UK government issues global HIV spending statement

The United Kingdom government has issued a new policy statement on global  HIV spending, saying it will target HIV funding up to 2015 towards prevention, with its main focus on countries with a high burden of HIV in southern Africa.

The Department for International Development statement also promises continued support for the scale-up of access to diagnosis, treatment, care and support, chiefly through the Global Fund to Fight AIDS, Tuberculosis and Malaria.

The position paper emphasises the UK commitment to reducing rates of infection among women and girls, who are disproportionately affected by HIV in sub-Saharan Africa. DFID says it will work towards reducing new infections by 500,000 among women and key populations in at least six countries by 2015.

UK support will also be targeted towards prevention of mother to child HIV transmission, intensified action to improve rates of case detection for tuberculosis in people with HIV infection and improved completion rates for TB treatment in people with HIV. Tackling tuberculosis is much more strongly emphasised in the new UK position paper than in previous DFID policy statements on HIV.

DFID says that its responses to HIV are grounded in the principles of `know your epidemic` and `know your response`. It wants to see a greater emphasis on scaling up interventions that are known to work, and which match the local profile of the epidemic. DFID says it is “concerned by the lack of progress in developing effective prevention programmes, particularly in achieving and sustaining behaviour change by vulnerable groups”, but makes no promises about funding for prevention research.

On treatment, the position paper admits a global failure to reach the target for universal access to prevention, treatment and care by 2010, but says that the UK remains committed to the goal of universal access.

The UK will increase its funding to the Global Fund to Fight AIDS, Tuberculosis and Malaria, but the sum it will give will not be announced until later in 2011. The UK gives a high rating to the efficiency of the Global Fund, and will continue to channel most of its funding for HIV and TB treatment through the fund. But DFID says it wants to see the Fund support more prevention work.

DFID says its support to the Global Fund between now and 2015 will support treatment for 268,000 people at current prices, and it hopes that funding the work of the Clinton Health Access Initiative to drive down the costs of antiretroviral drugs will allow an extra 500,000 people to be treated by 2015.

DFID will also continue to support UNITAID, the international drug purchase fund, and will press pharmaceutical companies to support the Medicines Patent Pool, which is designed to produce cheap and innovative drug combinations for HIV treatment.

Bilateral funding will focus on Burma, Cambodia, Democratic Republic of Congo, India, Kenya, Malawi, Mozambique, Nepal, Nigeria, South Africa, Uganda, Vietnam, Zambia, Zimbabwe, and on regional programmes in Africa, Central Asia and the Caribbean.

The United Kingdom governments says it will also continue to advocate at national and international level for the needs of vulnerable populations, particularly those neglected by national responses, such as injecting drug users, men who have sex with men, sex workers and prisoners.

At country and regional level the UK will fund scale-up of harm reduction in Central Asia, services for vulnerable populations in the Caribbean.

The position paper does not mark a significant departure from commitments made in a 2008 policy statement under the previous Labour government, but does contain more explicit targets for the results UK spending is intended to achieve.