02/08/10

UGANDA:  Freeze on HIV Spending Sparks Concern in Africa

Ugandan AIDS advocates are worried that a change in priorities of US-supported HIV/AIDS efforts there will have a negative impact on patients.

George W. Bush launched the President's Emergency Plan for AIDS Relief program in 2003, with a primary focus of treating patients in urgent need of medicine. Between 2003 and 2008, Uganda received $929 million under PEPFAR. An estimated 150,000 Ugandan patients now receive treatment through the program.

But while PEPFAR expanded access to treatment, new infections rose. Now, the Obama administration is shifting away from emergency treatment and more toward preventing new infections. "We have all lost momentum on the prevention front and we're paying for it now in the form of rising prevalence," said Lynne McDermott, PEPFAR's Kampala-based spokesperson.

Peter Mugyenyi, who heads Uganda's Joint Clinical Research Center, a leading HIV/AIDS treatment clinic, said the switch in emphasis means that clinics must now turn away new patients. "They have changed their program very regrettably," he said. "The number-one thing is availability of treatment."

McDermott noted that the United States cannot provide treatment to an ever-increasing number of patients indefinitely. Until new infections are reduced, Ugandans will continue to face drug shortages, she said. PEPFAR provides two-thirds of all HIV/AIDS money in Uganda, but the country must work "to identify other resources to fill the remaining gap."

Eric Goemaere, an HIV specialist with Doctors Without Borders, said the Obama administration's stance creates a "fake argument." Any prevention strategy relies on people getting tested, he said. "Why were people getting tests? It is because treatment was available," he added.

Mugyenyi concurred. "There is no prevention program that can succeed without treatment," he said.

Source: Agence France Presse (02.08.10); Courtesy of the CDC National Center for HIV, STD, and TB Prevention