Experts Grow Louder In Questioning AIDS Funding

As World AIDS Day is observed Monday, several experts are increasingly more blunt in complaining that AIDS is eating up funding at the cost of more immediate health concerns.

They insist that we have gone into a post-AIDS age in where the disease and the spread of it are restricted in much of the world, Africa exempt.

"AIDS is a terrible humanitarian tragedy, but it’s just one of many terrible humanitarian tragedies," said Jeremy Shiffman, who studies health spending at Syracuse University.

Roger England of Health Systems Workshop is even more outspoken. He insists that UNAIDS, the U.N. agency heading the battle waging against the disease, has fulfilled its purpose and should be dissolved.

"The global HIV industry is too big and out of control. We have created a monster with too many vested interests and reputations at stake, … too many relatively well paid HIV staff in affected countries, and too many rock stars with AIDS support as a fashion accessory," he stated in the British Medical Journal in May.

Paul de Lay, a director at UNAIDS, vehemently disagrees. It’s legitimate to question AIDS’ place in the world’s hierarchy, he says, but is adamant that the turnaround is very new and it is a mistake to assume that the outbreak is under control.

"We have an epidemic that has caused between 55 million and 60 million infections," de Lay said. "To suddenly pull the rug out from underneath that would be disastrous."

U.N. officials approximate that about 33 million people worldwide have the HIV virus. Scientists state that infections topped the charts in the late 1990s and are not likely to have large epidemics outside of Africa.

In developed countries, AIDS drugs have allowed the once-fatal disease to become a controllable illness.

England insists that disbanding UNAIDS would allocate its $200 million yearly budget for other health issues such as pneumonia, which kills more children annually than AIDS, malaria and measles together.

"By putting more money into AIDS, we are implicitly saying it’s OK for more kids to die of pneumonia," England said.

His comments tap on the bigger grievance: that AIDS hoards money and could hurt other health programs.

By 2006, AIDS funding allocated for 80 percent of all American aid for health and population problems.

In Ethiopia, Rwanda, Uganda and other areas, donations for HIV projects regularly surpass the whole national health budget.

In a 2006 report, Rwandan officials indicated a "gross misallocation of resources" in health: $47 million to HIV, $18 million to malaria, the country’s biggest health concerns, and $1 million was sent to combat childhood illnesses.

"There needs to be a rational system for how to apportion scarce funds," said Helen Epstein, an AIDS specialist who has conferred with UNICEF, the World Bank, and others.

AIDS activists state that their projects do more than stop the virus; their efforts reinforce additional health programs by allowing for essential health services.

Nevertheless, across Africa, approximately 1.5 million doctors and nurses are still wanted, and hospitals frequently are without basic medicines.

Experts are focusing on the struggle to catch any attention when contending with AIDS.

"Diarrhea kills five times as many kids as AIDS," said John Oldfield, executive vice president of Water Advocates, a Washington, D.C.-based group that promotes education about clean water and sanitation.

"Everybody talks about AIDS at cocktail parties," Oldfield said. "But nobody wants to hear about diarrhea," he added.

These challenging claims on public money are probably going to increase, as the world financial meltdown most likely will exhaust health dollars.

"We cannot afford, in this time of crisis, to squander our investments," Dr. Margaret Chan, WHO’s director-general, announced in a recent statement.

Some experts inquire whether it is logical to have UNAIDS, WHO, UNICEF, the World Bank, the Global Fund plus innumerable other AIDS organizations, all helping the same issue.

"I do not want to see the cause of AIDS harmed," said Shiffman of Syracuse University. But "For AIDS to crowd out other issues is ethically unjust."

De Lay insists that the answer is not to rearrange resources but to increase them.

"To take money away from AIDS and give it to diarrheal diseases or onchocerciasis (river blindness) or leishmaniasis (disfiguring parasites) doesn’t make any sense," he said. "We’d just be doing a worse job in everything else."