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US cuts to HIV funding has left the global response to HIV in crisis. That's the Morning from the UNAIDS Agency Executive Director Winni Bianima.
Clinics have closed, prevention services have halted, people are losing access to life saving medicines. People are scared.
Seventy five percent of people living with HIV are in Africa, and many saw twenty twenty five as a chance for a breakthrough year in tackling the disease, hopes that now seem in tatters.
A Republican government, President Bush came out at the time of the worst crisis pandemic of the century and put down a program to save lives right now. There are tools that could make us come to the end of this pandemic. I say to President Trump, you're a man who likes to do a deal. Here's a deal.
On today's podcast, we're looking at the state of the global HIV response in the wake of US funding cuts, and whether South Africa's leadership of the Global Fund will find the donors needed to get the work moving again. I'm Jennifer's Abasajob and this is the next Africa podcast bringing you one story each week from the continent driving the future of global growth with the context only Bloomberg can provide. Well, here to help us break down that
really fascinating Bloomberg Weekend Interview. I'm joined by our healthcare reporter here in Johannesburg, Jennis Q. Jennis, thanks so much for being with us.
Thank you. I wish that we would chat under happier circumstances. We seem to always come in with pretty dire stories, but they are important.
Yeah, and it's been actually quite a while since we've had you on the podcast to speak about healthcare in the region, So you know, let's talk about this latest story we heard from Winnie b a Yuma, who painted quite a bleak picture of the state of the global fight against HIV. Can you give us some context as to how serious things have gotten over the past few months.
In some African countries, it is dire where people aren't able to get the anti retrovirals at all. In most cases, these medications need to be taken daily, so disruption and supply translates into a critical situation, not least because a person that's newly infected with HIV is highly infectious, especially during the first few weeks off to infection, there's acute phase. The viral load or the amount of HIV in the blood is very high, and so it significantly increases the
risk of transmission. For example, if a pregnant woman acquires the disease or the virus, especially in your last trimester, the chances of the child being born with HIV increases significantly. And while made can be taken to keep it under control, it is an incurable disease, so you can live long with HIV if you've got the medication. But the point is that a child who's born HIV positive has to be on meds for life, and that has both physical and financial costs.
And when we think about the cuts and the cuts to some of these services, how has that affected what is already a dire situation in the region.
In many places, it's meant that clinic doors have been closed. In South Africa, though, which is unlike many other countries on the continents, the government provides the ravs, so in some ways the impact has been a little less harsh here. That's still not to say it isn't significance In South Africa. Many of the NGOs have had to severely scale back.
I spoke with the national chairwoman of the Treatment Action Campaign, a South African nonprofit that lost eighty eight percent of its staff after the US funding was halted at the end of February. She described how are their mobile clinics and the work that they were doing specifically with sex workers has effectively ended, and how with our regular drugs everything gets bad pretty quickly. Even in South Africa, it's
hard to cater for what we call key populations. These are migrants, men who have sex with men, sex workers, and drug users. And as Mitchell Warren, who is the executive director of the New York based Global HIV Prevention Advocacy Group AVAC, he says, you know, governments are not great at dealing with some of these issues of sexuality
and HIV AIDS programs don't have on off switches. They take time, and those relationships take time, and it's easy to break something down, but it's really hard to build something up.
And even prior to these cuts there, I mean, this has been something that many health advocates for years had tried to bring down at least the statistics for decades, and you know, so that there had been plans to hold HIV as a public health crisis by twenty thirty. Was that within reach prior to these cuts? And I wonder with some of the other advocates that you speak to, do they think potentially we've pushed out the goalposts essentially on achieving that even further.
Absolutely, a small amount of foreign aid means that plan in the disease is a public cult threat by twenty thirty is only going to get more off track, Willdn't it be? A NEMO said as much in a recent press conference here in South Africa, and it was going to be a challenge twenty thirties only five years away, but it definitely makes it a whole lot more challenging.
And Jennie, what does that look like on a day to day basis You're somebody who's been covering this for quite some time. What is the current situation on the ground.
So certainly here in South Africa we've got the government's being resolute that it's not going to know these cuts, aren't going to sync their HIV programs, and they are taking steps to move files from that were at you know, various clinics run by NGO's move them into the public sector hospitals. But it's not an easy thing to do. It's not a smooth transition. And then, as I was talking about those key populations a little earlier, many of them are not likely to be able to go to
public clinics. They migrants need the correct paperwork to be attended to. Sex workers. You know, if you've worked the whole night and now you've got to line up and a queue at a public hospital before seven o'clock in the morning, and you know that that's going to be challenging. But then there's also going to be a lot of
staff training and how to treat people more sensitively. On top of that, if you feel that you're going to be questioned, your life choices are going to be questioned, you're probably not going to be open and honest with a healthcare provider, and that means that you're probably not going to get targeted treatments and the correct kind of interventions. In the rest of Africa, we've seen even worse situations
where because the Arabs are simply not available. We've even had some impact in South Africa because of neighboring countries that have shortages of the Arabs. Where a lot of the action campaigns had spent years making sure that people could gets six or more months supply of arabs at
a time. This was important because for many people to not just the time out of their job or their day to get the arabs, but it's the transport costs, etc. And so we'd moved in South Africa to a situation where people were able to get six months or more medication, and that has been rolled back in South Africa because of concerns that people will get the medication and then set it over the border to people who desperate because they just have no access at all.
