Latest news with #anti-HIV
Telegraph
26-03-2025
- Health
- Telegraph
New modelling predicts up to 10 million additional HIV infections following aid cuts
Aid cuts by Donald Trump and Sir Keir Starmer could trigger a resurgence in HIV cases, with up to 10.8 million more people infected globally. Modelling published in the Lancet HIV medical journal shows the cuts could reverse decades of progress in slowing the epidemic that still kills around one person per minute. It says there will be between 4.4m to 10.8m additional new infections by the end of this decade in low-and-middle income countries unless the funding shortfall can be filled. The peer-reviewed study also estimated there could be between 0.8m and 2.9m HIV-related deaths in children and adults by 2030. Overall new infections and deaths from HIV will return to those last seen in the early 2000s. The grim forecast comes only days after the chief of the United Nations Aids agency made her own warning that US funding cuts could lead to an additional six million deaths in the next four years. Winnie Byanyima this week said she feared a return to the 1990s, when HIV medication was scarcely available in poorer countries, and infections and deaths soared. Foreign donors provide around two-fifths of all anti-HIV funding in low and middle-income countries, with America, the UK, France, Germany, and the Netherlands between them making up 90 per cent of that. Yet each of these countries has recently announced significant aid cuts, giving reasons including the cost of rearming and reacting to the war in Ukraine, the desire to slim down public spending, or ideological opposition. America's cuts are potentially the steepest, after the Trump administration paused all foreign aid for a 90-day review into programmes. The US Pepfar anti-HIV programme is a cornerstone of the global fight against the virus and the largest commitment by a country ever to address a single disease. In the 20 years since it was introduced by George W. Bush, it is credited with saving 26 million lives in more than 50 countries. The Trump administration has vowed to keep 'lifesaving' parts of it, but other parts have been scrapped and it remains unclear how much will survive. 'Decades of progress' could unravel Foreign aid goes to pay for everything from research into new vaccines and treatments, to giving anti-retroviral drugs to those already infected, to providing anti-HIV preventative jabs and tablets to those most at risk of catching the virus. Taken across all five donors, the cuts are between them projected to see a 24 per cent fall in global international HIV funding by next year. Dr Debra ten Brink, a scientist at Australia's Burnet Institute and one of the paper's lead authors, said: 'The current cuts to Pepfar and USAID-supported programmes have already disrupted access to essential HIV services including for antiretroviral therapy and HIV prevention and testing. '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.' The modelling looked at the impact on 26 countries and then extrapolated across all lower and middle income countries. If the funding reductions continue as planned, they found there could be between 4.4m to 10.8 million extra new HIV infections by 2030. That would represent a 1.3 to six-fold increase in new infections for people at higher risk of acquiring HIV, compared to if funding levels remained consistent. Dr Rowan Martin-Hughes, also of the Burnet Institute, said: 'There could be an even greater impact in sub-Saharan Africa, where broader prevention efforts, such as distributing condoms and offering pre-exposure prophylaxis (PrEP – a medication that reduces the risk of getting HIV) are at first risk to be discontinued. 'This is in addition to disruptions in testing and treatment programmes could cause a surge in new HIV infections, especially in some of the areas where the greatest gains have been made, such as preventing mother-to-child transmission of HIV and paediatric HIV deaths.' The billions of foreign aid poured into anti-HIV efforts have contributed to significant progress in treating and preventing the virus. There has been an average 8.3 per cent yearly decrease in new infections and a 10.3 per cent decrease in HIV-related deaths, the researchers said. If that trend continued, many countries would be on track to meet global targets to eliminate HIV/Aids as a public health threat by around 2036. That could now go into reverse, the modelling suggests. 'There is an urgent need for innovative, country-led financing strategies and an integration of HIV services into broader health systems, however, this can't happen overnight,' said Dr Nick Scott, also of the Burnet Institute (Australia). 'Long-term strategic planning is required for countries to transition from internationally supported to domestically financed programmes. Our study highlights how important international collaboration and investment have been in maintaining progress against HIV.'
