Episode Transcript
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Speaker 1 (00:02):
Bloomberg Audio Studios, podcasts, radio news.
Speaker 2 (00:09):
US cuts to HIV funding has left the global response
to HIV in crisis. That's the Morning from the UNAIDS
Agency Executive Director Winni Bianima.
Speaker 3 (00:19):
Clinics have closed, prevention services have halted, people are losing
access to life saving medicines. People are scared.
Speaker 2 (00:29):
Seventy five percent of people living with HIV are in Africa,
and many saw twenty twenty five as a chance for
a breakthrough year in tackling the disease, hopes that now
seem in tatters.
Speaker 3 (00:41):
A Republican government, President Bush came out at the time
of the worst crisis pandemic of the century and put
down a program to save lives right now. There are
tools that could make us come to the end of
this pandemic. I say to President Trump, you're a man
(01:03):
who likes to do a deal.
Speaker 4 (01:04):
Here's a deal.
Speaker 2 (01:06):
On today's podcast, we're looking at the state of the
global HIV response in the wake of US funding cuts,
and whether South Africa's leadership of the Global Fund will
find the donors needed to get the work moving again.
I'm Jennifer's Abasajob and this is the next Africa podcast
bringing you one story each week from the continent driving
(01:28):
the future of global growth with the context only Bloomberg
can provide. Well, here to help us break down that
really fascinating Bloomberg Weekend Interview. I'm joined by our healthcare
reporter here in Johannesburg, Jennis Q. Jennis, thanks so much
for being with us.
Speaker 4 (01:46):
Thank you.
Speaker 1 (01:47):
I wish that we would chat under happier circumstances. We
seem to always come in with pretty dire stories, but
they are important.
Speaker 2 (01:55):
Yeah, and it's been actually quite a while since we've
had you on the podcast to speak about healthcare in
the region, So you know, let's talk about this latest
story we heard from Winnie b a Yuma, who painted
quite a bleak picture of the state of the global
fight against HIV. Can you give us some context as
to how serious things have gotten over the past few months.
Speaker 1 (02:19):
In some African countries, it is dire where people aren't
able to get the anti retravirals at all. In most cases,
these medications need to be taken daily, so disruption and
supply translates into a critical situation, not least because a
person that's newly infected with HIV is highly infectious, especially
during the first few weeks off to infection.
Speaker 4 (02:40):
This acute phase, the viral load or.
Speaker 1 (02:42):
The amount of HIV in the blood is very high,
and so it significantly increases the risk of transmission.
Speaker 4 (02:48):
For example, if.
Speaker 1 (02:49):
A pregnant woman acquires the disease or the virus, especially
in your last trimester, the chances of the child being
born with HIV increases significantly. And while made can be
taken to keep it under control, it is an incurable disease,
so you can live long with HIV if you've got
the medication. But the point is that a child who's
(03:11):
born HIV positive has to be on meds for life,
and that has both physical and financial costs.
Speaker 2 (03:18):
And when we think about the cuts and the cuts
to some of these services, how has that affected what
is already a dire situation in the region.
Speaker 1 (03:28):
In many places, it's meant that clinic doors have been closed.
In South Africa, though, which is unlike many other countries
on the continents, the government provides the ravs, so in
some ways the impact has been a little less harsh here.
That's still not to say it isn't significance. In South Africa.
Many of the NGOs have had to severely scale back.
(03:48):
I spoke with the national chairwoman of the Treatment Action Campaign,
a South African nonprofit that lost eighty eight percent of
its staff after the US funding was halted at the
end of February. She described how are their mobile clinics
and the work that they were doing specifically with sex
workers has effectively ended, and how with our regular drugs
everything gets bad pretty quickly. Even in South Africa, it's
(04:12):
hard to cater for what we call key populations. These
are migrants, men who have sex with men, sex workers,
and drug users. And as Mitchell Warren, who is the
executive director of the New York based Global HIV Prevention
Advocacy Group AVAC, he says, you know, governments are not
great at dealing with some of these issues of sexuality
(04:35):
and HIV AIDS.
Speaker 4 (04:36):
Programs don't have on off switches.
Speaker 1 (04:38):
They take time, and those relationships take time, and it's
easy to break something down, but it's really hard to
build something up.
