Latest news with #TheLancetHIV
Yahoo
27-03-2025
- Health
- Yahoo
HIV-funding cuts could drive millions of deaths
When you buy through links on our articles, Future and its syndication partners may earn a commission. We could see up to 10.8 million more HIV cases than anticipated in the next five years if planned cuts to international HIV funding take place. This surge in infections in low- and middle-income countries would contribute up to 2.9 million more HIV-related deaths by 2030. These disturbing figures come from a new modeling study published March 26 in the journal The Lancet HIV. The researchers wanted to analyze the potential impact of cuts to international funding for HIV/AIDS programs, which work to prevent both transmission and deaths related to the infection. As of February 2025, the five top donors of this funding — the United States, United Kingdom, France, Germany and the Netherlands — have all announced significant cuts to foreign aid that threaten HIV programs worldwide. The study predicts how these cuts would impact low- and middle-income countries (LMICs), which since 2015 have relied on international sources for 40% of their HIV program funding. "These findings are a sobering reminder that progress in the fight against HIV is not guaranteed — it is the result of sustained political will and investment," said Dr. Ali Zumla, a professor of infectious diseases and international health at University College London who was not involved in the research. But equally, "the projected surge in new infections and deaths is not an inevitability; it is a consequence of choices being made today," Zumla told Live Science in an email. "If these funding cuts move forward, we risk unraveling decades of hard-won progress, leaving millions vulnerable and pushing global HIV goals further out of reach." Related: We could end the AIDS epidemic in less than a decade. Here's how. As of 2023, five donors have supplied more than 90% of the international funding for HIV programs, with the United States providing over 72% of the total. Specific populations at high risk of HIV — including people who inject drugs, men who have sex with men, female sex workers and their clients, and transgender and gender diverse people — particularly rely on these international funding sources for access to HIV prevention and testing. Much of the U.S. funding comes from the President's Emergency Plan for AIDS Relief (PEPFAR), which is largely implemented by the Agency for International Development (USAID). However, PEPFAR and USAID were hit by an unprecedented funding pause and staffing reduction in January, following an executive order from President Donald Trump. PEPFAR later received a temporary waiver to continue some services, including those for antiretroviral therapy (ART), the drugs that keep HIV from progressing to AIDS. These treatments must be taken consistently or the virus will rebound. "The widespread rollout and uptake of antiretroviral therapy funded by international sources has been one of the most important factors reducing AIDS related deaths in lower income settings," said Justin Parkhurst, an associate professor of global health policy at the London School of Economics and Political Science who was not involved in the study. ART also cuts the number of new infections by suppressing the virus in people living with HIV, thus preventing transmission, he told Live Science in an email. "In the worst-case scenario, if PEPFAR funding were ceased entirely and no equivalent mechanism replaced it, surges in HIV incidence could potentially undo nearly all progress achieved since 2000." However, despite the waiver, PEPFAR's services still haven't resumed as normal, given the waiver didn't trigger immediate funding to eligible programs and many clinics had already shuttered by the time it was issued. Even now, PEPFAR's future after the waiver's expiration remains uncertain. Following the U.S., the next top four donors for international HIV funding are the U.K., France, Germany and the Netherlands. However, as of February 2025, each of these donors has also announced major cuts in foreign aid spending — "and more might follow," the study authors wrote. Based on the projected cuts being made by the top five donors, the researchers used a mathematical model to predict the rates of new HIV cases and deaths. They focused their model on 26 LMICs, which together receive 49% of international HIV aid, overall, and 54% of PEPFAR aid. They then used the data from these 26 countries to extrapolate to all LMICs worldwide. The researchers considered several scenarios in their model. The first — the "status quo" — served as a baseline, projecting the rates of cases and deaths if recent levels of HIV spending were maintained between 2025 and 2030, rather than cut. In this