Speaker 1: Bloomberg Audio Studios, podcasts, radio news.
Speaker 2: US cuts to HIV funding has left the global response
Speaker 2: to HIV in crisis. That's the Morning from the UNAIDS
Speaker 2: Agency Executive Director Winni Bianima.
Speaker 3: Clinics have closed, prevention services have halted, people are losing
Speaker 3: access to life saving medicines. People are scared.
Speaker 2: Seventy five percent of people living with HIV are in Africa,
Speaker 2: and many saw twenty twenty five as a chance for
Speaker 2: a breakthrough year in tackling the disease, hopes that now
Speaker 2: seem in tatters.
Speaker 3: A Republican government, President Bush came out at the time
Speaker 3: of the worst crisis pandemic of the century and put
Speaker 3: down a program to save lives right now. There are
Speaker 3: tools that could make us come to the end of
Speaker 3: this pandemic. I say to President Trump, you're a man
Speaker 3: who likes to do a deal. Here's a deal.
Speaker 2: On today's podcast, we're looking at the state of the
Speaker 2: global HIV response in the wake of US funding cuts,
Speaker 2: and whether South Africa's leadership of the Global Fund will
Speaker 2: find the donors needed to get the work moving again.
Speaker 2: I'm Jennifer's Abasajob and this is the next Africa podcast
Speaker 2: bringing you one story each week from the continent driving
Speaker 2: the future of global growth with the context only Bloomberg
Speaker 2: can provide. Well, here to help us break down that
Speaker 2: really fascinating Bloomberg Weekend Interview. I'm joined by our healthcare
Speaker 2: reporter here in Johannesburg, Jennis Q. Jennis, thanks so much
Speaker 2: for being with us.
Speaker 1: Thank you. I wish that we would chat under happier circumstances.
Speaker 1: We seem to always come in with pretty dire stories,
Speaker 1: but they are important.
Speaker 2: Yeah, and it's been actually quite a while since we've
Speaker 2: had you on the podcast to speak about healthcare in
Speaker 2: the region, So you know, let's talk about this latest
Speaker 2: story we heard from Winnie b a Yuma, who painted
Speaker 2: quite a bleak picture of the state of the global
Speaker 2: fight against HIV. Can you give us some context as
Speaker 2: to how serious things have gotten over the past few months.
Speaker 1: In some African countries, it is dire where people aren't
Speaker 1: able to get the anti retrovirals at all. In most cases,
Speaker 1: these medications need to be taken daily, so disruption and
Speaker 1: supply translates into a critical situation, not least because a
Speaker 1: person that's newly infected with HIV is highly infectious, especially
Speaker 1: during the first few weeks off to infection, there's acute phase.
Speaker 1: The viral load or the amount of HIV in the
Speaker 1: blood is very high, and so it significantly increases the
Speaker 1: risk of transmission. For example, if a pregnant woman acquires
Speaker 1: the disease or the virus, especially in your last trimester,
Speaker 1: the chances of the child being born with HIV increases significantly.
Speaker 1: And while made can be taken to keep it under control,
Speaker 1: it is an incurable disease, so you can live long
Speaker 1: with HIV if you've got the medication. But the point
Speaker 1: is that a child who's born HIV positive has to
Speaker 1: be on meds for life, and that has both physical
Speaker 1: and financial costs.
Speaker 2: And when we think about the cuts and the cuts
Speaker 2: to some of these services, how has that affected what
Speaker 2: is already a dire situation in the region.
Speaker 1: In many places, it's meant that clinic doors have been closed.
Speaker 1: In South Africa, though, which is unlike many other countries
Speaker 1: on the continents, the government provides the ravs, so in
Speaker 1: some ways the impact has been a little less harsh here.
Speaker 1: That's still not to say it isn't significance In South Africa.
Speaker 1: Many of the NGOs have had to severely scale back.
Speaker 1: I spoke with the national chairwoman of the Treatment Action Campaign,
Speaker 1: a South African nonprofit that lost eighty eight percent of
Speaker 1: its staff after the US funding was halted at the
Speaker 1: end of February. She described how are their mobile clinics
Speaker 1: and the work that they were doing specifically with sex
Speaker 1: workers has effectively ended, and how with our regular drugs
Speaker 1: everything gets bad pretty quickly. Even in South Africa, it's
Speaker 1: hard to cater for what we call key populations. These
Speaker 1: are migrants, men who have sex with men, sex workers,
Speaker 1: and drug users. And as Mitchell Warren, who is the
Speaker 1: executive director of the New York based Global HIV Prevention
Speaker 1: Advocacy Group AVAC, he says, you know, governments are not
Speaker 1: great at dealing with some of these issues of sexuality
Speaker 1: and HIV AIDS programs don't have on off switches. They
Speaker 1: take time, and those relationships take time, and it's easy
Speaker 1: to break something down, but it's really hard to build
Speaker 1: something up.