Speaker 2 (04:46):
And even prior to these cuts there, I mean, this
has been something that many health advocates for years had
tried to bring down at least the statistics for decades,
and you know, so that there had been plans to
hold HIV as a public health crisis by twenty thirty.
Was that within reach prior to these cuts? And I
(05:08):
wonder with some of the other advocates that you speak to,
do they think potentially we've pushed out the goalposts essentially
on achieving that even further.
Speaker 1 (05:18):
Absolutely, a small amount of foreign aid means that plan
in the disease as a public cult threat by twenty
thirty is only going to get more off track, wouldn't
it be? A NEMO said as much in a recent
press conference here in South Africa, and it was going
to be a challenge twenty thirties only five years away,
but it definitely makes it a whole lot more challenging.
Speaker 2 (05:42):
And Jennie, what does that look like on a day
to day basis? You're somebody who's been covering this for
quite some time. What is the current situation on the ground.
Speaker 1 (05:53):
So certainly here in South Africa we've got the government's
being resolute that it's not going to know these cuts,
aren't going to sync their HIV programs, and they are
taking steps to move files from that were at you know,
various clinics run by NGO's move them into the public
sector hospitals. But it's not an easy thing to do.
(06:15):
It's not a smooth transition. And then, as I was
talking about those key populations a little earlier, many of
them are not likely to be able to go to
public clinics. They migrants need the correct paperwork to be
attended to. Sex workers. You know, if you've worked the
whole night and now you've got to line up and
a queue at a public hospital before seven o'clock in
(06:37):
the morning, and you know that that's going to be challenging.
Speaker 4 (06:41):
But then there's also going to be a lot of staff.
Speaker 1 (06:43):
Training and how to treat people more sensitively. On top
of that, if you feel that you're going to be questioned,
your life choices are going to be questioned, you're probably
not going to be open and honest with a healthcare provider,
and that means that you're probably not going to get
targeted treatments and the correct kind of interventions. In the
(07:09):
rest of Africa, we've seen even worse situations where because
the Arabs are simply not available.
Speaker 4 (07:15):
We've even had.
Speaker 1 (07:17):
Some impact in South Africa because of neighboring countries that
have shortages of the Arabs, where a lot of the
action campaigns had spent years making sure that people could
gets six or more months supply of arabs at a time.
This was important because for many people to not just
(07:37):
the time out of their job or their day to
get the arabs, but it's the transport costs, etc. And
so we'd moved in South Africa to a situation where
people were able to get six months or more medication,
and that has been rolled back in South Africa because
of concerns that people will get the medication and then
send it over the border to people who desperate because
(07:59):
they just have no access at all.
Speaker 2 (08:02):
And Janna is stick with us. When we come back,
we'll look at the efforts to try and find new
sources of funding, including the role that the South African
government will potentially be playing. We'll be right back. Welcome back.
Speaker 4 (08:18):
Today.
Speaker 2 (08:18):
We're looking at the state of global efforts to tackle
HIV after the executive director of unaid's declared that it
was in crisis. Our healthcare reporter Janis q is still
with us now.
Speaker 4 (08:29):
Jana.
Speaker 2 (08:29):
South African Presidents Zoo A Ramaposa has decided to take
on the responsibility to try and rebuild the Global Fund
to fight HIV. We were just talking about some of
the challenges though that this fight already faces. How difficult
of a task is he facing though? In terms of
the funding our position.
Speaker 1 (08:48):
From a POSA has a lot of respects globally and
is a very diplomatic man, but it is going to
be incredibly difficult. The Global Fund, which is an independent
partnership whose money mainly comes from public sector donors, plans
to raise at least eighteen billion dollars at IT as
it launches its twenty twenty six to twenty twenty eight
(09:09):
fundraising cycle, and success of the exercise will be crucial
for expanding efforts to combat HIV and TB and malaria.
But it fell short already in its most recent efforts
a couple of years ago, and so you know, if
it was already falling short, then it makes it an
especially tall order.
Speaker 2 (09:29):
Now where can Ramaposa even even look though for this funding?
If the US in fact is going to continue to
pull back on funding and contribute to aid, are there
other countries that are then stepping up and saying they
will contribute at least in regards to health and HIV
in the fight against it?
