AIDS Still Kills Over 1 Million People Each Year. Are Funders Doing Enough?

We’re decades into the fight against HIV/AIDS, and funders are getting tired—and maybe even a little bit bored. In recent years, funding has all but flatlined. This is unfortunate, because for the most part, HIV/AIDS remains epidemic the world over. Last year, 1.2 million people died from AIDS. Another 37 million were living with HIV. Numbers like that suggest that this isn't the moment for funders to be easing up on the grants. 

The news isn’t all bad, thankfully. While funding levels are still down overall, the past couple of years have shown a slight uptick, thanks to private donor dollars.

A recent report released by Funders Concerned about AIDS (FCAA) studied the global private funding for HIV and found that the recent increase was largely attributed to the philanthropic efforts of the Gates Foundation and Gilead Sciences. Other leaders here include M.A.C. AIDS Fund, Wellcome Trust, and the Ford Foundation. Any increases in HIV/AIDS funding is good news, but the FCAA study uncovered a few interesting trends while also revealing some significant—and scary—gaps in this space.

A race to find a cure is and will likely always be the ultimate goal for many top HIV/AIDS funders. AmfAR launched a $100 million initiative toward those ends and Gates is no stranger to funding innovative research in this field.

In the same regard, better and more affordable HIV treatments is often a top priority for donors as well because it plays a vital role in tipping the scales in favor of ending AIDS. According to ONE, that tipping point will only be reached when people receiving treatment outnumber those receiving a new HIV diagnosis.

The world is getting close, ONE says, with some 1.9 million placed on antiretroviral treatments in 2014 compared to 2 million newly diagnosed HIV cases that same year. Unfortunately, those numbers were better in 2013, when the number of people receiving treatment exceeded the number of new HIV cases.

The FCAA study found that around 43 percent of total funding ($262 million) went toward the support projects and programs with a global reach. Meaning, these grant dollars were not country- or demographic-specific. That said, when FCAA broke down that total grant amount, the top recipient country was the United States.

While the report notes that the rise in private funding from 2013 to 2014 was directed to the U.S. HIV/AIDS epidemic, this is a bit misleading, as the report also indicates that most of that money went toward research work. This makes sense, considering that Gates and Gilead are in the lead, here. The United States is among the world’s leaders in HIV/AIDS funding and research and both Gates and Gilead place a heavy emphasis on research, both in finding better treatments and discovering a cure, and increasing access to affordable treatment.

Coming in behind the U.S. as a top regional recipient of private donor dollars for HIV/AIDS were East and Southern Africa. Again, no surprises, here, as both regions are the most highly affected by HIV/AIDS in the world.

Meanwhile, according the report, over 80 percent of that increase in private donor dollars dedicated to HIV/AIDS went to high- and middle-income countries—half of that going to the former. Again, this makes sense as Gates and Gilead are leading the funding charge and given both organization’s proclivities toward funding research.

The argument can be made that the beneficiary of that main chunk of funding is the global population at large, so no region or population is left untouched. However, a strong argument can also be made that low- and middle-income countries—regions of the world with the highest HIV/AIDS burdens—are all but ignored here.

More specifically, the FCAA’s report shines a spotlight on some very real, very serious, and seemingly widening funding gaps when it comes to particular populations that are disproportionately affected by HIV/AIDS.  

Here’s a quick breakdown: 11 percent of funding was devoted to women; nearly 9 percent was dedicated to youth populations; and around seven to 8 percent of that increase in HIV/AIDS funding dollars went to disadvantaged populations and women/mothers with babies.

Now for some key statistics

  • Women represent around 50 percent of all adults living with HIV.
  • Young people ages 15 to 24 account for around 30 percent of new HIV infections
  • Nearly 90 percent of children in the world with HIV live in sub-Saharan Africa
  • Young women account for over 60 percent of all young people living with HIV in sub-Saharan Africa  

While the slight increase in HIV/AIDS funding from private donors good news, with only around one-third of those funds devoted to populations that demonstrate the most need, the news isn’t all good. And an 8 percent increase isn’t likely to bend the mortality curve here—certainly not in low- and middle income countries. According to UNAIDS, that will take an increase of at least 76 percent in global HIV/AIDS investments between 2014 and 2020.

That’s looking like an unsurmountable jump, at least in the U.S., where an estimated $0.71 out of every $100 awarded by U.S.-based charities and foundations are allocated to HIV.

The HIV/AIDS news isn’t all doom and gloom, here. Overall, viable treatment options have improved, access to treatment has increased globally, and the number of children under five dying from HIV has decreased.

That being said, the rate of new HIV infections isn’t falling fast enough, threatening to knock back the progress made over past decades by a significant number of paces. So far back, in fact, that according to UNAIDS and Lancet Commission report, if funding for HIV/AIDS and access to treatment isn’t increased, the world may bear witness to a dramatic and deadly rebound of the HIV epidemic.