Global crisis casts pall over AIDS science meet

CAPE TOWN, South Africa - The global financial crisis is casting a pall in the world's largest science gathering for the treatment and prevention of the HIV-AIDS pandemic due to looming threats of possible cuts in funding for AIDS research and prevention.

Julio Montaner, president of the International AIDS Society (IAS), criticized world leaders who attended the Gleneagles G8 summit in 2005 for failing to follow through on their promise to deliver universal access to treatment and prevention of HIV-AIDS by next year.

"The UK put AIDS on the G8 agenda, we call on the UK to keep it on the G8 agenda …We must hold the G8 leaders accountable for their failure to deliver on their promises. It is rather incredible that the United States, the country saddled with the worst of the fiscal crisis, remains the only one of the G8 that has met its stated fiscal commitments," he said at the start of the 5th IAS Conference on HIV Pathogenesis, Treatment and Prevention.

He added that the global recession “represents an immediate threat to the progress we have witnessed over the last decade. A retrenchment now would be catastrophic. … We know what needs to be done yet implementation flounders, costing thousands of lives each day."

Stephen Lewis, the former UN Secretary-General's envoy on AIDS to Africa, said scientists should become forceful advocates for AIDS funding and for greater resources for global health.

“When the Global Fund faces a shortfall of several billion, you would do the world a tremendous service by finding a way, from your positions of authority, to remind the political leadership of how they used precious public money to bail out the banks, so that Goldman Sachs could make a profit of $3.4 billion in the second quarter of 2009, JP Morgan Chase could make a profit of $2.7 billion in the same period," he said.

The warnings are not without merit. A report issued by the Joint United Nations Programme on HIV/AIDS (UNAIDS) earlier this month said countries in Africa, the Caribbean, Europe and Central Asia are currently being faced with shortages of antiretroviral drugs and other disruptions to HIV/AIDS treatment.

The report said affordability of antiretroviral treatment in some countries is being threatened by budget cuts and falling household income. This has led to crippled social safety nets and poor nutrition.

While the report does not indicate marked reductions in donor assistance for this year, it stated that almost 40 percent of the surveyed 20-plus countries report current funding commitments for treatment programs will end in 2009 or 2010. It added that most of the affected countries fear external assistance will not increase or even be maintained at current levels.

Nobel laureate Françoise Barré-Sinoussi of the Institut Pasteur in Paris said reducing international efforts on universal access to highly active antiretroviral therapy because of the global recession would be a disaster.

"HIV is not in recession," added Dr. Barré-Sinoussi, who shared the 2008 Nobel prize in medicine for her work in discovering the human immunodeficiency virus.

Cut in AIDS vaccine research funding

Data from the HIV Vaccine and Microbicide Resource Tracking Working Group also showed that funding for AIDS vaccine research fell by 10 percent in 2008, which is the first decline recorded in a decade.

The report, Adapting to Realities: Trends in HIV Prevention Research Funding 2000 to 2008, identified investments of almost $1.2 billion in HIV prevention research in 2008, of which $868 million supported vaccine R&D, and $244 million supported microbicide R&D, while other HIV prevention R&D received much lower levels of funding. AIDS vaccine research declined for the first time since 2000, falling by ten per cent from 2007 levels.

The report said a decrease in investment from the US National Institutes of Health contributed to the overall decline of funding for HIV vaccine R&D. The US government investment fell by $39 million, a six per cent decrease. Other governments also decreased funding for HIV vaccine research in 2008: European government funding fell by 13 percent, and total funding from other countries (including Brazil, Canada, India, South Africa, and Thailand) fell by 16 percent.

“We face tremendous challenges – both scientific and economic – over the coming years, but we must not lose the momentum we have gained. The field needs sustained support from a range of funders. The AIDS epidemic shows no signs of slowing, and the desperate need for new HIV prevention options will not change,” said Mitchell Warren, executive director of the AIDS Vaccine Advocacy Coalition (AVAC).

The report said the US government was once again the primary funder for HIV prevention research, supporting 71% of HIV vaccine R&D, 63% of microbicide R&D, and providing 46% of funding for PrEP prevention research in 2008.

The 2008 decline in vaccine research was not attributable to the global economic downturn, the working group said. Instead it was partly attributable to the end of the Step and Phambili vaccine trials, which were testing a candidate vaccine developed by Merck. The Step trial showed that the product was not effective, and the results led to a retrenchment in vaccine research which has redirected research efforts towards basic laboratory research.

However, major vaccine studies are continuing. The South African AIDS Vaccine Initiative announced Monday the start of a trial to study a vaccine candidate developed by local South African scientists. Results are also expected later this year from the largest vaccine trial ever, which successfully enrolled more than 16,000 participants to study.