Crisis set to hit treatment for 1.7m with HIV

Life-saving drug treatment for up to 1.7m people with HIV is under threat because of funding pressures triggered by the global financial crisis, according to an analysis released yesterday by the World Bank.

A survey of the impact of the economic downturn on 69 of the globe's poorest countries showed that 15 believed they were "highly exposed" to the risk of interrupting anti-retroviral medicines from declines in external and domestic funding.

The findings highlight the danger to human lives and of drug resistance following the rapid expansion in HIV treatment to 3.4m people round the world since the start of the decade.

They add to recent warnings from the World Bank that health, education and other social services will come under severe pressure, with a study from previous financial crises suggesting 200,000 to 400,000 additional children under five could die each year as a result of budget cuts.

Joy Phumaphi, the World Bank's vice-president for human development and the former health minister of Botswana, said: "This new report shows that people with Aids could be in danger of losing their place in the lifeboat. The global economic downturn has taken a wrecking ball to growth and development in the developing world."

With a reluctance by governments to stop treatment of those already being treated, the data suggest that prevention programmes and other policies designed to limit the continuing fast spread of the disease could suffer even more.

Thirty-four countries, representing three-quarters of those people living with HIV, said they expected HIV prevention programmes for those most at risk of infection to be negatively affected.

Jon Liden, of the Global Fund to fight Aids, TB and Malaria, said: "Everybody knew that once started, a continuous supply of commodities was a lifelong pledge. We are talking about a set of global commitments that the world cannot run away from."

He said that the fund had commitments from its government donors at least until 2011-12, although there were signs of a possible squeeze for its latest, ninth round of requests.

He said the fund might be willing to consider more rapid additional funding support to countries that requested help to fill short-term budget crises in order to maintain health spending.

However, he stressed that no such requests had yet been made, and that the fund would not be prepared to countenance any extra support if the money it provided allowed countries to divert their own domestic spending to such non-health activities as defence.

The World Bank said requests for its funds from developing countries identified for its current financial year had trebled from 12 months before, in a sign of efforts to stave off the effects of the downturn. Until the end of its financial year on June 30, it anticipated authorising $3.1bn (€2.3bn, £2.1bn), compared with $1bn in the same period last year.