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The United States of America has long led the world in its response to infectious pandemics. As the largest bilateral donor to the global response to HIV, investing more than US$ 85 billion in the United States President’s Emergency Plan for AIDS Relief (PEPFAR) since 2003, the United States, working with multilateral organizations, the United Nations, civil society and affected countries, has played a pivotal role in reducing new HIV infections and AIDS-related deaths. The United States has contributed generously to the Global Fund to Fight AIDS, Tuberculosis, and Malaria (Global Fund), investing US$ 55 billion since 2002.
Collectively, these investments have saved millions of lives, particularly on the African continent. Yet, as UNAIDS’ latest global report shows, much work remains. Of the 38 million people living with HIV, 12.6 million are not accessing life-saving treatment.
“Prior to COVID-19, we were off track on our goal of fewer than 500 000 new HIV infections by 2020; in 2019, 1.7 million people became newly infected with HIV. COVID-19’s early impact on the African continent portends a major health disaster that, if unmitigated, will have both direct and long-term residual effects.”
At a time when many governments and economies, particularly in Africa, are reeling from COVID-19 and struggling to maintain health and social services, continued leadership by the United States in global health is essential—it could be the difference between a health challenge and a health catastrophe.
With the world now facing colliding pandemics, turning away from any one of them to focus solely on any of the others risks a surge in new infections and deaths. The exponential harm of several concurrent pandemics will bring unprecedented suffering and economic fallout. The coronavirus’ effect on AIDS, tuberculosis, and malaria programming will be devastating if not buffered. In June, the Global Fund reported that 85% of the programmes it supports in 106 countries struggled with disruption to service delivery, including 18% with high or very high disruptions. UNAIDS estimates that a six-month complete disruption in treatment could cause more than 500 000 additional deaths in sub-Saharan Africa over the coming year, bringing the region back to 2008 AIDS mortality levels. Even a 20% disruption could cause an additional 110 000 deaths. Such an outcome would represent unacceptable and preventable collateral damage from the COVID-19 pandemic, wiping out nearly two decades of progress.
“UNAIDS appreciates that COVID-19 is having a disproportionate impact on the American people. However, as we have learned from HIV, no one is safe from a virus, which knows no borders, or political divides, until all are safe. No pandemic can be stopped without global solidarity. Working together will help to accelerate the safety of the whole world. We count on the United States to build on decades of leadership in global health, maximizing and protecting impacts made to date on HIV, tuberculosis and malaria, by strongly supporting efforts against COVID-19,” said Winnie Byanyima, Executive Director of UNAIDS.
The United States Global Leadership Coalition is calling on Congress to allocate US$ 20 billion in the next Emergency Supplemental Funding Bill for COVID-19. The global health community supports this request and calls for including an explicit allocation of US$ 700 million for one year, or US$ 1.4 billion over two years, for bilateral global HIV and tuberculosis programmes under PEPFAR and US$ 4 billion over two years for the Global Fund’s COVID-19 Response Mechanism. These funds will offset the impact of COVID-19 on PEPFAR and Global Fund programmes while supporting PEPFAR’s and the Global Fund’s work to combat COVID-19, including through increasing testing and care. The Global Fund’s currently available resources for COVID-19 will be fully depleted in weeks. The need is urgent.
The global health community’s requests for additional funding reflect needs in three areas:
- Scaling up health-care workforces to offset task-sharing/task-shifting due to COVID-19.
- Ensuring a supply of personal protective equipment and training on the safe use of, and proper disposal of, personal protective equipment for health-care workers.
- Protecting continuity of HIV, tuberculosis, malaria, and other priority services (including laboratories and diagnostic efforts) and responding to cost escalations due to COVID-19.
COVID-19 presents not only challenges but also opportunities for even greater progress against HIV, tuberculosis, and malaria, three of the world’s most pernicious killers.
Original source: UNAIDS
Published on 31 July 2020