New York — US President Donald Trump’s plan to cut foreign aid supporting HIV/AIDS treatment could cost 9-million years of lost life in SA and Ivory Coast, according to a global study released on Monday.
In the first study to measure the impact of cuts in global investment in HIV care in terms of health and costs, scientists found sky-rocketing deaths in the African nations would far outweigh savings.
SA has the highest prevalence of HIV worldwide, with 19% of its adult population carrying the virus in 2015, according to UNAIDS, with a total of 7-million HIV-infected people.
Ivory Coast counted 460,000 HIV-infected people in that same year.
Trump’s proposed budget for 2018, made public in May, envisions cuts to the President’s Emergency Plan for AIDS Relief (Pepfar) programme, a cornerstone of US global health assistance, which supports HIV/AIDS treatment, testing and counselling for millions of people worldwide.
Under Trump’s budget, which pursues his "America First" world view, annual Pepfar funding would be $5bn — compared with about $6bn a year now, the US State Department has said.
No patient currently receiving antiretroviral therapy through Pepfar funds will lose that treatment, officials have said.
Should the cuts keep South Africans and Ivorians from receiving antiretroviral drugs, an additional 1.8-million HIV-infected people would die over the next 10 years, 11 researchers in America, Europe and Africa concluded, using mathematical models.
The combined deaths amount to nearly 9-million years of life lost, the scientists calculated, in what they said was the first effort to put figures on the proposed cuts.
The researchers measured expected savings over the next decade, whose small scale they said raised efficacy and ethical questions.
In SA, it would amount to about $900 for every year of life lost, and between $600 and $900 in Ivory Coast.
"We leave it to readers to draw their own conclusions about whether imposing such trade-offs on vulnerable populations accurately reflects how donor countries value life in recipient nations," the researchers wrote in Annals of Internal Medicine.
Savings would eventually dry up over the decade, they found, due to higher costs tied to the spread of HIV amid scaled-back screening and care.
"Would the relatively small savings realised by currently proposed budget reductions be worth these large humanitarian costs?" asked lead author Rochelle Walensky, a professor of medicine at Harvard Medical School.
"Over the past decade-and-a-half we’ve spent considerable money to save lives in these and other African nations."
About 90% of Ivory Coast’s funding for HIV care and prevention depends on international aid, while SA self-finances most of its HIV expenditures, according to US government figures.
Thomson Reuters Foundation
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