scenario, more than 1.8 million new infections and over 720,000 HIV-related deaths occurred in LMICs. In the worst-case scenario the team considered, all PEPFAR funding was indefinitely stopped on Jan. 20, 2025, and no alternative funding sources emerged to fill that gap. Simultaneously, other, non-PEPFAR sources of international funding were also reduced. That scenario led to an estimated 10.8 million more cases and 2.9 million more deaths than the status quo. Related: Single-shot HIV treatment suppresses virus 10,000-fold for months, animal study finds This suggests that "the number of new infections in 2026 could return to 2010 levels, and by 2030 the number of new infections could surpass historical estimates," the study authors wrote. "In the worst-case scenario, if PEPFAR funding were ceased entirely and no equivalent mechanism replaced it, surges in HIV incidence could potentially undo nearly all progress achieved since 2000." This worst-case scenario would hit sub-Saharan Africa (SSA) particularly hard — out of eight SSA countries included in the analysis, six receive over 40% of their HIV funding through PEPFAR. Children in the region could see a nearly three-fold increase in HIV infections, the authors predicted. And outside of SSA, other vulnerable populations, such as sex workers, would be much harder hit by such cuts than the general population, showing up to a six-fold higher increase in cases than other demographics, the data suggested. The team also looked at a less extreme scenario, modeling what would happen if new funding sources filled the gap left by PEPFAR. In this scenario, they assumed that the gap could be partially filled by 2026 and then fully filled by 2027. If that mitigation were to happen, the number of extra cases drops to 4.4 million and the extra deaths to 770,000 over the course of five years. So while filling the gap left by PEPFAR would help substantially, that sudden loss of funding would still have devastating impacts, the study suggests. "Modelling reveals the potential for severe consequences following abrupt stopping, with no notice, of international support aimed at stopping AIDS as a global public health threat," Dr. Catherine Hankins, a professor of global and public health at McGill University in Canada who was not involved in the study, told Live Science in an email. According to the study authors, even if the PEPFAR gap could be filled within two years, the ripple effects would be felt for decades to come. They estimated that it would take 20 to 30 extra years of 2024-level funding to end AIDS as a public health threat. Ambitious goals set by UNAIDS have aimed to end the threat by 2030. And historic HIV trends suggested that many of the LMICs featured in the new paper could have hit their targets by about 2036, if funding continued at past levels, the authors wrote. "This study indicates that an abrupt termination of programmes has serious risks to human life," Parkhurst said. "Even for those who believe the US or other governments should reduce foreign aid spending in this area, there can be planning around how to do so without producing serious harm to millions of people around the world who have come to rely on the treatment." The study suggests that, if that abrupt stop could be avoided, many lives could be spared. The researchers looked at what would happen if PEPFAR was reinstated or "equivalently recovered" and estimated that there could be 70,000 to 1.73 million extra cases and 5,000 to 61,000 extra deaths, compared to status quo. Those estimates assume that other international funding will still be reduced, but that countries will be able to make up for some of the lost funds domestically. RELATED STORIES —'It is a dangerous strategy, and one for which we all may pay dearly': Dismantling USAID leaves the US more exposed to pandemics than ever —Kids under 5 with HIV are dying at high rates. Here's why. —'We have to fight for a better end': Author John Green on how threats to USAID derail the worldwide effort to end tuberculosis The new study has some limitations, one being that the HIV fiscal space is "unpredictable," and the trajectory of future funding cuts is unclear. It also doesn't account for potential behavioral changes that could help prevent HIV transmission in the wake of funding cuts, and it included only 26 countries that might not be fully representative of LMICs worldwide, the study authors wrote. But the researchers argue that, if anything, these limitations would likely cause the model to underestimate the potential impacts of the funding cuts, rather than overestimate them. "It is paramount now to track AIDS mortality and HIV incidence while urgently reversing the cuts, mitigating the effects, and creating new funding strategies to prevent further suffering," Hankins said.
