Controversy Over AIDS Funding Should Not Overlook Importance of Prevention

Wednesday, June 25, 2008

DURHAM, NC -- At the end of September, the President’s Emergency Plan for AIDS Relief (PEPFAR) will expire, unless senators can work through the impasse that is keeping the bill from coming to the floor. Senate Majority Leader Harry Reid (D-Nev.) has said that he will attempt to bring legislation to the Senate floor this week.

The new bill would continue the program and increase the spending to $50 billion over five years (up from $15 billion). It also would lift the restriction that 55 percent of the money be used for treatment, allowing more money to be spent on programs supporting prevention.

Dr. Michael Merson, director of the Duke Global Health Institute and former director of the WHO Global Program on AIDS, said the new bill brings to the fore some differing views on how best to tackle AIDS.

“$50 billion is a lot of money in today’s economic climate,” said Merson. “However, I am a strong believer in the need for more prevention efforts and for letting each country decide how it wants to use the PEPFAR funds. There is no way we can treat ourselves out of the AIDS epidemic: for every two patients placed on antiretroviral drugs during 2007, five new HIV infections occurred.”

Merson also said that to effectively battle the AIDS pandemic, governments and policymakers “need to better understand the broader issues at play in HIV transmission -- poverty, gender, human rights, religion -- and invest in health systems for our programs to be effective.”

The bill was approved by the Senate Foreign Relations Committee in March, and the House passed a similar bill in April. But a small number of senators, led by Sen. Tom Coburn (R-Okla.), are preventing the bill from reaching the Senate floor. They support the increased funding for the program, but wish to reinstate the requirement to spend the majority of the funds on treatment.