The 2 Bills _ Clinton and Gates _ call for a more efficient worldwide fight against AIDS

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Clinton, Gates: Fight AIDS more efficiently

VIENNA — Two heavy hitters on the world health stage — Bill Clinton and Bill Gates — called Monday for a more efficient fight worldwide against the AIDS virus.

In separate speeches at an international AIDS conference in the Austrian capital, the former American president railed against spending too much money on reports that just sit on shelves and urged that funds directly target AIDS sufferers. Gates, the founder of Microsoft Corp., said health groups must adopt better business practices that deliver more bang for the buck.

Clinton said many countries are misspending foreign aid. He said funding should go directly to local organizations, because developing countries can deliver health services at a lower cost and less overhead than established organizations.

“In too many countries too much money goes to pay for too many people to go to too many meetings, get on too many airplanes,” Clinton said. “Keep in mind that every dollar we waste today puts a life at risk.”

The number of people taking crucial AIDS drugs climbed by a record 1.2 million last year to 5.2 million overall, the World Health Organization said Monday. Between 2003 and 2010, the number of patients receiving lifesaving antiretroviral treatment increased twelve-fold, according to the Geneva-based body.

“We are very encouraged by this increase. It is indeed the biggest increase that we have seen in any single year,” said Gottfried Hirnschall, director of the WHO’s HIV/AIDS department.

Clinton also called on aid groups to remember that the world was “awash in trouble” due to the impact of the financial crisis.

“It is easy to rail at a government and say why doesn’t the government give us more money if they’re giving somebody else money,” he said. “But the government gets its money … from taxpayers who have lower incomes today than they did two years ago.”

Gates said although finding new funding was critical, more could be done with the resources that were already available.

The Global Fund to Fight HIV, Tuberculosis and Malaria, one of the biggest funders of AIDS programs, has in the past found evidence of fraud in countries’ health programs — like Uganda and Zambia — and suspended their programs or tried to get the money back.

“Even if we advocate for more funding, we can do more to get the most benefit from each dollar,” Gates told delegates. “If we push for a new focus on efficiency in both treatment and prevention and we continue … to create new tools, we can drive down the number of infections dramatically and start writing the story of the end of AIDS.”

Some countries — such as Russia — are not using data to make funding decisions that target the right populations because those groups make politicians uncomfortable, Gates added.

“If you’re afraid to match your prevention efforts to the right populations, then you’re wasting money and that costs lives,” he said.

Activists, such as Asia Russell of the Health Global Access Project, scoffed at the mention of efficiency and said it was misplaced.

“Unfortunately, the language around efficiency gets deployed, I think, often, as a distraction,” Russell said, adding that more funding was absolutely crucial.

In Uganda, she noted, there was already acute rationing of treatment due to cost cutting.

“Under the guise of efficiencies, implementers have desperately tried to find ways to cut fat from programs and have ended up cutting into lean as well — that is, they’ve cut away patient outreach and follow up programs … so they’re left with these bare-bones programs that undermine actual supportive care services because they’re urgently trying to cover as many people as possible,” Russell said.

Clinton said in order to have the “moral standing” to ask for more funding, organizations should prove to governments that “we’re doing our job faster, better and cheaper.” He also defended President Barack Obama’s efforts on AIDS.

“You can demonstrate and call the president names or we can go get some more votes in Congress to get some more money,” Clinton said. “My experience is that the second choice is the better one.”

On Sunday, the head of the conference said world leaders lack the political will to ensure that everyone infected with HIV and AIDS gets treatment.

Julio Montaner — the president of the International AIDS Society and chairman of the AIDS 2010 conference — said the G-8 group of rich nations has failed to deliver on a commitment to guarantee universal access to AIDS drugs and warned this could have dire consequences.

Montaner’s comments foreshadowed one of the key topics for the weeklong gathering, which organizers say has drawn 20,000 policymakers, experts and advocates.

In 2005, G-8 leaders committed to an Africa-focused package for HIV prevention and treatment that gets “as close as possible to universal access to treatment for all those who need it by 2010.” They reaffirmed that commitment again in 2006.

But a G-8 report from last month’s summit of world leaders in Canada acknowledged that the AIDS treatment targets will not be met by 2010.

According to the World Health Organization, 33.4 million people were living with HIV in 2008. While the number of deaths declined to 2 million in 2008 from 2.2 million in 2004, about 2.7 million new infections still occur each year.

Associated Press Medical Writer Maria Cheng contributed to this report from London.

Online:

www.aids2010.org/