For those who came of age in the 1980s, HIV and AIDS were frightening and misunderstood acronyms. HIV (human immunodeficiency virus) and the subsequent condition of AIDS (acquired immune deficiency syndrome) were considered a virtual death sentence.
A great deal of improvement has been made in both the understanding and treatment of HIV/AIDS since then. Drugs that are more effective have been developed, and the earlier generations of medicines have become much cheaper and more readily available to lower-income countries where AIDS is prevalent, such as in Sub-Saharan Africa.
Despite this progress and all of the Ebola headlines, HIV/AIDS is still the leading infectious killer in the world and it continues to spread at a disturbing pace. According to the World Health Organization (WHO), an estimated 35 million people currently live with HIV. A report from UNAIDS estimates that 19 million of that 35 million do not even know that they have AIDS.
Since its discovery, AIDS has been responsible for the deaths of approximately 39 million people worldwide, according to the World Health Organization (WHO). Approximately 1.5 million of those 39 million people died in 2013… and worse still, an estimated 2.1 million people were newly infected with AIDS in 2013.
The collective costs of HIV/AIDS are staggering. Pooled global funding efforts to combat HIV/AIDS are approaching the $10 billion mark annually, but these numbers are likely dwarfed by the domestic efforts of individual countries to deal with their infected populations.
Let’s look at U.S. funding as an example. Funding has been slowly rising in recent years, from $25 billion in fiscal 2009 to a budgeted $30.4 billion for 2015 (divided between $24.2 billion for domestic funding and $6.2 billion toward the global effort). The U.S. has certainly borne a disproportionate share of global costs – for example, in 2012 the U.S. contribution of $6.4 billion was over 72% of the total $8.9 billion global effort.
Care and treatment for domestic cases of HIV/AIDS makes up over half (57%) of the overall 2015 U.S. AIDS funding. Domestic cash and housing assistance accounts for another 10% of the total, thus approximately two-thirds of the expenses deal with existing cases. Costs are rising in part from discretionary spending and in part through mandatory spending in Medicare, Medicaid, and the Social Security support programs SSI and SSDI.
Global funding consumes 20% of the budget, leaving preventative measures and domestic research with only 12% of the respective budget ($2.8 billion for research and only $900 million for domestic prevention programs). As percentages of expenditures, these two categories have remained essentially flat since 2009.
This distribution leads advocates to argue that AIDS prevention/research is significantly underfunded. Arguably, all of the good efforts to date have produced a standoff with AIDS, not a cure. Prevention and research efforts are key to moving beyond this point.
The costs of a more aggressive strategy to defeat AIDS were modeled back in 2009 for the AIDS 2031 project. Under this strategy, domestic costs were projected to increase to over $35 billion during 2031 with the cumulative costs for that 20-year period at $722 billion – and all that strategy would buy us is a reduction of new adult HIV cases by almost half, with over a million new HIV infections in 2031.
Those are bleak numbers indeed. Still, the costs of treating and combatting HIV/AIDS likely pale in comparison to the cost of ignoring them. The battle can be won, but it will take a long time and require significant resources. Consider doing your part to fight against AIDS by supporting the effort however you can, via a financial contribution or the offer of your time and skills to care and prevention programs.