between US$41 and US$58 billion. "We expect they'll all get to universal access, but not all by 2010," De Lay told IRIN/PlusNews.

A number of countries are on track to meet their national treatment targets by 2010, with Brazil and Botswana even making good progress towards universal access to ARVs, but prevention targets have proved harder to define and even harder to meet. The UNAIDS estimates include spending on prevention interventions that address some of the social factors driving the epidemic, such as violence against women and injecting drug use.

The report, which De Lay described as a tool to help countries plan their AIDS budgets, breaks down the costs of individual prevention, treatment and care interventions. The figures were based on consultations with governments, economists, AIDS experts and civil society groups.

It was released ahead of a donor conference for the Global Fund to Fight AIDS, TB and Malaria, taking place in Berlin on Thursday. Donors are expected to pledge around US$8 billion to the Global Fund, which currently accounts for one-quarter of all international donor expenditure on AIDS.

A Global Fund initiative called RED, launched last year with the aim of harnessing corporate marketing savvy and consumer spending power against AIDS, announced that sales of its RED-branded products, including cell phones, iPods, credit cards and t-shirts, had raised US$45 million.


Theme(s): (IRIN) Care/Treatment - PlusNews, (IRIN) HIV/AIDS (PlusNews), (IRIN) Prevention - PlusNews, (IRIN) Research - PlusNews


[This report does not necessarily reflect the views of the United Nations]
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This material comes to you via IRIN, the humanitarian news and analysis service of the UN Office for the Coordination of Humanitarian Affairs. The opinions expressed do not necessarily reflect those of the United Nations or its Member States. Republication is subject to terms and conditions as set out in the IRIN copyright page.