Speaker 1 (09:50):
We have a very good relationship with China in South Africa,
and there is a possibility that they could step in.
Speaker 4 (09:58):
I would like to believe that presented.
Speaker 1 (10:02):
In the right way, it may be seen in the
US as something that's worth considering still, and then there
is a chance of other African governments perhaps stepping in
somewhat or be it.
Speaker 4 (10:14):
Many have no regal room because.
Speaker 1 (10:17):
There's also an urgent need to restructure their debt to
cut debt service costs. Many African countries have debt service
costs that are many times larger than their entire.
Speaker 4 (10:26):
Healthcare budget, so that is a real challenge.
Speaker 1 (10:29):
While not in the public sector, we've seen the Gates
Foundations say that it plans to give away two hundred
billion dollars over the next twenty years before shutting down
entirely in twenty forty five, and that target represents a
doubling and spending for that nonprofit, and they have said
that much of that will be focused in Africa.
Speaker 4 (10:47):
So maybe even.
Speaker 1 (10:49):
If it's not direct, there is the ripple effects from
that that could could help this as well.
Speaker 2 (10:55):
Yeah, and we've heard Bill Gates in particular be quite
outspoken and critical about some of these cuts that have
been made in the US, and how they're contributing potentially
could contribute to setbacks in progress on some of these
health fights, Jannis, When we think about some of the
breakthroughs that we had, we talked about twenty thirty a
(11:15):
goal that we had wanted for HIV AIDS to no
longer be a public health threat. Are there any treatments
or prevention that had previously been progressing potentially that could
still make some headway even throughout all of these turbulent times.
Speaker 4 (11:34):
Absolutely.
Speaker 1 (11:35):
One of the concerns with these funding cuts, specifically in
South Africa, is that it's going to hit research funding.
And South Africa has for decades been a medical research powerhouse,
and we're now hearing of HIV researchers having to tell
long time workers that the money's gone and so their
jobs and that's rough effect is going to be significant.
(11:57):
But that all being said, one of the areas where
there is still a lot of hope. We recently saw
an HIV prevention injection that's got one hundred percent efficacy
being improved by the FDA, So Lenard Kapevera is twice.
Speaker 4 (12:14):
Yearly injection, and that goal.
Speaker 1 (12:18):
That twenty to thirty goal that we were talking about
earlier factored in this because it's been in development for
some time. The big issue with this is that the
US company that makes it has set its price at
about twenty five thousand US dollars per person per year.
Speaker 4 (12:39):
Wow, and that is.
Speaker 1 (12:41):
Not something that most of Africa could afford. When he
was talking about having spoken to researchers at Liverpool University
that said that they've estimated that this drug could be
rolled out at a cost of forty dollars per person
per year, and then within a year, as that market
expanded for this drug, that could come down to twenty five.
Speaker 4 (13:02):
Dollars per per year.
Speaker 1 (13:05):
If that pricing issue could be resolved, then a Kapavea
is genuinely a game changer. And we're talking about the
closest thing to vaccine that we've got for this disease.
And if you are able to prevent its spreading in
the first place, those new infection numbers are going to
drop rapidly, etc. And that robber effect is significant. So
(13:26):
there is hope, but there's certainly a lot of work
to still be done. And you know, while we look
at the NGOs that have had to cut staff. There
are a number of incredibly dedicated people aren't there, who
even though they're not getting a salary, are still going
out and still working with communities where they have built
(13:49):
at trust and they are still doing the work. And
there is a lot of people who it's personal for
them and they do not want to see these programs fail.
And so I think that there are definitely soil the lightnings.
That's going to be a tough job ahead.
Speaker 4 (14:06):
Jennis.
Speaker 2 (14:07):
Thank you so much for joining us and for all
of your reporting. As always, you can read all of
our coverage on HIV AIDS across Bloomberg platforms now, including
Michelle Hussein's interview with Winnie Biannima will post a link
to that in the show notes. This program was produced
by Adrian Bradley and tiwa Adebayo. Don't forget to follow
(14:29):
and review this show wherever you usually get your podcasts.
I'm Jennifer's Abasanja. Thanks as always for listening.