Britain is to commit £1.5 billion over the next three years to fighting AIDS, Prime Minister Tony Blair announced today, of which £150 million will be spent on supporting orphans.
In a new international HIV strategy launched today, the UK government highlights the gap between the UNAIDS estimate of what is needed in 2005 (£6.6 billion) and the amount spent in 2003 (£2.6 billion).
The United Kingdom will also double its commitment to the Global Fund to Fight AIDS, TB and Malaria to £150 million over three years and will make AIDS a centrepiece of its presidencies of the European Union and the G8 in 2005. In particular the UK government will push for clear commitments from EU and G8 governments for higher levels of financial support for efforts to stem the progress of the epidemic.
A spokesman for the UK-based International HIV/AIDS Alliance told aidsmap.com: “This marks a tremendous leap forward in the UK Government’s commitment to the global response to the HIV/AIDS epidemic. We whole-heartedly welcome this announcement, particularly the commitment to work with the most marginalised people in society, whose rights are often abused or neglected.”
Peter Piot, Executive Director of UNAIDS said: “The strategy reinforces the United Kingdom's position as a pre-eminent global AIDS funder. UNAIDS also applauds the strategy’s strong focus on women, young people and orphans; often the most vulnerable groups. The UK is once again showing the importance of directed and informed leadership.”
Although the US remains the largest AIDS-related donor in cash terms, the UK is now the largest donor in terms of spending as a proportion of national income.
Commitment to treatment
The new strategy ends any doubts about the willingness of the UK government to support treatment. Under International Development secretary Clare Short, the UK government was notoriously sceptical about spending money on HIV drugs. A new UK policy on HIV treatment and care states: “The UK supports efforts to provide increased and eventually universal access to treatment and care.”
Furthermore the UK government wants to see its money used to ensure that women and children have equal access to treatment, partly in order to prevent or delay children becoming orphans.
Differences with US out in the open
The document also contains an implicit critique of US approaches to treatment scale up, emphasising the importance of programmes which build health system capacity and which respect the domestic priorities of national governments rather than donors.
“The UK is committed to strengthening health services as part of longer term development objectives and will not support `vertical` or `parallel` programmes whereby HIV and AIDS treatment and care programmes are developed separate to national health services”, the document states.
According to a New York Times report last week, governments in Mozambique and Zambia have struggled with the US approach, which they say pays little attention to the long-term development of the health care system and involves too much decision making from Washington.
The British government is now being more open in its criticisms of the US approach to AIDS after more than a year of behind the scenes wrangling with the US.
In remarks to a reception for British NGOs at last week’s International AIDS Conference in Bangkok, Parliamentary Undersecretary of State for International Development Gareth Thomas MP told delegates that the UK would step up funding for condom distribution (the UK already funds around half the condoms distributed in the developing world), supports the use of generic antiretrovirals and wants to see more money go to the Global Fund. All these policies are in direct opposition to recent US policy pronouncements and leave the US more isolated than ever in the global fight against AIDS.
The US will face increasing pressure from multilateral institutions like UNAIDS and donor countries like the UK to fall ito line with an approach known as the Three Ones: one national AIDS programme, one national coordinating body and one system for monitoring and evaluation. At last week's International AIDS Conference there were frequent complaints from speakers of the difficulties being caused on the ground by competing donor priorities and lack of coordination.
Further information
Taking Action - the UK's strategy for tackling HIV and AIDS in the developing world (direct link to 1.31Mb PDF file)
DFID's HIV and AIDS treatment and care policy(direct link to 369kb PDF file)