And Janna is stick with us. When we come back, we'll look at the efforts to try and find new sources of funding, including the role that the South African government will potentially be playing. We'll be right back. Welcome back. Today. We're looking at the state of global efforts to tackle HIV after the executive director of unaid's declared that it was in crisis. Our healthcare reporter Janis q is still
with us now. Jana, so South African Presidents Zoo Ramaposa has decided to take on the responsibility to try and rebuild the global Fund to fight HIV. We were just talking about some of the challenges though that this fight already faces. How difficult of a task is he facing though in terms of the funding our position.
From a POSA has a lot of respects globally and is a very diplomatic man, but it is going to be incredibly difficult. The Global Fund, which is an independent partnership whose money mainly comes from public sector donors, plans to raise at least eighteen billion dollars at IT as it launches its twenty twenty six to twenty twenty eight fundraising cycle, and success of the exercise will be crucial for expanding efforts to combat HIV and TB and malaria.
But it fell short already in its most recent efforts a couple of years ago, and so you know, if it was already falling short, then it makes it an especially tall order.
Now where can Ramaposa even look though for this funding? If the US in fact is going to continue to pull back on funding and contribute to aid, are there other countries that are then stepping up and saying they will contribute at least in regards to health and HIV in the fight against it?
We have a very good relationship with China in South Africa, and there is a possibility that they could step in. I would like to believe that presented in the right way, it may be seen in the US as something that's worth considering still, and then there is a chance of other African governments perhaps stepping in somewhat or be it many have no regal room because there's also an urgent need to restructure their debt to cut debt service costs.
Many African countries have debt service costs that are many times larger than their entire healthcare budget, so that is a real challenge. While not in the public sector, we've seen the Gates Foundations say that it plans to give away two hundred billion dollars over the next twenty years before shutting down entirely in twenty forty five, and that target represents a doubling and spending for that nonprofit, and they have said that much of that will be focused
in Africa. So maybe even if it's not direct, there is there ripple effects from that that could could help this as well.
Yeah, and we've heard Bill Gates in particular be quite outspoken and critical about some of these cuts that have been made in the US and how they're contributing potentially could contribute to setbacks in progress on some of these health fights, Jannis, When we think about some of the breakthroughs that we had, we talked about twenty thirty a goal that we had wanted for HIV AIDS to no
longer be a public health threat. Are there any treatments or prevention that had previously been progressing potentially that could still make some headway even throughout all of these turbulent times.
Absolutely. One of the concerns with these funding cuts, specifically in South Africa, is that it's going to hit research funding. And South Africa has for decades been a medical research powerhouse, and we're now hearing of HIV researchers having to tell long time workers that the money's gone and so their jobs and that's rough effect is going to be significant. But that all being said, one of the areas where
there is still a lot of hope. We recently saw an HIV prevention injection that's got one hundred percent efficacy being improved by the FDA, So lenar Kapevera is twice yearly injection, and that goal that twenty to thirty goal that we were talking about earlier factored in this because it's been in development for some time. The big issue with this is that the US company that makes it has set its price at about twenty five thousand US dollars per person per year. Wow, and that is not
something that most of Africa could afford. When he was talking about having spoken to researchers at Liverpool University that said that they've estimated that this drug could be rolled out at a cost of forty dollars per person per year, and then within a year, as that market expanded for the drug, that could come down to twenty five dollars per per year. If that pricing issue could be resolved,
then a kapaya is genuinely a game changer. And we're talking about the closest thing to vaccine that we've got for this disease. And if you are able to prevent its spreading in the first place, those new infection numbers are going to drop rapidly, etc. And that robber effect is significant. So there is hope, but there's certainly a
lot of work to still be done. And you know, while we look at the NGOs that have had to cut staff there are a number of incredibly dedicated people, aren't there, who even though they're not getting a salary, are still going out and still working with communities where they have built at trust and they are still doing the work. And there is a lot of people who it's personal for them and they do not want to see these programs fail. And so I think that there
are definitely soil the lightnings. That's going to be a tough job ahead.
Jennis. Thank you so much for joining us and for all of your reporting. As always, you can read all of our coverage on HIV AIDS across Bloomberg platforms now, including Michelle Hussein's interview with Winnie Biannima. Will post a link to that in the show notes. This program was produced by Adrian Bradley and tiwa Adebayo. Don't forget to follow and review this show wherever you usually get your podcasts. I'm Jennifer's Abasanja. Thanks as always for listening.