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TOPIC: Bill Clinton: We need to save more lives – with less (Independent UK 12/01/10)

Jen the Michigander

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Date: Nov 30, 2010

Bill Clinton: We need to save more lives – with less (Independent UK 12/01/10)	Permalink

By the Big Dawg himself... http://www.independent.co.uk/opinion/commentators/bill-clinton-we-need-to-save-more-lives-ndash-with-less-2147827.html We risk losing our momentum, unless we find new ways to fill gaps left by reductions in Aids funding caused by the economic crisis On World Aids Day 10 years ago, as I was preparing to leave office, the world was only beginning to grasp the severity of the Aids crisis. Nearly 36 million men, women and children were living with the disease, but only about 200,000 were receiving the treatment they needed. Funding was nowhere near the levels needed to prevent the disease from reaching pandemic levels. Over the last decade, we have seen dramatic progress in both treatment and funding. In 2008 alone, $15bn was invested to fight Aids in developing countries, up from $6bn just three years earlier, due in large part to the US Government’s PEPFAR (President’s Emergency Plan for Aids Relief) programme. In spite of these efforts, only one-third of people who need treatment are receiving it. We risk losing our momentum, unless we find new ways to fill the gaps left by reductions in government funding caused by the global economic crisis. And we need to save more lives with the money we do have. The most promising way to raise more funds is through very large numbers of small contributions which can be made in user-friendly ways. For example, France raises a lot of money every year from a service fee on airline tickets. The amounts raised provide much of the funding for the International Drug Purchase Facility (UNITAID,) which buys medicines to treat Aids and other diseases in poor countries. We are now trying to give airline passengers in other nations the opportunity to make small, voluntary contributions when they purchase tickets. In the meantime, we must do more with less. That means saving money on commodities and promoting better co-ordination of funding between donors and national governments. It means ensuring that low-cost/high-impact interventions are widely adopted, and asking donor nations to improve their own delivery systems so that a higher percentage of aid funds are spent in the beneficiary nations and on the problems they are intended to alleviate. My foundation has focused on lowering the cost of commodities since we began our work in 2002. Thanks to those efforts – along with the support of organisations like UNITAID, the Global Fund, PEPFAR, and the Gates Foundation – the cost of antiretroviral drug treatment (ARVs) has gone down to below $200 per person annually. The cost of CD4 tests, which allow doctors to assess how patients are responding to treatment, and other laboratory tests, has also dropped by over 50 per cent. But we need to break down remaining barriers – including trade agreements that prevent generic manufacturers from supplying effective ARVs for the developing world, and we need to do a better job on forecasting demand, to avoid overstocking, drug shortages, and expired inventory. We must co-ordinate funding flows better between donors and national governments to ensure that resources are aligned with the most pressing national priorities. We must also reduce duplication and under-investment. For example, the government of Rwanda has required that its implementing partners submit budget and expenditure data. From these reports, the government learned that some areas were receiving $15 per capita of external aid per year, whereas others only received $4. The Rwandan ministry of health used this data to form agreements with partners to ensure a more equitable and efficient allocation of resources. Other governments should follow Rwanda’s lead. We can maximise our return on investment by ensuring that low-cost/ high-impact interventions are adopted on a wider scale. For example, providing all HIV-positive people in sub-Saharan Africa with the antibiotic Co-trimoxazole – from the time that they are diagnosed – would dramatically lower mortality from common conditions such as pneumonia and diarrhoea at a cost of just $0.37 per patient, per year. This should be a basic standard of care. Another important intervention is the prevention of TB, which directly causes one in four deaths among HIV-positive patients. Treatments like Isoniazid prophylaxis can reduce TB infection amongst HIV patients by up to 64 per cent. Finally, all of us should continue to urge donor nations, as Bill Gates and I did before the US Senate Foreign Relations Committee, to review their own budgets with a view to reducing overheads. If the cost of consultants from donor nations were cut, more aid could be spent on saving lives. __________________ Nobody puts THIS baby in the corner!

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