Health

U.S. Funding Of HIV/AIDS Fight Overseas Carries Other Benefits

By Richard Knox

Published May 15, 2012 at 5:10 PM CDT

A mother and child wait to receive treatment at the HIV clinic in Nyagasambu, Rwanda, in Feb. 2008. The clinic was built by the Washington-based Elizabeth Glaser Pediatric AIDS Foundation with a grant from the PEPFAR program.

U.S. government spending to fight HIV/AIDS in developing countries is also preventing death from other diseases, a new study finds.

Some experts worry the billions of dollars the United States spends to treat people with HIV in poor countries may crowd out prevention and treatment of other illnesses.

But the findings of a study just published in JAMA, the Journal of the American Medical Association, suggest the opposite. The analysis indicates the President's Emergency Plan for AIDS Relief, or PEPFAR, has had substantial spillover benefits.

Stanford's Dr. Eran Bendavid, lead author of the study, says deaths from all causes dropped nearly 20 percent over five years in nine African countries where PEPFAR operates.

That works out to nearly three-quarters of a million lives saved. Many would have died from other diseases. Bendavid thinks that's because PEPFAR improved the general quality of health care.

In an editorial about the study, the University of Pennsylvania's Dr. Ezekiel J. Emanuel says the report "is welcome news in helping to document the even greater benefits of PEPFAR not only on HIV/AIDS but on overall mortality in countries." But, he writes, it's fair to ask: "Is PEPFAR worth it?"

From 2003 to 2008, $20.4 billion was poured into PEPFAR. And during the three years that ended in 2011, more than $20 billion more has been given to PEPFAR, he writes, which has helped bring the number of people to receiving antiretroviral drugs for HIV/AIDS to 4 million.

Other health programs of value aren't getting funded to the same tune. "The fundamental ethical, economic, and policy question is not whether PEPFAR is doing good," he writes, "but rather whether other programs would do even more good in terms of saving life and improving health."