The Independent
27-03-2025
- Health
- The Independent
Foreign aid cuts will lead to more HIV infections and deaths, study suggests
HIV infections and deaths will rise as a result of cuts to foreign aid, according to a study. Researchers said that funding cuts could undo decades of progress. A new report says that infections and deaths could surge to levels not seen for more than two decades. Experts, led by academics from Australia, estimate there could be up to 10.8 million additional HIV infections by 2030 in low-and-middle income countries as a result of the cuts. And there could be up to 2.9 million HIV-related deaths between 2025 and 2030 if funding cuts proposed by the top five donor countries, including the USA and the UK, are not mitigated. Sir Keir Starmer recently slashed overseas aid spending to fund defence commitments he said were necessary to protect the UK amid uncertainty over the Ukraine war and its implications for European security. Anneliese Dodds resigned as international development minister over the decision, which will see the budget cut from 0.5% of gross national income to 0.3% in the next two years. After taking up post in January, US president Donald Trump announced a pause in most US foreign aid spending. He also announced that the US would withdraw from the World Health Organisation. A paper, published in The Lancet HIV, highlights how international donors have contributed to 40% of all HIV funding in low-and-middle income countries since 2015. The USA, UK, France, Germany, and the Netherlands together account for more than 90% of international funding, but they have each recently announced plans to implement significant cuts to foreign aid, the article adds. It is estimated that these plans will lead to a 24% reduction in international HIV funding by 2026. As a result, the team modelled the human cost of the cuts. They estimated there could be between 4.4 million to 10.8 million additional HIV infections by 2030 in low-and-middle income countries. And between 770,000 to 2.9 million HIV-related deaths in children and adults could occur in the same time frame. 'Unmitigated funding reductions could significantly reverse progress in the HIV response by 2030, disproportionately affecting sub-Saharan African countries and key and vulnerable populations,' the authors wrote. It comes after the UN programme for combating HIV and Aids, UNAids, said that daily new HIV infections around the world could almost double without the aid provided by the United States. 'The United States has historically been the largest contributor to global efforts to treat and prevent HIV, but the current cuts to Pepfar (the US President's Emergency Plan for Aids Relief) and USaid-supported programmes have already disrupted access to essential HIV services including for antiretroviral therapy and HIV prevention and testing,' said co-lead study author Dr Debra ten Brink of the Burnet Institute (Australia). 'Looking ahead, if other donor countries reduce funding, decades of progress to treat and prevent HIV could be unravelled. 'It is imperative to secure sustainable financing and avoid a resurgence of the HIV epidemic which could have devastating consequences, not just in regions such as sub-Saharan Africa, but globally.' And reports suggest that the Trump administration is planning to end funding for Gavi, the vaccine alliance. Responding to the reports, Professor Sir Andrew Pollard, director of the Oxford Vaccine Group at the University of Oxford, said: 'The funding cuts in the first three months of this year affecting USaid, ODA, WHO and now Gavi are suffocating global health.' Commenting on the study, the National Aids Trust said it is 'extremely alarmed' by the potential impact of proposed cuts. Daniel Fluskey, director of policy, research and influencing at the charity, said: 'These funding cuts will have a devastating impact for millions of people across the world as well as threatening the progress that has been made, both globally and in the UK, on ending the HIV epidemic. 'Like any virus, HIV does not stop at international borders. We will not reach the goal of ending new transmissions by 2030 in the UK with a resurgence of HIV across the world.' Anne Aslett, chief executive of the Elton John Aids Foundation, added: 'This report demonstrates the critical and urgent need for donors to recognise the cumulative impact of their decisions to cut aid budgets. 'If funding for the global HIV response falls away to the extent this report suggests it could, millions more people will get sick, and health budgets will simply not be able to cope.' A Foreign, Commonwealth and Development Office spokesperson said: 'The UK provides significant funding to the global HIV response, supporting work to end Aids-related deaths and prevent new HIV infections. 'We remain firmly committed to tackling global health challenges, not only because it is the right thing to do, but also because it will help us deliver on our Plan for Change in the UK by supporting global stability and growth.'
