A New G8 Opportunity on Aids
By John H. Tedstrom
As the 25th anniversary of the start of the AIDS epidemic takes place this summer, we will look back on a world forever changed. AIDS has shaken the foundations of nations and shaped the history of our generation. Nearly 40 million people are living with HIV/AIDS; 25 million have lost their battles.
The word coming out of the United Nation’s recent high-level meeting on AIDS is one of cautious optimism. Indeed, in a handful of African and Caribbean countries the HIV prevalence rate seems to be tapering off, at least for now. But focus on these early signs of hope should not lead to complacency. Africa and other regions are still under siege by HIV. New pockets of HIV are emerging in the United States and other wealthy countries.
Perhaps most worrisome is the simmering HIV epidemic in Eurasia and the slowness of the international community to address it. Russia, China and India, critical regional players in energy, trade and security, with shared borders and promising economic futures, not to mention 40 percent of the world’s population, are facing generalized epidemics in a few short years unless their governments and the international community take a more strategic stance and allocate the necessary resources.
In July, Russia will host G8 leaders in St. Petersburg for their annual Summit. The G8 should use this year’s summit to put the AIDS epidemic in Eurasia on its strategic agenda and commit the necessary resources to avert catastrophe. The G8 can add Eurasia without diverting attention or resources to the hardest-hit regions, which must remain priorities.
The threat from AIDS in Eurasia is clear: In China, over 800,000 people are living with HIV/AIDS. In Russia, despite the fact that it reports 338,000 officially registered cases, the number is at least one million. In India, over 5 million people are HIV-positive. Adult prevalence rates for both Russia and India are already at or above 1 percent, and growing. UNAIDS reports prevalence rates of 1 percent or more among unmarried young Chinese.
In all three countries, HIV is spreading beyond its initial concentration in high-risk groups including, especially, intravenous drug users and sex-trade workers. International experts put the number of sexual transmissions in China at over half. The same is true for many Russian regions. Heterosexual transmission accounts for over 80 percent of new infections in India.
All three countries face complex challenges from pockets of poverty, trafficking in narcotics and people that fuel the spread of HIV. And in all three countries the connection between Tuberculosis and HIV is a serious and growing challenge.
The potential for HIV to spin out of control in these circumstances is real. Left unchecked, generalized epidemics in Russia, China and India would quickly add several million HIV-positive people to today’s total, overwhelming national HIV programs and international support systems.
Governments in all three countries have led important improvements in HIV policy in the past few years. All three countries have increased their budgets for HIV significantly, and all three countries implement programs financed by the Global Fund and other donors. Global Fund grants approved for all three countries total over $630 million. But that is far from enough funding even for today, not to mention tomorrow.
On Thursday, the State Duma, together with the British House of Commons and Transatlantic Partners Against AIDS, is convening parliamentarians and officials from the Group of Eight countries, China and India to examine both the threat posed by Eurasia’s emerging HIV epidemics and opportunities to cut it off. This meeting presents a historic opportunity for the G8 and its Eurasian partners to tackle a number of issues of strategic importance:
n Building a sustainable financial base: While the generous investments of wealthy countries to the Global Fund are of historic proportions, the Fund’s sixth round needs to be funded fully soon. The Fund and other donors should act more proactively with regard to Eurasia. Recent increases in AIDS funding from Russian, Chinese and Indian government budgets should grow at least as fast as international contributions going forward. If we are to achieve the goal of universal access, increased funding — at national and international levels — is non-negotiable.
n Strengthen public-private partnerships: The business community has demonstrated its tremendous capacity to fight AIDS around the world through education and prevention programs, media campaigns, support for NGOs and donations of life-saving medicines. In Russia, China and India the new generations of business leaders are just getting started and should be encouraged to do more.
n Enhance scientific collaboration: At the G8 Summit, Russia will announce important new research initiatives on HIV, including an international vaccine lab. Indian and Chinese scientists have a great deal to offer in this regard and should be brought more fully into the international research community.
n Ensuring supplies and access to treatment: Russia, China and India will all be major consumers of ARV treatments in the coming years. China and India have recognized production capacities. The place of these three countries in the global market will only grow and become more complex. They should be engaged now in a broader international policy dialogue to ensure adequate and reliable flows of medications.
Only the G8 has the political capacity and resource base to deal with challenges of this magnitude. With leadership from Russia in St. Petersburg and the partnership of China and India, the G8 can add to its positive legacy on HIV/AIDS. Let us hope the G8 seizes the opportunity.
John E. Tedstrom is president and founder of Transatlantic Partners Against AIDS. He served as director for Russian, Ukrainian and Eurasian Affairs at the U.S. National Security Council for former-President Bill Clinton.