Speaker 2: And even prior to these cuts there, I mean, this
Speaker 2: has been something that many health advocates for years had
Speaker 2: tried to bring down at least the statistics for decades,
Speaker 2: and you know, so that there had been plans to
Speaker 2: hold HIV as a public health crisis by twenty thirty.
Speaker 2: Was that within reach prior to these cuts? And I
Speaker 2: wonder with some of the other advocates that you speak to,
Speaker 2: do they think potentially we've pushed out the goalposts essentially
Speaker 2: on achieving that even further.
Speaker 1: Absolutely, a small amount of foreign aid means that plan
Speaker 1: in the disease is a public cult threat by twenty
Speaker 1: thirty is only going to get more off track, Willdn't
Speaker 1: it be? A NEMO said as much in a recent
Speaker 1: press conference here in South Africa, and it was going
Speaker 1: to be a challenge twenty thirties only five years away,
Speaker 1: but it definitely makes it a whole lot more challenging.
Speaker 2: And Jennie, what does that look like on a day
Speaker 2: to day basis You're somebody who's been covering this for
Speaker 2: quite some time. What is the current situation on the ground.
Speaker 1: So certainly here in South Africa we've got the government's
Speaker 1: being resolute that it's not going to know these cuts,
Speaker 1: aren't going to sync their HIV programs, and they are
Speaker 1: taking steps to move files from that were at you know,
Speaker 1: various clinics run by NGO's move them into the public
Speaker 1: sector hospitals. But it's not an easy thing to do.
Speaker 1: It's not a smooth transition. And then, as I was
Speaker 1: talking about those key populations a little earlier, many of
Speaker 1: them are not likely to be able to go to
Speaker 1: public clinics. They migrants need the correct paperwork to be
Speaker 1: attended to. Sex workers. You know, if you've worked the
Speaker 1: whole night and now you've got to line up and
Speaker 1: a queue at a public hospital before seven o'clock in
Speaker 1: the morning, and you know that that's going to be challenging.
Speaker 1: But then there's also going to be a lot of
Speaker 1: staff training and how to treat people more sensitively. On
Speaker 1: top of that, if you feel that you're going to
Speaker 1: be questioned, your life choices are going to be questioned,
Speaker 1: you're probably not going to be open and honest with
Speaker 1: a healthcare provider, and that means that you're probably not
Speaker 1: going to get targeted treatments and the correct kind of interventions.
Speaker 1: In the rest of Africa, we've seen even worse situations
Speaker 1: where because the Arabs are simply not available. We've even
Speaker 1: had some impact in South Africa because of neighboring countries
Speaker 1: that have shortages of the Arabs. Where a lot of
Speaker 1: the action campaigns had spent years making sure that people
Speaker 1: could gets six or more months supply of arabs at
Speaker 1: a time. This was important because for many people to
Speaker 1: not just the time out of their job or their
Speaker 1: day to get the arabs, but it's the transport costs, etc.
Speaker 1: And so we'd moved in South Africa to a situation
Speaker 1: where people were able to get six months or more medication,
Speaker 1: and that has been rolled back in South Africa because
Speaker 1: of concerns that people will get the medication and then
Speaker 1: set it over the border to people who desperate because
Speaker 1: they just have no access at all.
Speaker 2: And Janna is stick with us. When we come back,
Speaker 2: we'll look at the efforts to try and find new
Speaker 2: sources of funding, including the role that the South African
Speaker 2: government will potentially be playing. We'll be right back. Welcome back. Today.
Speaker 2: We're looking at the state of global efforts to tackle
Speaker 2: HIV after the executive director of unaid's declared that it
Speaker 2: was in crisis. Our healthcare reporter Janis q is still
Speaker 2: with us now. Jana, so South African Presidents Zoo Ramaposa
Speaker 2: has decided to take on the responsibility to try and
Speaker 2: rebuild the global Fund to fight HIV. We were just
Speaker 2: talking about some of the challenges though that this fight
Speaker 2: already faces. How difficult of a task is he facing
Speaker 2: though in terms of the funding our position.
Speaker 1: From a POSA has a lot of respects globally and
Speaker 1: is a very diplomatic man, but it is going to
Speaker 1: be incredibly difficult. The Global Fund, which is an independent
Speaker 1: partnership whose money mainly comes from public sector donors, plans
Speaker 1: to raise at least eighteen billion dollars at IT as
Speaker 1: it launches its twenty twenty six to twenty twenty eight
Speaker 1: fundraising cycle, and success of the exercise will be crucial
Speaker 1: for expanding efforts to combat HIV and TB and malaria.
Speaker 1: But it fell short already in its most recent efforts
Speaker 1: a couple of years ago, and so you know, if
Speaker 1: it was already falling short, then it makes it an
Speaker 1: especially tall order.
Speaker 2: Now where can Ramaposa even look though for this funding?
