Global AIDS fund facing a financial nightmare

December 1, 2011
Written by Gary Pettus

Back when Joyce Kamwana was diagnosed with HIV, it was considered "equal to death," she said.

More than 20 years later, Kamwana, an HIV survivor with two children, is on a mission to ensure the virus that leads to AIDS does not became a death sentence for others as nations lose their will to help them.

"This is a matter of life and death," said Kamwana, 48, a native of the African country of Malawi.

Kamwana delivered that message in Jackson on Wednesday, the eve of World AIDS Day, as an ambassador for the Global Fund to Fight AIDS, TB and Malaria, an initiative that has committed $22.4 billion in 150 countries to support prevention, treatment and care programs against the three diseases.

Across the globe, more than 33 million people are living with HIV/AIDS, and 2.5 million are infected each year, the World Health Organization says.

In the United States, HIV treatment regimens can cost up to $24,000 per year per patient, reports the journal, Clinical Infectious Diseases. But several countries, Including the United States, are threatening to slash monetary commitments to such initiatives as their governments fight economic emergencies at home.

"Since 2003, 7.7 million lives have been saved by the Global Fund," said Crickett Nicovich, a Starkville native who's the outreach and advocacy associate with RESULTS, a Washington, D.C.-based nonprofit agency that helped sponsor Kamwana's visit here.
"But because many countries aren't living up to their pledges to it, the Global Fund is in a financial crisis itself.

"For the first time in a decade, global AIDS spending fell in 2010, and President Obama and the 112th Congress have presided over the first decrease in U.S. global AIDS spending."

The U.S. House of Representatives has proposed overall cuts to global health funding that would hamper efforts to fight AIDS and other diseases, Nicovich said.
Reductions to anti-AIDS initiatives should resonate here, said Linda Rigsby, an attorney with the Mississippi Center for Justice.

"Mississippi is one of nine Southern states identified as being particularly hard-hit by AIDS," she said, citing a report from the Duke Center for Health Policy and Inequalities Research, "HIV/AIDS Epidemic in the South Reaches Crisis Proportions in Last Decade."

Thirty-five percent of new HIV infections were in these nine "targeted" states, which hold only 22 percent of the U.S. population, says the report, which used 2009 data from the Centers for Disease Control and Prevention.

Brave New Day in Jackson, a support group of people living with AIDS or HIV, receives an estimated average of 20 calls a month on its 24-hour help line, said Maurice Brown, the organization's operations manager.

"Most people who call are recently diagnosed, and are just lost," he said.
Mississippi, with an estimated 9,500-plus people living with HIV/AIDS, has the 10th highest rate of AIDS diagnosis in the country; it has the 16th highest rate of HIV diagnosis.

"Shame, embarrassment are associated with an HIV diagnosis, particularly in the Southeast. This could prevent some people from getting regular medical care," said Dr. Harold Henderson, a University of Mississippi Medical Center professor of medicine and HIV expert. "People who are poor may be reluctant to go to the doctor because they worry about paying for any medical bill."

Kamwana battled social stigma and poverty in her own country, she said. At one point she lost her job after she admitted she was HIV-positive, she said.

Except for a couple of brief interludes where she was able to receive the costly antiretroviral drugs for free, for years she had no access to this effective treatment for the human immunodeficiency virus, for which there is no cure.

"I depended on nutrition, a certain diet, to stay alive," Kamwana said. "I ate only natural foods, and no processed foods with preservatives."

In 2004, she was able to receive medication through the Global Fund, but not before being sickened twice by tuberculosis, a disease that often afflicts HIV patients.
"My health has greatly improved since I have had access to the drugs," she said.
Grateful for her survival, Kamwana performs HIV-patient advocacy work, including participation in World AIDS Day events.

The theme of that annual observance through 2015 is "Getting to Zero," a vision to achieve, among other things, zero new HIV infections.

A key is the prevention of HIV transmission, which can depend on early treatment, said Nicovich, citing a finding released this year by the HIV Prevention Trials Network: Antiretroviral therapy reduces the risk of HIV transmission by 96 percent.
It also cuts by 84 percent the occurrence of tuberculosis in HIV/AIDS patients, who often die of TB in undeveloped countries.

"HIV care costs money; most governments of undeveloped countries can't pay for all of the care needed," Henderson said.