Boston Globe
28-01-2025
- Business
- Boston Globe
Does Trump have the power to block spending that Congress has authorized?
Advertisement Here is a closer look at the attempt. What has Trump done? In his first week in office, Trump barred spending on certain initiatives whose mission he disagreed with, including programs involving 'diversity, equity and inclusion' and funding to nongovernmental organizations he believes undermine the national interest. He also ordered a 90-day freeze on all foreign aid spending to review it for any conflicts with his priorities, making exceptions for military assistance to Israel and Egypt. Get Starting Point A guide through the most important stories of the morning, delivered Monday, Wednesday, and Friday. Enter Email Sign Up That freeze has jeopardized a broad swath of congressionally authorized aid, like military assistance to Ukraine in its fight against Russia's invasion, helping pay the salaries of a Kurdish-led militia guarding Islamic State detainees in northeast Syria, and the distribution of anti-HIV medication in Africa and developing countries. By the start of his second week, Trump signaled an escalation. On Monday, the White House, in a memo, ordered a temporary halt to 'all federal financial assistance' like loans and grants on domestic soil as well. While Social Security and Medicare were exempted, the memo said it would apply to as much as $3 trillion in government programs and activities. Should the freeze become permanent for a program that Congress approved but the White House does not like, it could set off a court fight over the constitutionality of a law banning unilateral 'impoundment' by presidents. What is impoundment? Impoundment is the act by a president to withhold or delay the spending of funds that Congress has appropriated for the federal government to disburse. Advertisement While it is routine for the executive branch to hold back some authorized spending if it is able to come in under budget while still accomplishing Congress's goal, the practice becomes contentious when a president refuses to spend money Congress has appropriated for a program because he objects to it. Congress essentially banned presidents from unilaterally and permanently impounding funds in a 1974 law. But during the presidential campaign, Trump, in a video on his campaign website, vowed to restore the power so that he could 'squeeze the bloated federal bureaucracy for massive savings.' Legalizing permanent impoundment would transfer power from Congress to the presidency. The founders devised the separation of powers to keep each branch from accumulating too much authority and posing a threat to liberty. Central to that is Congress's control of decisions about taxation and spending — its power of the purse. In the Federalist Papers, James Madison wrote that this power was a 'most complete and effectual weapon' for elected lawmakers to wield. But supporters of concentrating more power in the presidency argue that the Constitution gives the president the authority to choose not to execute particular spending provisions Congress has written into the law. They say the phrase 'the president shall take care that the laws be faithfully executed' should be interpreted to allow for that. What would impoundment mean for spending cuts? Permanent impoundment would make it easier to restrain federal spending. In an era of persistent budget deficits and mounting federal debt, people who think the government spends too much have grown frustrated with Congress's record and sought ways to expand presidential power to cancel some of lawmakers' spending decisions. In 1996, for example, Congress passed a law that would allow presidents to veto specific line items in spending bills, rather than having to accept or veto the entire legislative package. But the Supreme Court struck down that law as unconstitutional. Advertisement Is unilateral and permanent impoundment lawful? Not under current federal law, with narrow exceptions. There are rare examples of presidents impounding funds for certain programs dating to the early 19th century. But the practice became more common during the 20th century, especially with vast spending during the Cold War era on weapons and disputes between presidents and Congress over which to buy. The practice peaked under Nixon, who impounded billions lawmakers had appropriated for matters including highway spending and pollution control. In response, Congress in 1974 sought to restore its power of the purse by enacting a law called the Impoundment Control Act. The statute outlawed the ability of presidents to unilaterally and permanently rescind congressional funding decisions. Instead, it set up a narrow procedure by which presidents could submit proposed cuts to Congress for approval. Without it, the funds eventually had to be spent. While the Trump White House publicly disclosed the 'temporary' freezes in broad strokes in an executive order and the memo, it is not clear whether it sent any such notice to Congress. This article originally appeared in