Speaker 2: If the US in fact is going to continue to
Speaker 2: pull back on funding and contribute to aid, are there
Speaker 2: other countries that are then stepping up and saying they
Speaker 2: will contribute at least in regards to health and HIV
Speaker 2: in the fight against it?
Speaker 1: We have a very good relationship with China in South Africa,
Speaker 1: and there is a possibility that they could step in.
Speaker 1: I would like to believe that presented in the right way,
Speaker 1: it may be seen in the US as something that's
Speaker 1: worth considering still, and then there is a chance of
Speaker 1: other African governments perhaps stepping in somewhat or be it
Speaker 1: many have no regal room because there's also an urgent
Speaker 1: need to restructure their debt to cut debt service costs.
Speaker 1: Many African countries have debt service costs that are many
Speaker 1: times larger than their entire healthcare budget, so that is
Speaker 1: a real challenge. While not in the public sector, we've
Speaker 1: seen the Gates Foundations say that it plans to give
Speaker 1: away two hundred billion dollars over the next twenty years
Speaker 1: before shutting down entirely in twenty forty five, and that
Speaker 1: target represents a doubling and spending for that nonprofit, and
Speaker 1: they have said that much of that will be focused
Speaker 1: in Africa. So maybe even if it's not direct, there
Speaker 1: is there ripple effects from that that could could help
Speaker 1: this as well.
Speaker 2: Yeah, and we've heard Bill Gates in particular be quite
Speaker 2: outspoken and critical about some of these cuts that have
Speaker 2: been made in the US and how they're contributing potentially
Speaker 2: could contribute to setbacks in progress on some of these
Speaker 2: health fights, Jannis, When we think about some of the
Speaker 2: breakthroughs that we had, we talked about twenty thirty a
Speaker 2: goal that we had wanted for HIV AIDS to no
Speaker 2: longer be a public health threat. Are there any treatments
Speaker 2: or prevention that had previously been progressing potentially that could
Speaker 2: still make some headway even throughout all of these turbulent times.
Speaker 1: Absolutely. One of the concerns with these funding cuts, specifically
Speaker 1: in South Africa, is that it's going to hit research funding.
Speaker 1: And South Africa has for decades been a medical research powerhouse,
Speaker 1: and we're now hearing of HIV researchers having to tell
Speaker 1: long time workers that the money's gone and so their
Speaker 1: jobs and that's rough effect is going to be significant.
Speaker 1: But that all being said, one of the areas where
Speaker 1: there is still a lot of hope. We recently saw
Speaker 1: an HIV prevention injection that's got one hundred percent efficacy
Speaker 1: being improved by the FDA, So lenar Kapevera is twice
Speaker 1: yearly injection, and that goal that twenty to thirty goal
Speaker 1: that we were talking about earlier factored in this because
Speaker 1: it's been in development for some time. The big issue
Speaker 1: with this is that the US company that makes it
Speaker 1: has set its price at about twenty five thousand US
Speaker 1: dollars per person per year. Wow, and that is not
Speaker 1: something that most of Africa could afford. When he was
Speaker 1: talking about having spoken to researchers at Liverpool University that
Speaker 1: said that they've estimated that this drug could be rolled
Speaker 1: out at a cost of forty dollars per person per year,
Speaker 1: and then within a year, as that market expanded for
Speaker 1: the drug, that could come down to twenty five dollars
Speaker 1: per per year. If that pricing issue could be resolved,
Speaker 1: then a kapaya is genuinely a game changer. And we're
Speaker 1: talking about the closest thing to vaccine that we've got
Speaker 1: for this disease. And if you are able to prevent
Speaker 1: its spreading in the first place, those new infection numbers
Speaker 1: are going to drop rapidly, etc. And that robber effect
Speaker 1: is significant. So there is hope, but there's certainly a
Speaker 1: lot of work to still be done. And you know,
Speaker 1: while we look at the NGOs that have had to
Speaker 1: cut staff there are a number of incredibly dedicated people,
Speaker 1: aren't there, who even though they're not getting a salary,
Speaker 1: are still going out and still working with communities where
Speaker 1: they have built at trust and they are still doing
Speaker 1: the work. And there is a lot of people who
Speaker 1: it's personal for them and they do not want to
Speaker 1: see these programs fail. And so I think that there
Speaker 1: are definitely soil the lightnings. That's going to be a
Speaker 1: tough job ahead.
Speaker 2: Jennis. Thank you so much for joining us and for
Speaker 2: all of your reporting. As always, you can read all
Speaker 2: of our coverage on HIV AIDS across Bloomberg platforms now,
Speaker 2: including Michelle Hussein's interview with Winnie Biannima. Will post a
Speaker 2: link to that in the show notes. This program was
Speaker 2: produced by Adrian Bradley and tiwa Adebayo. Don't forget to
Speaker 2: follow and review this show wherever you usually get your podcasts.
Speaker 2: I'm Jennifer's Abasanja. Thanks as always for listening.